A health care system consists of all organizations; people and actions that promote restore or maintain health. This study explores the existing health policy environment and current activities to further the progress towards Universal Health Coverage ⦠The majority of this population lives in the absolute poverty; they have to access public sector facilities, which are not providing satisfactory care [39]. Pakistan is listed as one of 57 countries with critical health workforce deficiency [31]. Health System of Bangladesh 1. In addition, equity must be the overarching guiding principle underpinning the health systems. There are now also some demand-side financing mechanisms, such as a maternal health voucher scheme implemented in ⦠The basic food requirement and health are problems for the people, the paper by Nishtar [18] indicated that malnutrition is worst in the rural areas of Sindh, and Baluchistan with 20-30% children are being retarded, and high infant mortality is as a result of malnutrition, diarrhea, and pneumonia. The statistics of the health care facilities in Pakistan is shown in Table 3. In Phase 2, FHS Bangladesh is pursuing branding and social franchising mechanisms and marrying them to new technologies such as telemedicine and the “health box”. The papers in this series, published in Globalization and Health, analyze the factors that enable and constrain the emergence and diffusion of health system innovations. Furthermore, in Pakistan under article 18th amendment the health care services are the obligations of provisional government except for the federal area. The Government of Bangladesh has made a substantial commitment to provide comprehensive health care to its people. Healthcare facilities in Bangladesh. Islam is the faith of eighty-five percent of the population, while Hindus, Buddhist, and Christians making up the most of remaining fifteen percent. It occupies 147, 570 square kilometers. Private facilities which are steadily growing now provide mainly for-profit curative services and handle more than half of all facility birth deliveries. Presently, Pakistan has Gross Domestic Product (GDP) stagnant at 4.71%, Gross National Income (GNI) per capita is approximate US$ 1550, and is categorized as low-income country and positioned at 65th among 102 developing countries. Gilgit-Baltistan with the help of COMSATs university, and Association of Pakistani Physicians of North America [3]. The statistics of health professionals at Pakistan and Bangladesh is shown in Table 4. The allocation of health care resources like finance and transport are not in use of need-based in the both countries. It comprised of unqualified allopathic providers (e.g., rural doctors, drug shop retailer), traditional healer, faith healer, Unani, and semi qualified allopathic providers (e.g., medical assistants, technician, and community health worker). Bangladesh health care services are shown in Table 3. Engaging communities in health facility management and monitoring is an effective strategy to increase health system responsiveness. The core primary health care facilities in Bangladesh are CCs. Over the 45 years after independence, the HCDS of Bangladesh has gone through a number of reforms and established an extensive health infrastructure [12]. Moreover, the financing for health expenditures in Bangladesh comes from the different sources via different mechanism and payments. The health system of Pakistan expands more than eighty percent of their health expenditures on medical products and pharmaceuticals [32]. Though these are not part of mainstream health system but a major health care provider to poor rural population, especially in remote and hard to reach an area. The MOHFW has Directorates of General and Health Services (DGHS) and Family Planning (DGFP) that manage the dual system of general health and family planning across the country. Yet, Bangladesh is still a long way from achieving universal health coverage. Drug prices in Pakistan are controlled under the section 12 of Drug Act 1976 which gave the authority to Ministry of National Regulation and Services to control over the pricing of drugs. HCDS of both countries hugely relies on private organizations and these organizations provide the more advanced facilities but the whole population of the countries cannot afford these facilities. On the other hand, Bangladesh has surpassed many neighboring countries in South Asia as well as other developing countries in terms of progress in achieving the health-related MDGs. Currently, health services in Pakistan are a major obligation and constitutionally a provincial subject except for federally administered areas. While over-the-counter drugs can be dispensed by the village doctors themselves, dispensing prescription drugs will be guided by linking them with qualified physicians. These challenges must be resolved in order to improve the existing health system so that the disadvantaged and vulnerable people can get better access to basic health care services. Currently there are 13,500 community clinics (CC) in Bangladesh, aimed to cover every 6000 rural population. The public health sector facilities in Bangladesh are poorly equipped with medical equipment and instruments. Bangladesh aims to provide all citizens and communities with the health services they need, at a price they can afford, by 2032. Mahmood, S.S., Rasheed, S., Chowdhury, A.H. et al. All rights reserved. There are gaps in logistics, quality assurance procedures and the facilities suffer from high staff absenteeism, unskilled staff and inefficient use of supplies. In the health care arena of Bangladesh, the doctor to patient ratio is 0.58:1000, and nurse-patient ratio is 0.3:1000 (Bangladesh Health Watch 2008; WHO, 2009). Pakistan; Bangladesh; Health care delivery system; Health indicators; Health issues. Strengthening the health system