Over view of the Study

Effective health policy is prime need of developing and developed countries to ensure people’s

access in health care system. This paper aims to explore the current status of health services &

promotional activities comparing developed countries i.e. (Japan, Canada, England, Saudi Arabia

and Australia). Healthcare system in Bangladesh has been achieved a changed and improved

status now. A continuous significant progress in many areas of maternal as well as child health

has been obtained during the last decade. One of the main goals of the National Health Policy of

Bangladesh is to improve the health of mothers and children and to ensure the provisions of

facilities for the safe and clean delivery of children at local level. The Government of

Bangladesh envisages ensuring safe birth and survival to all children through provision of

appropriate and adequate family planning services, prenatal and postnatal health care as well as

essential obstetrical services and encouraging all mothers to breastfeed their children . The

Government of Bangladesh (GoB) has formulated the National Reproductive Health Strategy

(1997) on the basis of the principles of International Conference on Population and Development

(ICPD). In that strategy, four basic areas have been outlined in the analysis of reproductive

health which includes, safe motherhood, family planning, MR and care for post abortion

complications and management of Sexually Transmitted Diseases (STI)/Reproductive Tract

Infections (RTI) (WHO, 2003).

Bangladesh has some problems in health policy service. People are more interested in taken

service private medical than public medical. Hospitals are not providing 24 hours essential

services due to lack of trained staff and related support facilities. High rate of mortality is one of

the important problems of Bangladesh. Low quality of services, poor status, insufficient

expertise and experience of doctors, lack of advancement of health care technology, high quality

hospitals and nutrition etc. other problems of health services are corruption, illiteracy rate,

shortage of medical technology, poverty, insufficient of professional doctors, shortage of drugs

etc. The main lacking of Bangladesh health service is that health services are not sufficient for all

citizen of this country. In Bangladesh the total fertility rate (TFR) has declined from around 6 in

the mid-seventies to 3.4 in 1993-94. According to the WHO composite index for overall health

system attainment of 191 member states, Bangladesh is ranked 131, worse than Sri Lanka, India

and the Maldives but better than Pakistan, Bhutan and Nepal (WHO, 2000). Similarly, out of 162

Page 1 of 19

countries, Bangladesh ranks 132, according to the Human Development Index, 2001, behind the

Maldives, Sri Lanka, India, Pakistan, Nepal and Bhutan (UNDP, 2001). The infant mortality and

maternal mortality rates are still very high in Bangladesh, 79.6 per thousand live births and 4.3

per thousand live births respectively (BDHS Preliminary Report, 2001; BIRPERHT, 1996). The

perinatal mortality rate is 57.4 per thousand pregnancies (of more than 7 months). The major

causes of death are pneumonia, respiratory failure, injuries; upper respiratory tract infection and

diarrhoea, while the major causes of morbidity appear to be ulcer, diarrhoea, malaria, and asthma

and rheumatism/rheumatic fever. There are only 18 doctors and 5 nurses for every 100,000

people in Bangladesh. (H.N Syeda (2012).This paper mainly contrast Bangladesh health care

system with developed countries, such as Japan, Canada, England, Saudi Arabia and Australia

health care system. We try to identify gaps among them.

Bangladesh health policy comparing with developed countries (Japan, Canada, England,

Saudi Arabia and Australia)

1. Bangladesh VS Japan

Healthcare system in Bangladesh has been achieved a changed and improved status now. A

continuous significant progress in many areas of maternal as well as child health has been

obtained during the last decade. Bangladesh is the most populated country in the world than her

capacity, her population 161,083,804 (July 2012 est.), Population growth rate 1.579% (2012

est.), Birth rate 22.53 births/1,000 population (2012 est.), Death rate 5.71 deaths/1,000

population (July 2012 est.), Infant mortality rate male-51.48 deaths/1,000 live births and

female-46.39 deaths/1,000 live births (2012 est.), Life expectancy at birth total population-70.06

years within male-68.21 years and female-71.98 years (2012 est.)1In the sphere of Japan have the

highest life expectancy, the lowest infant mortality, and the most aged population in the world

today. Her Population-127,368,088 (July 2012 est.) Population growth rate -0.077% (2012 est.),

Birth rate-8.39 births/1,000 population (2012 est.), Death rate-9.15 deaths/1,000 population (July

