To reach SDG goals we must focus on healthcare
Health and Sustainable Development Goals (SDGs) are deeply interlinked, in fact, promoting health and wellbeing is one of the 17 SDG goals
Healthcare issues and the SDGs are interrelated. It would be tough to achieve the SDGs by neglecting healthcare issues. Nearly all countries in the world have promised to improve the planet and the lives of their citizens by 2030 through 17 life-changing goals outlined by the UN in 2015. These goals are known as Sustainable Development Goals (SDGs).
Promoting health and wellbeing is one of the 17 SDG goals. SDG 3 aspires to ensure healthy lives and wellbeing for all by 2030. It also aims to achieve universal health coverage and provide access to safe and effective medicines and vaccines for all.
Infectious diseases were once the main health problem in Bangladesh. Bangladesh achieved remarkable success in preventing such diseases due to the construction of necessary health facilities and various steps taken at both the public and private levels.
With time, the nature of diseases has also changed. The prevalence of non-communicable diseases is increasing due to changes in lifestyle and dietary habits, including tobacco use, excessive calorie intake (fat and sugar), excessive salt consumption, a lack of physical activity, increasing mental pressure, addiction to mobile phones and online media, and reduced opportunities for physical play.
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Unplanned urbanisation and environmental pollution are also blamed for the rise of non-communicable diseases. It is well known that several non-communicable diseases, such as cardiovascular disease, stroke, cancer, diabetes, and chronic respiratory diseases, are responsible for 71% of deaths worldwide.
According to the World Health Organization (WHO), 67% of deaths are caused by non-communicable diseases, resulting in significant economic losses for Bangladesh.
The spread of non-communicable diseases poses a major obstacle to achieving comprehensive development in Bangladesh. The country is actively working to achieve the UN-declared SDGs by 2030, and ensuring the good health and well-being of its people is essential to achieving this objective.
Controlling non-communicable diseases would be challenging without implementing preventive measures and ensuring adequate medical facilities.
Therefore, increasing investment in the health sector is necessary, particularly in preventing non-communicable diseases. It's important to remember that the results of investments in the health and education sectors are not immediately apparent; they have far-reaching impacts.
Thus, there is an urgent need to allocate more resources to the health sector and ensure their proper utilisation for national interests. Modern medical treatment facilities should be prioritised, and sufficient funds should be allocated for disease control and prevention. Additionally, investing in research, public awareness campaigns and mass education is crucial.
In the previous budget, the government allocated 5.4% of the total budget to healthcare. However, this year's budget allocated only 5% of the total, despite the high out-of-pocket healthcare expenditure in the country. Many experts believe that this budget allocation will further increase out-of-pocket healthcare spending, becoming a barrier to accessing healthcare.
In 2020, according to the National Health Accounts, a division of the Health Economics Unit, individuals had to pay Tk 68.5 out of pocket for every Tk 100 spent on healthcare, up from Tk 67 five years prior. Among SAARC countries, Bangladesh has the second-highest out-of-pocket health expenditure after Afghanistan, at 78%.
The country's out-of-pocket health expenditure was 55% in 1997, steadily rising over the years, while public financing in health declined from 37% in 1997 to slightly over 23% in 2020.
Bangladesh's allocation of about 5% of its national budget to the health sector remains among the lowest health investments globally. Experts suggest the health budget should comprise at least 8% of the budget.
Media reports indicate that per capita health expenditure in Bangladesh is only $45, compared to $58 in Nepal, $73 in India, $103 in Bhutan, and $157 in Sri Lanka. Building skilled manpower is essential for modern and improved treatment systems. Therefore, the government must develop a master plan to train skilled professionals such as expert physicians, nurses, paramedics, and technicians.
Ensuring health services for the people is the responsibility of the government. Simultaneously, the government should support private institutions providing healthcare services, supervise the quality of services offered by the private sector, and regulate fees charged to patients. By doing so, real benefits can be delivered to the people.
Furthermore, the government should take effective initiatives to provide free medicine to impoverished patients suffering from complex diseases like diabetes and cardiovascular disease and offer long-term medical treatment loans. As the population's average age increases due to the control of communicable diseases, the government should also address the rising risks of age-related diseases.
Addressing non-communicable diseases requires collaboration between the government, the private sector, and development organisations. Individual awareness is essential, as these diseases are linked to lifestyle choices. People need to understand the importance of physical activity, exercise, and the consumption of healthy and nutritious foods to prevent non-communicable diseases. Mass media can play a crucial role in raising awareness.
Establishing an effective referral system for emergency and complex patient treatments is vital. However, such a system is still lacking, from community clinics and medical sub-centres to upazila hospitals, district hospitals, and tertiary or specialised hospitals. This lack of coordination is hindering medical activities.
Health services are the result of comprehensive teamwork. Physicians lead this team, supported by three nurses each. According to the WHO's guidelines, each team should have 22 trained members. By international standards, Bangladesh currently has only half the required number of doctors relative to its population.
Over the last three decades, the private sector's role in the healthcare industry has grown. Private sector capacities have expanded more than those of the public sector. Authorities lack the proper will to effectively monitor, control, and manage the private sector's role in healthcare. It is now necessary to make the private sector more people-friendly and appropriately guide its development.
The importance of health cannot be neglected, as the population's good health is a prerequisite for a country's economic development.
Dr Samir Kumar Saha is the former Executive Director of Public Health Foundation, Bangladesh.
Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the opinions and views of The Business Standard.
