Health sector of occupational therapy

1. HEALTHCARE DELIVERY
SYSTEM OF
BANGLADESH
SHAMIMA AKTER
B. SC IN OT, M. SC IN RS
ASSISTANT PROFESSOR,
DEPARTMENT OF OCCUPATIONAL THERAPY
BANGLADESH HEALTH PROFESSIONS INSTITUTE
CENTRE FOR THE REHABILITATION OF THE PARALYSED
CHAPAIN, SAVAR

2. MANAGEMENT STRUCTURE
Management structure follows the general
administrative setting of the country;
 Secretariat –responsible for policy planning and
decision making at macro-level. Headed by Hon’ble
Minister & staffed by civil servants.
 Directorates –implementation wings staffed by
professionals and technical manpower
 Directorate of health services
 Directorate of family planning
 Directorate of drug administration
 Directorate of nursing services
 Construction Management & Maintenance Unit (CMMU)

3. In Ward Level:
Community Clinic,
Family Welfare Centre (FWC).

6. Manpower in ward level
1. Family Welfare Visitor (FWV),
2. Family Welfare Assistants (FWAs),
3. Medical Assistant (MAs),
4. Skill Birth Attendance (SBA),
5. Village Health Volunteer (VHV),
6. Community Midwife (CMW).

7. Services in ward level
 Establishing referral linkage with higher
facilities,
 Family planning,
 EPI (Expanded Programme on Immunization),
 Primary health care,
 Oral rehydration therapy,
 Sanitation,
 Nutrition.

8. Role and Activities in ward
level
 Creating awareness going door to door,
 Immediate refer system,
 Home visit of pregnant women,
 Normal delivery conduct.

9. In Union Level
 Family welfare centre (FWC),
 Community clinic,
 Union sub centre,
 Rural dispensary.

10. Manpower in union level
1. MBBS doctor,
2. Medical assistant,
3. Nurse,
4. Word boy or patient care attendance.

12. Services in union level
 Maternal and neonatal
health care services,
 Integrated Management of
Childhood illness (IMCI),
 Reproductive Health and FP
services,
 Registration of newly
married women, pregnant
women,
 Birth & death, preservation
of EDD (Expected Date of
Delivery),
 Nutritional education and
micro-nutrient supplements,
 Health , Nutrition and FP
Education & counselling,
 EPI (Expanded Programme
on Immunization),
 Delivery conduct,
 Primary health care,
 Outpatient service for
injuries, wound and minor
alignment,
 Identifications of emergency
& complicated cases & refer
to higher facilities,
 Treatment of Common
diseases & first aid.

13. Role and Activities in union
level
 Immediate refer system,
 Home visit,
 Create awareness and monthly meeting with
union council,
 Delivery of some essential drugs.

14. In Upazilla Level:
Upazilla Health Complex (UHC),
TB Clinic.

15. Manpower in upazilla level
1. Upazilla health family planning officer(UHFPO),
2. Maternal child welfare officer(MCWO),
3. Consultant doctor,
4. Residential medical officers (RMO),
5. Medical officers (MO),
6. Nurse,
7. Laboratory technician,
8. Pharmacist,
9. Traditional trained birth attendance,
10. Family panning officers.

16. Services in upazilla level
 Comprehensive emergency obstetric care,
 Facilitate services of gynaecology, anaesthesia,
 Nursing service and basic laboratory facilities,
 Admission and discharge,
 General health problem treatment,
 Normal Delivery conduct,
 Caesarean delivery,
 TB treatment,
 Leprosy treatment,
 Maternal child care,
 EPI (Expanded Programme on Immunization),
 Family planning.

17. Role and Activities in upazilla
level:
 Trained union level health care staff,
 Create awareness,
 Referral system,
 Control communicable disease,
 Pre service education,
 Health education and health promotion.

18. In District Level:
 District hospital with nursing institute,
 General hospital,
 Medical college with nursing institute,
 Chest disease clinic,
 Leprosy clinic,
 Medical assistant training institute,
 Private clinic.

19. Manpower in district level
1. Civil Surgeon,
2. Consultant doctor,
3. RMOs (Residential Medical Officers),
4. MOs (Medical Officers),
5. Superintendent of drugs,
6. Family Planning supervisor,
7. Public health nurse,
8. FPO (Family Planning Officer),
9. EPI supervisor,
10. MCW officer,
11. Pharmacist,
12. Technicians,
13. Record keeper.

20. Services in district level
 All general healthcare,
 Operative care,
 Rehabilitation centre,
 Support to upazilla health complex,
 Supplements materials to UHC,
 Co-ordination with all health care centre,
 Training of health care personnel and Capacity
building,
 Nursing education and service,
 Hospital service management and safe blood
transfusion.

21. Role and Activities in district
level
 Development and administration of care
service in district level,
 Specialist, diagnostic and laboratory service,
 Strengthening of drug administration and
management,
 Training, research and development,
 Referral system.

22. In Divisional Level:
 Medical College and Hospital, with Nursing
Institute,
 General Hospital with Nursing Institute,
 Infectious Disease Hospital,
 Institute of Health Technology.

23. Manpower in divisional level
1. Divisional director,
2. Civil surgeon,
3. Consultant doctor,
4. Resister medical officers,
5. RMOs,
6. MOs,
7. Superintendent of drugs,
8. Family Planning supervisor,
9. Public health nurse,
10. FPO,
11. EPI supervisor,
12. MCW officer,
13. Pharmacist,
14. Technicians,
15. Record keeper.

24. Services in divisional level
 Provide care of all complicated disease,
 Rehabilitation care,
 Training, research and development,
 Provide care of infectious and communicable
disease,
 Ensure nursing care.

25. Role and Activities in
divisional level
 Responsible for policy formulation and
decision making in health care sectors.
 Planning and implementation of programs and
projects and technical guidance to the health
sector.

26. In National level:
 Public health institute,
 Postgraduate medical institute and hospital
with nursing institute,
 Specialized health institute.

27. Manpower in national level
1. Director of the institute,
2. Principal of medical college,
3. Consultant doctor,
4. Registered medical officer,
5. RMOs,
6. MOs,
7. Public health nurse,
8. Record keeper.

28. Services in national level
 Facilitate opportunity of higher education,
 Provide super specialty care.