2012 est.) Life expectancy at birth total population-83.91 years among them male-80.57 years

and female-87.43 years (2012 est.) It will age even further in the first half of this century. By the

year 2055, life expectancy for men is expected to reach 83.7 years, compared with 79.2 years in

2007, while women’s life expectancy is expected to reach 90.3 years, compared with 86 years in

1 http://www.indexmundi.com/bangladesh/demographics_profile.html accessed on 22-06-13

Page 2 of 19

2007. Reflecting the improved longevity and low fertility, the percentage of the population at age

65 or older increased dramatically, from 4.9 percent in 1955 to 20.1 percent in 2005. It is

expected to reach 40.5 percent in 2055.2 Bangladesh health indicators are- Sex ratio at birth-1.04

male(s)/female, under 15 years-1.01 male(s)/female and 15-64 years-0.89 male(s)/female, 65

years and over-0.93 male(s)/female, total population: 0.93 male(s)/female (2011 est.) ,UHFWC –

3375 31-50 bed UHC – 397,Various types of district level hospitals – 80 ,Government medical

college hospitals – 13,Postgraduate hospitals – 6,Specialised hospitals – 25,Doctor to population

ratio – 1:4,719,Nurse to population ratio – 1:8,226,Hospital beds – 40,773 (over 29,000 in GOB).

Whereas Japan Infant mortality rate total-2.21 deaths/1,000 live births, male-2.44 deaths/1,000

live births and female- 1.97 deaths/1,000 live births (2012 est.) ,Life expectancy at birth total

population-83.91 years male-80.57 years and female-87.43 years (2012 est.), Total fertility rate

1.39 children born/woman (2012 est.) ,Maternal mortality rate 5 deaths/100,000 live births

(2010) Health expenditures 9.3% of GDP (2009), Physicians density 2.063 physicians/1,000

population (2006), Hospital bed density 13.75 beds/1,000 population (2008), Obesity - adult

prevalence rate 3.1% (2000).3 Japan has a national health insurance system. The insurance covers

the entire population either through employee programs, municipal programs, or special

programs. All programs offer the same benefits. Employers pay 50 percent of the insurance

premium. Patients currently contribute either 10 percent (age 70 or older) or 30 percent (all

others and affluent elderly) to the cost of inpatient or outpatient care, or prescription drugs.

Children also have a 20 percent co-payment, but many municipalities and cities are now bearing

some or all of these costs to attract and keep citizens. For people between age 70 and 74, the co-

payment rate was scheduled to move up to 20 percent, but the move is temporarily suspended.

There is a maximum subsidy of ¥350,000 (about US$3,200) to the cost of delivery for childbirth.

Routine checks during pregnancy are not covered by health insurance. Japan ranks slightly below

the average in terms of health spending per capita, but the contribution of its public sector to

health spending is – at 83 percent – well above the OECD average of 73 percent. Japan has fewer

2 CIA World Factbook:Unless otherwise noted, information in this page is accurate as of February 21, 2013

Available at http://www.economywatch.com/economic-statistics/Bangladesh/Age_Structure/ accessed on 23-06-13

3 https://www.cia.gov/library/publications/the world fact book

Page 3 of 19

physicians per capita, about two thirds of the OECD average, which is at least partly due to

government policies fixing limits on the number of new entrants to medical schools. Japan has

the highest number of hospital beds, more than twice the OECD average, and the highest number

of magnetic resonance scanners, about four times the OECD level. Physicians density-2.063

physicians/1,000 population (2006), Hospital bed density-13.75 beds/1,000 population (2008)

and Obesity - adult prevalence rate-3.1% (2000).In the field of Bangladesh Government Service

Providers In order to increase the access of the people to quality health care services, 5,000 posts

of doctors should be created in the next five years. There should be proper manpower planning to

absorb the medical graduates into the national medical service. There should be a doctor

available in every Union Health and Family Welfare Centre (UHFWC) and in Community

Clinics (CC) for a fixed number of days. The health centers/clinics can be made more functional

if female doctors are employed for women patients. In addition, presence of health personnel

should be ensured in their work places. Community participation is essential to make the health

centres/clinics functional. The communities are to be empowered with resource management and

decision-making. In order to ensure commitment of the doctors, it should be made mandatory for

doctors to serve in rural areas before they are allowed to practice in the cities. The government

should devise a mechanism for evaluating and monitoring the professional development of

doctors. Physicians density-0.295 physicians/1,000 population (2007), Hospital bed density-0.4

beds/1,000 population (2005). The infant mortality and maternal mortality rates are still very

high in Bangladesh, 79.6 per thousand live births and 4.3 per thousand live births respectively

