Post on 14-Dec-2015
MINISTRY OF HEALTH & FAMILY MINISTRY OF HEALTH & FAMILY WELFARE (MOHFW)-BANGLADESHWELFARE (MOHFW)-BANGLADESH
MOHFW is responsible to ensure basic MOHFW is responsible to ensure basic health care to the people of the country ; health care to the people of the country ;
At present the population is nearly 150 At present the population is nearly 150 million million
with a per capita GDP–US$ 421with a per capita GDP–US$ 421
MOHFW is the sector leader asMOHFW is the sector leader as It provides most of the HNP servicesIt provides most of the HNP services It manages & coordinates services of It manages & coordinates services of
non-govt. & private sector non-govt. & private sector
MANAGEMENT STRUCTUREMANAGEMENT STRUCTURE
Management structure follows the general Management structure follows the general administrative setting of the country;administrative setting of the country;
Secretariat –responsible for policy planning Secretariat –responsible for policy planning and decision making at macro-level. Headed and decision making at macro-level. Headed by Hon’ble Minister & staffed by civil by Hon’ble Minister & staffed by civil servants.servants.
Directorates –implementation wings staffed Directorates –implementation wings staffed by professionals and technical manpowerby professionals and technical manpower
• -Directorate of health services-Directorate of health services• -Directorate of family planning-Directorate of family planning• -Directorate of drug administration-Directorate of drug administration• -Directorate of nursing services-Directorate of nursing services• -CMMU-CMMU
Divisions -Divisional Directors office of Divisions -Divisional Directors office of (Six) health and family planning (Six) health and family planning responsible for support and HRD responsible for support and HRD function function
Districts-Civil Surgeons for district Districts-Civil Surgeons for district health (64) management & DD(FP) for health (64) management & DD(FP) for MCH-RH-servicesMCH-RH-services
Upazilas:Upazilas:
-UHFPO –Preventive & clinical -UHFPO –Preventive & clinical (460)health service (460)health service
-UFPO -FP & RH service-UFPO -FP & RH service
MANAGEMENT STRUCTURE MANAGEMENT STRUCTURE (continued)(continued)
STRUCTURE at PRIMARY STRUCTURE at PRIMARY LEVELLEVEL
RuralRural One HA for 8000-10000 populationOne HA for 8000-10000 population One FWA for 4000 populationOne FWA for 4000 population MA, FWV and Paramedic works in Fixed sitesMA, FWV and Paramedic works in Fixed sites
UrbanUrban FWs are not available according to the FWs are not available according to the
populationpopulation Vaccinator and Paramedic works in Fixed sitesVaccinator and Paramedic works in Fixed sites NGOs are taking part a major roleNGOs are taking part a major role
Source: HPSP Manual, Bangladesh: 2001Source: HPSP Manual, Bangladesh: 2001
HEALTH ORGANIZATION OF HNP HEALTH ORGANIZATION OF HNP SERVICE DELIVERY SERVICE DELIVERY
Public sector health system is Public sector health system is structured as a hierarchical structured as a hierarchical pyramid with 5 layers;pyramid with 5 layers;
3 at Primary3 at Primary
1 at Secondary1 at Secondary
1 at Tertiary1 at Tertiary
Level of Health Care SystemLevel of Health Care SystemTertiary level
Medical college hospitalPost graduate/specialized hospital
Secondary levelDistrict hospital; Maternal and Child Welfare Centre
Upazila health complex
Union sub centerHealth & family welfare center
Community clinic (for 6000 people)
Primary level
HEALTH SERVICE DELIVERYHEALTH SERVICE DELIVERYPRIMARY LEVELPRIMARY LEVEL
FacilitiesFacilities ServicesServices
Community Community clinic & home clinic & home visitationvisitation
FP, MCH, immunization, communicable FP, MCH, immunization, communicable disease control, treatment of common disease control, treatment of common problems & referral.problems & referral.
Union health Union health & family & family welfare centre welfare centre (4300)(4300)
Out patient services : FP, MCH, Out patient services : FP, MCH, communicable disease control, clinical communicable disease control, clinical care, normal delivery & adolescent health care, normal delivery & adolescent health care.care.
