Download - Development in Medical Sector - Bangladesh Perspective

Development In Medical Sector – Bangladesh Perspective

Presented by - TEAM ALPHADept. of Development StudiesFaculty of Arts & Social Science

Bangladesh University of Professionals

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TEAM ALPHA - ABRAR, RASHIQ, SOHID, ADIBA, SAZZAD, ABIR 05/03/2023

Introduction

Few years back even, many diseases took place and became epidemic within a blink of eyes.

Time passed, technology came, development took place and those epidemic diseases simply

flee away from our life. But How? It was Development. Specially in health sector’s

development.

Development of Medicines, Environment, Hospitals, Diagnosis System etc are significant

among all.

Bangladesh developed it’s own Pharmaceuticals & Medical Sector and thus it reduced it’s

Mortality Rate and increased it’s Life Expectancy.

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Historical Study

In previous time, people were so afraid of many diseases like Polio, Cholera etc. Their fear was

DEATH – as there was no remedy of those diseases.

Some statistics of the than epidemic diseases are given below:

25% victims died during the Polio in 1916.

In 1817, Cholera became epidemic by the travelers in many countries where 18000 people died

during that time.

In 1970, Smallpox affected 100,000 people & killed 20000

In 1990, at least 60% of all deaths in Bangladesh were due to diarrhea

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Continued

In 1990, the infant mortality rate was 100 deaths per 1000 live births

The Influenza of 1918-19 killed tens of millions of people.

Between 1947 and 1951, the Black Death wiped out as much as two-thirds of

Europe's population.

Around A.D. 540, by some accounts, it claimed 5,000 lives a day and killed by a

disease plague.

That devastation period now known as the Dark Ages in Europe.

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Overview of the Improvement In Bangladesh

Bangladesh has made significant progress in improvement of the health of

its population to achieve Millennium Development Goals (MDGs) 4 and 5.

By 2006 it had declined to 52 deaths per 1000 live births.

Child mortality reduced due to malnutrition, and infectious diseases such as

malaria or tuberculosis.

The number of deaths has decreased by 91% and 79% in cases of diarrhea

and malnutrition, respectively.

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Continued

On the other hand, the number of deaths due to strokes and diabetes has decreased

200% since 1990.

Infant mortality has decreased from 100 deaths to 52

Deaths per 1000 live births decreased from 1990 to 2006.

The under-5 mortality rate fell from 149 to 69 between 1990 and 2006.

Neonatal deaths account

For infant deaths is two thirds of all deaths

For under 5 is over one half of all deaths.

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Development in Health Sector of BangladeshA Story of Achievements 7

❶Bangladesh over the years have achieved remarkable progress

❷Through the government agenda the country has been on track with the health MDGs

❸The country has the highest EPI coverage (82%) amongst neighboring countries


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Reduced Mortality and Increased Life Expectancy

1970 1975 1980 1985 1990 1995 1997 2000 2004 2007 20100

100

200

300

400

500

600

700

0

10

20

30

40

50

60

70

80650

550 574

500

410

320 295 280

194233.8 220.2

192.9167.1 143.4 133.0 116.0 94.0 88.0 65.0 51.0

153.0112.0 104.0 92.0 87.0 82.0 66.0 65.0 52.0 37.0

42.0 44.0

55.0 57.0 59.062.0 63.0 65.0 67.0 68.0 68.0

Mor

talit

y ra

te

Life

exp

ecta

ncy

at b

irth

8TEAM ALPHA - ABRAR, RASHIQ, SOHID, ADIBA, SAZZAD, ABIR 05/03/2023

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Progressive Improvement In Child Health Over The Years

1991-1992 1994-1995 1997-1998 2001-2002 2004-2005 2010 MDG Target0

20

40

60

80

100

120

140

160

52.0 48.0 42.0 41.0 37.0 32.018.0

35.0 34.024.0 24.0

15.0 13.0

10.0

5037

30 24

1411

20

Child 13-60 months Postnatal 1-12 months Neonatal <1 month

Per

1000

live

bir

ths

Average annual rate of re-duction

-9.3% per year

-6.0% per year

-2.6% per year

Sources: Measure DHS- Demographic and Health Survey URL: http://www.statcompiler.com/ 9


http://www.statcompiler.com/

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Reduced Fertility Rate AndIncreased Contraceptive Prevalence Rate