(BDHS Preliminary Report, 2001; BIRPERHT, 1996). The perinatal mortality rate is 57.4 per

thousand pregnancies (of more than 7 months). It is very disappointing to note that almost two-

thirds of the births do not receive any antenatal care. Among those who receive antenatal care,

only 16 per cent are informed of the signs of complications, and slightly more than one-third

receive iron tablets. For delivery, only 6 per cent use health facilities. Trained health personnel

assist deliveries of only 22 per cent of the births. Wearers Japan Infant mortality rate total-2.21

deaths/1,000 live births, male-2.44 deaths/1,000 live births and female- 1.97 deaths/1,000 live

births (2012 est.) ,Life expectancy at birth total population-83.91 years male-80.57 years and

female-87.43 years (2012 est.), Total fertility rate 1.39 children born/woman (2012

est.) ,Maternal mortality rate 5 deaths/100,000 live births (2010) Health expenditures 9.3% of

GDP (2009), Physicians density 2.063 physicians/1,000 population (2006), Hospital bed density

Page 4 of 19

13.75 beds/1,000 population (2008), Obesity - adult prevalence rate-3.1% (2000). Good diet, a

healthy lifestyle and high-quality healthcare are all factors contributing to Japanese longevity.

The remarkable gains in life expectancy in Japan in recent decades have been driven by a

dramatic reduction in heart diseases, which are now at the lowest level in the OECD for both

men and women. Japan also boasts one of the lowest incidences of obesity in the OECD, at 3.4%

of the population compared with 34.3% in the US. On a less positive note, 26% of adults in

Japan are smokers, compared with an OECD average of 24%. Japan has one of the highest male

smoking rates in the OECD, at 40%. There are also particularly high levels of chronic hepatitis C

virus (HCV) infection: according to a local pharmaceutical company, Chugai, there are more

than 1.5m cases of chronic HCV in Japan. The large number of cases partly reflects the reuse of

needles in government immunization campaigns and the dissemination of contaminated blood

products by local pharmaceutical firms in the late 1970s and 1980s. Hepatitis C is the most

common cause of hepatocellular carcinoma, which alone is associated with over 30,000 deaths in

Japan each year. The virus is also the main reason for the large number of liver transplants

carried out in Japan. The World Health Organization (WHO) reported the number of HIV cases

in Japan at 9,600 in 2007. This equates to less than 0.001% of the population, one of the lowest

ratios of HIV infection in the world. However, independent research suggests that actual

infection rates may be much higher, especially among the young, and the number of cases has

been increasing steadily. In Bangladesh Major Causes of Death (1997) Stratified et al., 2001,

Pneumonia-15.7 percent, Respiratory Failure-9.4 percent, Injuries (unintentional)-8.7 percent,

Upper Respiratory Tract-5.9 percent, Diarrhoea-4.9 percent, Ulcer-7.0 percent ,Diarrhoea-5.1

percent, Malaria-3.2 percent, Asthma-2.6 percent, Rheumatism/Rheumatic Fever-1.8 percent.

Japan spends a modest amount on healthcare by the standards of the industrialized world, at an

estimated 6.8% of GDP and US$2,622 per head in 2008. This compares with 16.1% of GDP and

US$7,490 per head in the US, which spends more on healthcare than any country in the world.

Nevertheless, Japan is the largest healthcare spender in the Asia region. Public expenditure

accounted for 81.3% of total health spending in Japan in 2006, according to the latest available

data from the OECD; private household expenditure accounted for 15%, and private insurance

for only 3%. Social security funds are the main source of public expenditure, representing 66%

of total healthcare spending, with general government accounting for 16% of total spending.