Upazila health Upazila health complex, complex,
(414)(414)
Out patient services, impatient services Out patient services, impatient services (31-50 beds) with diagnostic and (31-50 beds) with diagnostic and operative treatmentsoperative treatments
HEALTH SERVICE DELIVERY HEALTH SERVICE DELIVERY SECONDARY LEVELSECONDARY LEVEL
FacilitiesFacilities ServicesServicesDistrict District Hospitals Hospitals (64)(64)
Out door & Indoor Services Out door & Indoor Services (50-250 beds) with (50-250 beds) with laboratory, radio graphic & laboratory, radio graphic & ambulance servicesambulance services
Maternal Maternal & Child & Child welfare welfare Centre Centre (64)(64)
EOC and other related EOC and other related servicesservices
INSTUTUTIONS FOR HEALTH INSTUTUTIONS FOR HEALTH MANPOWER DEVELOPMENT MANPOWER DEVELOPMENT
1 Medical University 1 Medical University 15 Medical College 15 Medical College 8 Post graduate institute 8 Post graduate institute 2 Institute of Health Technology 2 Institute of Health Technology 8 Medical Assistant Training 8 Medical Assistant Training
School School 1 Nursing College 1 Nursing College 38 Nursing Institute 38 Nursing Institute
Major Health Programme-BangladeshMajor Health Programme-Bangladesh
Health Education and
Promotion
Communicable Disease Control
Mycobacterial Disease (TB,
Leprosy) Control
National AIDS Control Programme and
Safe Blood Transfusion Programme
Public Health Interventions
& Non-Communicable Disease Control
Essential Services Delivery
(ESD)
Health Programmes
Reproductive Health
Child Health (EPI, ARI, CDD,
IMCI, School Health Programme
Limited Curative
Care
Emerging & Re-emerging
Diseases
Filariasis Eliminatio
n
Vector Borne Disease Control
(malaria, Kala-Azar, Dengue)
Prevention and Management of
Non-communicable Disease
Emergency Preparedness & Response
Interventions relating to
Arsenicosis and other PH
interventions
Health of senior citizens, adolescent
& young peoplesInjury prevention,
management & violence against
women
Environmental and
occupational Health
Country reported Data for Country reported Data for Basic Health IndicatorsBasic Health Indicators
IndicatorIndicator Latest Latest available available
datadata
YearYear
Number of hospital bedsNumber of hospital beds 51,64851,648 20052005
Population per hospital Population per hospital
bedbed 25712571 20052005
Hospital beds per 10,000 Hospital beds per 10,000 populationpopulation
3.433.43 20052005
Number of physiciansNumber of physicians 4288142881 20052005
Population per physicianPopulation per physician 31693169 20052005
Physicians per 10,000 Physicians per 10,000 populationpopulation
33 20052005
Population per nursesPopulation per nurses 64426442 20052005
MAJOR HEALTH INDICATORS
Bangladesh has made considerable progress over the last decade in improving the health status;
Life expectancy at birth -65.1 yrs
IMR per 1000 live births -52
U-5 Child mortality rate per 1000 live births -65
MMR per 1000 births -3.65
Total Fertility Rate -2.7
Contraceptive Prevalence Rate -56%
Full vaccination coverage (12-23 months children) -82%
Attained and sustaining “Polio-free” status
Trends in Total Fertility Trends in Total Fertility RateRate
3.4 3.3 3.33
2.7
1993-94 BDHS 1996-97 BDHS 1999-2000 BDHS 2004 BDHS 2007 BDHS
Source: BDHS 2007
Trends in Childhood Mortality Trends in Childhood Mortality RatesRates
41
65
24
88
37
52
14
65
NeonatalMortality
Infant Mortality Child Mortality <5Yrs Mortality
2004 2007
Deaths per 1,000live births
Source: BDHS 2007
RISKS AND CHALLENGES
1. Relatively high MMR due to lack of antenatal & obstetric care.
2. High level of malnutrition from both –Protein energy malnutrition–Micro-nutrient deficiencies
3. Emerging and Re-emerging diseases-HIV/AIDS, TB, Malaria, Arsenicosis, Accidents & Injuries
4. Demographic & epidemiological transition accelerates-Non-Communicable diseases
5.5. Low utilization of HNP servicesLow utilization of HNP services