1970 1975 1980 1985 1990 1995 1997 2000 2004 2007 20100

1

2

3

4

5

6

7

8

9

10

0

10

20

30

40

50

60

70

7.0 6.86.4

5.5

4.5

3.4 3.3 3.3 3.0 2.72.3

6.5 7.712.7

25.3

39.944.6

49.253.8

58.1 55.8 58.0

TFR (per woman)

CPR (per 1,000 population)

Tota

l Fer

tilit

y Ra

te

Cont

race

ptiv

e Pr

eval

ence

Rat

e


Health Care Financing Features

We have a HCF system as part of the national financial management system. Main Features

❶Share in the national budget --- 4.27% (2013-14)1

❷Public spending as % of GDP --- around 1.4%1

❸Per capita Health expenditure---US$ 27 (2011)1 ❹Out-of-pocket---64% of Total health expenditure(THE)2

❺Coverage of insurance --- <1% of THE2

❻Government is financer and provider of services❼Budget norms follow civil service and budgetary regulations and codes.

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05/03/2023TEAM ALPHA - ABRAR, RASHIQ, SOHID, ADIBA, SAZZAD, ABIR 05/03/2023

Total Health Expenditure

0

50,000

100,000

150,000

200,000

250,000

300,000

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

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Mill

ion

Taka

Source: WHO-NHA Data-base

Is increasing over time, it has increased from 48,000 million taka in 1996 to 300,000 million taka in 2011 (almost 6 times in 15 years)

TEAM ALPHA - ABRAR, RASHIQ, SOHID, ADIBA, SAZZAD, ABIR 05/03/2023TEAM ALPHA - ABRAR, RASHIQ, SOHID, ADIBA, SAZZAD, ABIR 05/03/2023

Health Financing in Bangladesh (2006-2007)

Public SectorTk. 41,318; 26%

Rest of the WorldTk. 12,391; 08%

NGOsTk. 2,092; 0.1%

Household OOPTk. 103,459; 64%

Private FirmsTk. 1,325, 0.8%

Private InsuranceTk. 314; 0.2%

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Million TakaTaka 69 = 1 US $Source: BNHA 1997-2007


Comparison Of Health Expenditure - 2011

CountryPer capita total

health spending (US $)

THE as % of GDP

Public HE as % of GDP

Per capita Govt spending

(US $)

Bangladesh 27 3.7 1.4 9.7

India 59 3.9 1.2 18.3

Nepal 33 5.4 2.1 13.0

Pakistan 30 2.5 0.7 8.0

Sri Lanka 97 3.4 1.5 43.1

Indonesia 95 2.7 0.94 33

Vietnam 96 6.9 2.7 38

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Source: WHO-NHA Data-base


Increase In National And Health Budget - A Comparison15


Current Problems And Digital Solutions16


Challenges In Bangladesh

❶Inadequate funding for the whole health system. -Government budget is 1.4% of GDP, Total Health Expenditure (THE) is 3.7% of GDP.

❷Inequity in financing and utilization-main source of financing for health care is out-of-pocket payment (64% of THE)

❸Inefficient use of resources -due to absence of proper resource allocation formula, shortage of health workers, vacant posts (44%) in public health facilities, lack of provider autonomy, no purchaser-provider split, duplication of programs and insufficient coordination leading to wastage

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TEAM ALPHA - ABRAR, RASHIQ, SOHID, ADIBA, SAZZAD, ABIR

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Common Concerns Across The Globe

❶Increasing health care cost

❷Protect people from financial consequences of health care payment

❸Expand fiscal space in spite of macro-economic constraints

❹Use of available resources efficiently and equitably

For all these, Health care financing is moving towards

Universal Health Coverage (UHC)

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TEAM ALPHA - ABRAR, RASHIQ, SOHID, ADIBA, SAZZAD, ABIR05/03/2023TEAM ALPHA - ABRAR, RASHIQ, SOHID, ADIBA, SAZZAD, ABIR 05/03/2023

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TEAM ALPHA - ABRAR, RASHIQ, SOHID, ADIBA, SAZZAD, ABIR