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Health expenditures-9.3% of GDP (2009)4. In Bangladesh Health expenditures-3.4% of GDP

(2009), Bangladesh only $ 37 USD. The per head cost annually $ CAD 1643 to 1808, while

Bangladesh per head cost annually 590 taka (1.62 taka per day).5

4 World Bank Development Indicators (2006)5 World Health Organization(WHO)

Page 6 of 19

2. Analysis on comparison of health policy between Canada and Bangladesh

In Canada the improved hygienic sanitation facilities is 100%. But Improved sanitation in

Bangladesh: urban- 57% , Rural - 55% of population, Total - 56% of population. Unimproved

sanitation facilities in Bangladesh: urban- 43% of population, rural – 45% of population, total-

44% of population6 .In Bangladesh, the percentage of supply of improved drinking water has

increased at an annual average rate of 0.30% during the period of 2004 to 2009. (CIA world fact

book, 2012) The present percentage of improved water supply in Bangladesh: urban – 85% of

population, rural – 80% of population, total – 81% of population and unimproved water supply

urban – 15% of population, rural- 20% of population, total – 19% of population. Improved water

supply in Canada: urban – 100% of population, rural – 99% of population, total- 100% of

6 https://www.cia.gov/library/publications/the-world-factbook/

Page 7 of 19

population and unimproved water supply in Canada: urban – 0% of population, rural- 1% of

population, total – 0%. The fertility rate of Bangladesh is 2.55% while Canada is 1.59 %( CIA

World fact book).The present rate of maternal mortality in Bangladesh 240 deaths/ 100000 live

births and Canada 12 deaths / 100000 live births (global health facts, CIA fact book,2010).The

rate of infant mortality has decreased impressively during the period 2000-2008 in Bangladesh.

The average annual reduction rate of infant mortality during that time was 2.13%.(Bangladesh

Economic Update, 2010). The present infant mortality rate in Bangladesh total – 47.3 deaths/

1000 live deaths, Female – 44.71 deaths/ 1000 live deaths, Male–49.79 deaths / 1000 live deaths

and Canada infant mortality rate total – 4.78 deaths/ 1000 live deaths, Female – 4.43 deaths/

1000 live deaths and Male – 5.11 deaths/ 1000 live deaths. the annual number of births per 1000

people in Bangladesh is 20.7, while Canada birth rate is 10.29.Most of the child death of

Bangladesh happens because of for serious infections (31%) from ARI and diarrhea. The number

of deaths of child fewer than one year old in a year per 1000 lives in Bangladesh is 57.78 and

fewer than 5 are 52% and in Canada the number of child death is 4.99%. (CIA world fact

book)The number of births living with HIV/AIDS in Bangladesh 10% , while Canada 40% (CIA

World Fact book report).The present life expectancy of Canada total – 81.48 years, Female -

84.21 years and Male-78.89 years (CIA fact book 21 Feb,2012) on the other hand expectancy in

Bangladesh: total- 71.69 years, Female - 72.31 years and Male- 69.25 years(CIA world fact

book, 2013). There are currently 1365 hospitals in Canada while total number of hospitals in

Bangladesh is 1683. Of these hospitals 678 are governmental and 1005 are non-governmental.

25-40% beds are reserved for maternity patients in every hospital in Bangladesh. Bangladesh:

0.3 beds/ 1000 population and Canada: 3.2 beds/ 1000 population reserve for maternity patients.

In Canada, hospitals are largely public and non-profit, with financing based on an annual global

budget and all major surgery and high-technology diagnostic tests are provided in hospitals

while in Bangladesh people are interested in private services because public services are not

enough and sufficient for peoples need. The number of qualified physicians and nurses in

Bangladesh is quite low. Around 26% of professional posts in rural areas remain vacant. For

Bangladesh 3.6 (per 10000 populations) physicians other hand 20.7 physicians for Canada.

(global health fact,2012)The cost of Canada’s health care system, approximately 9% of Canada

GDP, but in Bangladesh the cost of health care system 1% of GDP. Per capita public and private

health expenditure combined in $ 3,673 USD and in Bangladesh only $ 37 USD. The per head

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cost annually $ CAD 1643 to 1808, while Bangladesh per head cost annually 590 taka(1.62 taka

per day) (world health organization).Canada health care services divided into the federal and

provincial levels. People of Canada received 99% health care services. The federal is responsible

for all health service but provincial government is responsible for the primary delivery of

physicians and hospital services. Bangladesh health care system divided into several parts, such

as upozila, district, division thana level etc. urban health services have been the responsibility of

the ministry of local government, rural development and cooperatives implemented through the

city corporations and the municipalities. But all services provided from central health ministry.