through better management and organization and effective use of resources can improve health conditions and enhance the quality of health care delivery in Bangladesh. Health Care Delivery System (HCDS) is the arrangement that serves best to any country’s population with effective, efficient, fair distributions of resources, and funds for organized infrastructure to thrive well. Simultaneously, the most critical challenge faced by the health systems in Bangladesh is in the arena of human resources, technology, and infrastructure [38]. In the early phase, the health syste⦠Catastrophic health expenditure forces 5.7 million Bangladeshis into poverty. Dr. Moyukh Chowdhury, SNIH Advisory Board Coordinator, Umea University Dr. Shuchesmita Das, Medical officer and Clinic Manager, Urban Primary Health Care Services Delivery Project, Bangladesh Prologue: Mental well-being is a fundamental component of WHOâs definition of âhealthâ and one of the major public health ⦠Private sector services are too expensive for many and out of pocket expenditures for health care are high. Globally, HCDS becomes a highly competitive and rapidly growing service and needs special attentions from different domains. It meets approximately 80% of country’s demand and 20% are being imported [10]. The Government of both the countries should take initiatives in the development of human resources like doctors, nurses, and welltrained lady health workers. As members of the SS network, qualified village doctors were awarded crests containing the SS logo. Public Health Administration in Bangladesh: Looking for a Pro-people Policy A reporting system has been set up to monitor the number of LA patients identifi ed, the number of HBCs issued, and ... make health care accessible for people who cannot pay for services. Above all Pakistan and Bangladesh should immediately translate its health policies into action to benefit the people of the countries by ensuring humanity, equity, accessibility, and disease alleviation [41]. Due to the high iron requirements for pregnancy, it is highly prevalent and severe in pregnant women. Close proximity to clients, availability to the community day and night, sympathetic behavior, well established relations within the community, and flexible payment methods have made the village doctors a popular source of care. Health in Bangladesh is delivered through two outlets â the public and private sector. Table 4: Health professionals statistics. In 2017, icddr,b initiated a CSC process to improve health service delivery at the community clinics (CC) providing primary healthcare in rural Bangladesh. Contracting-out (CO) to non-state providers is used widely to increase access to health care, but it entails many implementation challenges. The theoretical section focuses primarily on the importance of preventive care for the population of the world, and specifically for a poor country such as Bangladesh. The ministry and government should carefully allocate the available resources among the rural and urban population. The study has shown that training and branding has acceptability among village doctors although their behaviour has had no drastic changes due to the lack of financial incentives. The optimal HCDS provides hope, relief to the individual, community, and population. These components together will create a brand with serious content that is attractive to village doctors and even more attractive to customers through improvements in the quality of care. Despite the widespread establishment of the community clinics, challenges such as shortage of supply, provider absenteeism, lack of properly defined roles and responsibilities of human resources, poor behaviour towards patients, weak accountability and governance, and absence of active participation from community in healthcare delivery restrict efficient use of these facilities and available resources. However, most of the evidence is from observational epidemiological studies except for a very few randomised controlled trials. Since the time of independence, HCDS of Pakistan has undergone major reforms start its journey from National Health Policy, Primary Health Care services, TB control, and Immunization Program [22]. The optimal HCDS integrates the different health services encompasses the management and delivery of quality and safe health services [3]. In 2010, the authority has been shifted to provincial government from federal, and it has four directional boards. Since 2010, the leading pharmaceutical companies have significantly increased the prices of drugs up to 8-10% including some common drugs on basis of raw material import become costlier [34]. The funding is dominated by out of pocket payments, government revenues, developmental partners, private insurances, external resources to NGOs and world funding [27]. Thereafter, from 1992 to 2009 price was increased by 15%. The government of Bangladesh initiated community clinics (CC) to extend the reach of public health services and these facilities were planned to be run through community participation. In this paper, we describe the protocol of a community-based cluster randomised controlled trial that aims to evaluate the impact of maternal antenatal IFA supplements on perinatal outcomes. Health care delivery is a daunting challenge area of the Bangladeshâs healthcare systems. Currently there are 13,500 CCs throughout the country and each covers 6,000 population under its jurisdiction and are meant to provide maternal, child health, family planning and other primary health care services. The world funds and external resources to NGOs has been also an important source of health financing in Bangladesh. In Pakistan, health care delivery to the consumers is systematized through four modes of preventive, promotive, curative, and rehabilitative services. 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