The document discusses health status and challenges in Bangladesh. It notes that Bangladesh has made progress towards achieving some Millennium Development Goals like reducing child mortality, but still faces challenges in reducing maternal mortality and achieving full vaccination coverage. Current health issues include poor governance and management of health services, lack of resources, and unequal access between rural and urban or rich and poor populations. Moving forward will require strengthening health systems, increasing accountability, improving access to healthcare, and expanding use of digital health services.

2. Introduction
 Heath is…
 a state of complete Physical,mental and Social well being and not
merely an absence of disease or infirmity which allows a person to live a
socio-economic productive life.
 Illnes is..
 a state in which a person’s physical, emotional, intellectual,social
or spiritual functio ning is diminished or impaired,

3. Health status
 Health status is considered according to WHO.
 WHO has set MDGs for 191 UN member states by the year
2015.
 The Eight MDGs are..
1. To eradicate extreme poverty and hunger
2. To achive universal primary education
3. To promote gender equality and empower women
4. To reduce child mortality
5. To improve maternal health
6. To combat HIV,malaria,and other diseases
7. To ensure environmental sustainability
8. To develop a global partnership fo development.

4.  Recently United Nations’ Secretary General Ban Ki Moon,
during his visit to Asia, mentioned Bangladesh as an EPI
success model in the continent. It is worth mentioning
here that Bangladesh received the MDG4 Award from the
United Nations in 2010.
 We have established community clinics to make available
essential health care on the doorsteps of citizens. As of July
2012, about 12,000 community clinics are operating and a
further 6,000 community clinics are planned. These clinics
are run under a principle of community ownership to act as
focal points for health awareness campaigns and delivering
basic health care. Some community clinics have started
child birthing services.
 The United Nations provided Bangladesh Digital Health
for Digital Development Award in 2011.

6. Current challanges
 Bangladesh is currently working towards achievement of the
Millennium Development Goals. To achieve the target for the
reduction of child mortality which forms MDG 4,
Bangladesh should reduce under-five deaths per 1,000 live
births to 48 and increase measles immunisation to 100 per
cent by 2015. In 2012, under-five mortality stood at 41 deaths
per 1,000 live births, so this target has been achieved. Measles
immunisation is currently 96 per cent, which suggests that
with continued good progress the country could achieve
MDG 4 by 2015.

7.  The global MDG 5 target for maternal health is to reduce
the number of women who die in pregnancy and childbirth
by threequarters between 1990 and 2015. When applying
this target to Bangladesh, maternal mortality should fall to
200 cases per 100,000 live births. In 2007-11 Bangladesh
reported a maternal mortality ratio of 220 deaths per
100,000 live births (this figure was estimated at 240 deaths
per 100,000 live births by UN agencies/World Bank in
2010). Based on the data reported by the country, the
maternal mortality target is not close to being achieved.
Part of the goal also stipulates that 100 per cent of births
must be attended by a skilled health professional. In the
period 2007-12 this figure stood at 32 per cent, suggesting
that this target is highly unlikely to be met by 2015.

8.  MDG 6 aims for a reduction in the prevalence of HIV,
malaria and other diseases. HIV prevalence is low in
Bangladesh and the number of confirmed deaths from
malaria has dropped significantly between 2000 and
2011. However, other diseases such as rubella and TB
are present at considerable levels, indicating that this
goal is unlikely to be achieved by 2015.

10. Health Infrastructure
 The total expenditure on healthcare as a percentage of
Bangladesh GDP 3.7%
 Percentage of private expenditure on health is 96.5%
 Total expenditure on health per capita 88
 The number of hospitals beds per 10000 population is
3.
• Life expectancy at birth m/f 71/73

13. Current Health Issues
• The quality of health service delivery is unsatisfactory
• One of the reasons for this rests on governance issues in
health care organisations of rural and urban areas. These
governance issues include:
 Poor management,
 Resource constraints,
 Lack of professionalism,
 Inadequate policy initiatives
 Huge difference between rural and urban health facilities.
 Lack of education
 Over unskilled population

14. Lack of people’s voice and accountability within the
system
Weak monitoring and regulatory frame work
Centralized administration with limited
understanding of demand
Poor management of drug and Eqipments
Staffing and Absenteeism
Mismanagement of healthcare service delivery
Weak management and coordination network

15. Citizens with lower income and living in rural area
donot have much accessibility as health facilities
Both public and private sectors are distributed in an
unjust way
Delivery of services also varied depending on the level
of income
The poor in Bangladesh bear higher health risk and
suffer the burden of excess mortality and morbidity

16. Way to Forward
 Strengthening of health service system planning and
management
 Accountability and transparency
 Improvement in logistic of drug supplies and equipment to
health facilities at district and lower level
 Engage quality human resources for health sector
 Systematic regular maintenance of existing health facilities
 Universal access to basic healthcare and services of
acceptable quality
 Improvement in medical education

17.  Start “ONE DOCTOR ONE PHARMACIST” project.
 Include and open the government health care sectors for A
grade pharmacists
 Improve the heathcare services in government sectors.
 Community hospitals should be made well equipped and
modernised
 Strong policy and regulatory framework
• Digital health care should be reached at the door of rural and
lower income citizens