Only 60% people of Bangladesh has got very little access to basic health care because of limited

man power and resources (MOHFW, 2003).

3. Comparisons of health policy between Bangladesh and England

Bangladesh is a developing country it has 16 Crore population within its 1,47,570 square

kilometer. Most of the people of Bangladesh are illiterate they are ignorant and careless about

their health and the government of Bangladesh has no enough resources to provide health

facilities all the population of the country. England is a developed country and health facilities

of England are recognized all over the world. It has adequate resources to provide health

facilities to its people. As a developing country Bangladesh and as a developed England there do

exist several clear difference of the health policy between Bangladesh and England. These are

described below. Health program both in Bangladesh and England are based on urban and rural

area. In Bangladesh urban program includes Medical College Hospitals, Specialized Medical

College and rural program includes Upazila Health Complex, Community Clinic. In England

urban program includes Department of Health, Primary Care Trusts and rural program includes

The Countryside Agency, The Institute of Rural Health. Health facilities in Bangladesh both in

rural and urban area are not equally provided. In England health facilities in urban and rural both

areas are equally provided. Health instruments in Bangladesh are not sufficient particularly in

rural area but England are enriched with health instruments. In England private health

organizations are not so strong but in Bangladesh private health organization plays vital role

rendering health facilities. As a developing country Bangladesh health policy focus on

Millennium Development Goals(MDG) while England health policy focused on around

modeling future supply. Bangladesh spends 3.4% of GDP in health sector

Page 9 of 19

(nationmaster.com)that is not enough to providing health facilities noted that GDP of Bangladesh

is more less than England in contrast England spends 8.4% of GDP in health sector

(nationmaster.com). The determinant of health facilities in Bangladesh measured by income but

in England heath facilities determined by whether education, income, occupation. For

improvement of health facilities Bangladesh do not take proper strategies if they take can’t

implement properly while England take proper strategies for achieving specific goals. There is a

big difference of population and doctor between Bangladesh and England. The proportion of

doctor and population in England is 1:1000(wikipedia.org) on the other hand in Bangladesh

0.295 physicians against 1000 population(.bdnews24.com). Health policy in Bangladesh greatly

emphasis on infant, child mortality, and maternity on the contrary in England health policy

emphasis on the individual and changing behavior. Child mortality rate is also mentionable

difference, child mortality rate in Bangladesh is 38 of per 1000 live births but in England child

mortality rate is very low, child mortality rate in England is 4.2 of per 1000 live births (trading

economics). Almost 100% birth attended by skilled health personnel in England while birth

attended by skilled health personnel in Bangladesh is only 31% (.indexmundi). As birth attended

by skilled health personnel the life expectancy in England is 80.17% at birth but life expectancy

in Bangladesh is 70.06% at birth. In England government emphasis on people’s choice, right and

information though Bangladesh health policy has such features visible but not practically

implemented. There is exist individual choose and autonomy in England but this type of facilities

not get properly individual in Bangladesh. England Health Care System support for smoking

cessation and reducing tobacco advertising and promotion, reducing availability and supply of

tobacco including illicit and smuggled tobacco. In fine, both Bangladesh and England health

policy provide health care for people and service oriented though their found some common

distinction of services of health in Bangladesh and England.

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4. Comparisons between Bangladesh and Saudi Arabia’s Health System:

E-health vision is a safe, quality, health system based on patient centric care, guided by

standards, enabled by e-Health .In Bangladesh, e-health is not a popular process though Saudi

Arabians have developed the strategy of e-health with their consultants and involving people

from across the MOH (ministry of health).The project is structured with three ware streams;

Strategy, Governance and Technology.

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Both the health care systems of Bangladesh and Saudi Arabia fall under the control of the

Ministry of Health. But the pictures of the systems are different and vivid. For example, in the

late 1980’s in Bangladesh a sub-district health center had only 30 hospital beds and poorly

administrated. On the contrary, the MOH supervised 20 regional directorates-general of health

affairs in various parts of the country. Each regional health directorate has a number of hospitals

and health sectors and every health sector supervised a number of PHC (primary health care)

centers.

.

Bangladesh has a surprisingly extensive health infrastructure throughout the country. Health care

delivery system in Bangladesh based on PHC concept has got various Level of service delivery:

A. Home and community level. Union level, B. Union sub centre (USC) or Health and family

welfare centre; This is the first health facility level. C. Thana level, Thana Health Complex

(THC): This is the first referral level. D. District Hospital: This is the secondary referral level. E.

National Level: This is the tertiary referral level.7 Saudi health services have advanced greatly

over recent years in all levels of health services: primary, secondary and tertiary. As a 7 National Health policy in Post Natal Care in Bangladesh, 2012

Page 12 of 19

consequence, the health of the Saudi population has improved markedly. The MOH has

introduced many reforms to its services, with substantial emphasis on PHC. Both Countries have

strategic health services. In Saudi Arabia, it is MOH’s national strategy adopted in 2009, and in

Bangladesh it is PHC (primary health care) concept which got various levels of service delivery.

Comparatively, Bangladesh is less developed than Saudi Arabia as usual. Health care delivery

system in Bangladesh based on PHC (primary health care) concept has got various Level of

service delivery. On the other hand, The MOH (ministry of health) is considered the lead

Government agency responsible for the management, planning, financing and regulating of the

health care sector in Saudi Arabia. In Bangladesh Health expenditure, public (% of government

expenditure) in Bangladesh was 8.93 as of 2011. Its highest value over the past 16 years was

9.67 in 2009, while its lowest value was 7.35 in 2008( World Health Organization) on the

contrary, Allocations for health and social affairs in Saudi Arabia spending grew by 16 percent

year-on-year to reach $26.7 billion (SR100 billion) in the 2013 budget.( Jeddah Centre for

Forums and Events • Jeddah, Saudi Arabia.)

5. Comparison between Bangladesh and Australian health sector

As of July 2012, there were about 161 million people living in Bangladesh. Life expectancy in

the country is 70 years; the average woman lives to 72 years old, almost 4 years longer than the

average man. The population growth rate is about 1.6% per year, with a fertility rate of 2.55

children born to every woman. The birth rate compared to mortality rate is 22.5 births to 5.7

deaths per 1000 population. The maternal mortality rate is 240 deaths per 100000 live births

(2010), and the infant mortality rate is 49 deaths per 1000 live births; male infant mortality rate is

10% higher than that for female infants. About 41% of children under five years of age are

underweight (CIA World Fact Book). The age structure of the population is: 34.3% are between

0-14 years old; 61.1% are between 15-64 years old; 4.7% are 65 years or older (2011). The

estimated median age of the population is young, at 23.6 years (CIA World Fact Book). On the

other hands in Australia the Population: 22,015,576 (July 2012 est.) life expectancy of male is78

years life expectancy of female is 82 years .Population growth rate: 1.126% (2012 est.)Birth rate:

12.28 births/1,000 population (2012 est.) Death rate: 6.94 deaths/1,000 population (July 2012 est.

Health policy of Bangladesh 2011 didn’t describe male and female different health care system

Page 13 of 19

particularly. This policy not identified different stage of life of male and female for treatment.

Whereas, Australian government prepared health policy for male and female particularly for

better health of Australian, Male and Female health policy identify the different stage of life for

men and women particularly for better treatment. The budget of Bangladesh allotted to the health

sector below 1%. On the other hand, Australian government allotted8% of annual budget for the

health sector.51.5% of households in Bangladesh were using hygienic sanitation facility in 2009.

The average increase of percentage among 1990 to 2009 was 1.61 per year sanitation facilities

are given below, Improved sanitation in Bangladesh: urban- 57% of population, Rural - 55% of

population. Total - 56% of population. Unimproved sanitation facilities in Bangladesh: urban-

43% of population Rural – 45% of population. On the other hand In Australia people using 100%

sanitation facilities both urban and local areas.8 A report published by World Health

Organization (WHO) in 2011 revealed that while communicable diseases, maternal, perinatal

and nutritional conditions make up 39% of total mortality, NCDs account for 52% of total

mortality. Cardiovascular disease (CVD) is the leading cause of death, accounting for 27% of all

deaths in Bangladesh (WHO NCD). Malaria, Diarrhea, HIV/AIDS (source: Bangladesh Country

Report October, 2012). Whereas, The proportions of overweight and obese people have

significantly increased over the last 20 years. Obesity is associated with poor health and among

people aged 8 years and over, 6% of men and 7% of women are obese. Child and adolescent

obesity has also become a significant health problem over the past few decades, and about one in

four Australian children are now obese or overweight (Australian Institute of Health & Welfare

2005b). This rising tide of obesity threatens the positive trend in Healthy life expectancy. Some

common disease food-borne diseases emergence of antimicrobial resistant bacteria sexually

transmitted diseases vector-borne disease Vaccine-preventable diseases.9 Health expenditure in

Bangladesh is 3.4% of its GDP in 2009, which is relatively low for the South Asia region. The

physician and hospital bed density ratios are also low: there are 0.295 physicians and 0.4 hospital

beds for every 1000 people. Meanwhile, the health system is slowly shifting emphasis from the

traditional and charge-free public.10 Australia spends 9.7% of GDP on health, and expenditure

per capita in terms of purchasing power parity (PPP) was US$ 3652, which puts Australia

8 CIA World Fact books9 Vol. 8 No. 5 2006, Health Systems in Transition Australia: Health system review

10 Bangladesh Country Report October, 2012

Page 14 of 19

slightly above the OECD average. Expenditure is expected to rise further with growing demand

by the public, who have high expectations of health care goods and services, with increasing

costs of high-technology medicine, and with the increasing need for health care for a rapidly

ageing population. Bangladesh's economy has grown 5.8% per year since 1996 despite political

instability, poor infrastructure, corruption, insufficient power supplies, and slow implementation

of economic reforms. Bangladesh remains a poor, overpopulated, and inefficiently-governed

nation. Although more than half of GDP is generated through the service sector, 45% of

Bangladeshis are employed in the agriculture sector with rice as the single-most-important

product. Bangladesh's growth was resilient during the 2008-09 global financial crisis and

recession. Garment exports, totaling $12.3 billion in FY09 and remittances from overseas

Bangladeshis, totaling $11 billion in FY10, accounted for almost 12% of GDP. (Source:

Bangladesh Country Report October, 2012). On the other hand Australia's abundant and diverse

natural resources attract high levels of foreign investment and include extensive reserves of coal,

iron ore, copper, gold, natural gas, uranium, and renewable energy sources. A series of major

investments, such as the US$40 billion Gorgon Liquid Natural Gas project, will significantly

expand the resources sector. Australia also has a large services sector and is a significant

exporter of natural resources, energy, and food. Key tenets of Australia's trade policy include

support for open trade and the successful culmination of the Doha Round of multilateral trade

negotiations, GDP - real growth rate: 3.3% (2012 EST.)Population below poverty line: NA%,

Unemployment rate: 5.2% (2012 EST.

Conclusion

From the above differences between Bangladesh and developed countries(Japan, Canada,

England, Australia, Saudi Arabia) it is simply can say that there are some clear differences as

Page 15 of 19

population, nutrition, AIDS, child death, life expectancy etc. There is also a big between health

policy and reality in Bangladesh. In spite of the fact that Bangladesh did not have a proper

Health Policy until 1998, more than a quarter century after independence, the country made

impressive strides in improving the health status of its people during the 1980s and 1990s. This

is especially true for child mortality and morbidity and women’s reproductive health —leading

to a sharp fall in fertility. The achievements of Bangladesh with respect to mortality and fertility

have been widely hailed by the international community as being exceptional for its level of

economic and technological development. So, it can be said that in absence of national health

policy untilln2000, health sector planning was done through the frame work of five years plan. In

national health policy of Bangladesh, there have some salient features, goals and have some

strategies to fulfill the goals and principles. But in National health policy is properly

implemented in our country because of some restriction. So for solving this problem the

government must have taken some effective measures. By implementing an effective National

Health Policy we can be a healthy and prosperous nation. So it can be said that the health

facilities in Bangladesh now improving day by day with the economic progress.

References

Bangladesh Demographics Profile 2013 available at

http://www.indexmundi.com/bangladesh/demographics_profile.html accessed on 22-06-13

Page 16 of 19

"Health Policy 2011". Ministry of Health & Family Welfare, Government of the People's

Republic of Bangladesh (in Bengali). Ministry of Health & Family Welfare, Government of the

People's Republic of Bangladesh. Retrieved 7 June 2012.

H.N Syeda (2012), National Health Policy in Post Natal Care in Bangladesh: Gap between

Policy and Practice available at www.mppg-nsu.org/attachments/396_10.%20Nahida.pdf

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