This document summarizes the health services policy and health care system in Bangladesh, with a focus on Chandpur Sadar Hospital. It discusses Bangladesh's national health policy goals of making basic medical services accessible to all citizens. The document reviews literature on people's participation in health services and outlines Bangladesh's health indicators, infrastructure, and the multi-tiered health care system from primary to tertiary levels. It also examines the national health policy goals, principles, and strategies for improving health care delivery and access across the country.
The health care system of Bangladesh has three levels - primary, secondary, and tertiary. The primary level consists of community clinics and union health centers. The secondary level includes district hospitals. Tertiary care is provided through large hospitals affiliated with medical colleges. In addition to government facilities, NGOs and private providers play a large role in service delivery. However, challenges remain in human and physical resource allocation across the country.
The health system in Bangladesh is pluralistic and aims to ensure healthy lives for all citizens as outlined in its constitution and international agreements. It consists of community clinics, rural health centers, upazila health complexes, and district and specialized hospitals. However, the health workforce is unevenly distributed between urban and rural areas. National health programs target communicable diseases, family planning and maternal and child health. The government finances 26% of health spending while out-of-pocket payments account for 63.3%. Bangladesh aims to expand coverage through its health sector reform programs.
The document describes the health care network of Bangladesh, with three main points:
1) It outlines the hierarchy within the Ministry of Health and Family Welfare, which is responsible for national health policy, and its subordinate executing authorities and regulatory bodies.
2) It explains the organizational structure of the Directorate General of Health Services, the largest executing authority, and its implementation of health programs.
3) It provides an overview of the management structure and types of health facilities at different administrative tiers from national to village levels.
Universal health coverage aims to ensure everyone has access to health services without facing financial hardship. World Health Day 2022's theme focuses on achieving universal health coverage for everyone everywhere. India's Ayushman Bharat program aims to achieve this through two pillars - providing basic health services through health centers and providing insurance coverage for serious illnesses for poor families. Realizing universal coverage requires addressing issues like inadequate resources, uneven quality of care, and high out-of-pocket costs that push people into poverty.
The document discusses Pakistan's health care system. It begins by outlining the objectives of the unit, which are to define key terms, identify health services provided by the government system, explain roles of health care team members, and discuss the 2000 devolution plan. It then provides definitions of "system" and "health care system." The bulk of the document describes Pakistan's three-tiered public health care system including primary, secondary and tertiary levels. It also notes the growing private health care sector and some issues facing Pakistan's health care delivery.
About Healthcare system of Bangladesh: Health care delivery is a daunting challenge area of the Bangladesh’s healthcare systems. The Health
care system in Bangladesh falls under the control of the Ministry of Health and Family Planning. The
government is responsible for building health facilities in urban and rural areas.
The health care system of Bangladesh has three levels - primary, secondary, and tertiary. The primary level consists of community clinics and union health centers. The secondary level includes district hospitals. Tertiary care is provided through large hospitals affiliated with medical colleges. In addition to government facilities, NGOs and private providers play a large role in service delivery. However, challenges remain in human and physical resource allocation across the country.
The health system in Bangladesh is pluralistic and aims to ensure healthy lives for all citizens as outlined in its constitution and international agreements. It consists of community clinics, rural health centers, upazila health complexes, and district and specialized hospitals. However, the health workforce is unevenly distributed between urban and rural areas. National health programs target communicable diseases, family planning and maternal and child health. The government finances 26% of health spending while out-of-pocket payments account for 63.3%. Bangladesh aims to expand coverage through its health sector reform programs.
The document describes the health care network of Bangladesh, with three main points:
1) It outlines the hierarchy within the Ministry of Health and Family Welfare, which is responsible for national health policy, and its subordinate executing authorities and regulatory bodies.
2) It explains the organizational structure of the Directorate General of Health Services, the largest executing authority, and its implementation of health programs.
3) It provides an overview of the management structure and types of health facilities at different administrative tiers from national to village levels.
Universal health coverage aims to ensure everyone has access to health services without facing financial hardship. World Health Day 2022's theme focuses on achieving universal health coverage for everyone everywhere. India's Ayushman Bharat program aims to achieve this through two pillars - providing basic health services through health centers and providing insurance coverage for serious illnesses for poor families. Realizing universal coverage requires addressing issues like inadequate resources, uneven quality of care, and high out-of-pocket costs that push people into poverty.
The document discusses Pakistan's health care system. It begins by outlining the objectives of the unit, which are to define key terms, identify health services provided by the government system, explain roles of health care team members, and discuss the 2000 devolution plan. It then provides definitions of "system" and "health care system." The bulk of the document describes Pakistan's three-tiered public health care system including primary, secondary and tertiary levels. It also notes the growing private health care sector and some issues facing Pakistan's health care delivery.
About Healthcare system of Bangladesh: Health care delivery is a daunting challenge area of the Bangladesh’s healthcare systems. The Health
care system in Bangladesh falls under the control of the Ministry of Health and Family Planning. The
government is responsible for building health facilities in urban and rural areas.
Social medicine is concerned with how social and economic factors impact health and disease. It aims to understand these relationships and create conditions for a healthier society. Socialized medicine describes universal healthcare systems funded through taxation where medical care is available to all at low cost. Pros include affordability, uniform access to care regardless of income, and healthcare for all citizens. Cons can include potentially lower quality care, decreased medical innovation, and increased tax burden. Some countries with socialized medicine systems are described. In India, various state-run health insurance schemes have been launched to provide socialized care.
The document summarizes the Nepal Health Service Act of 2053 (1997) and its amendments. It outlines the classes within the health service, how vacancies are fulfilled, restrictions on fulfillment, provisions for upgrade, upgradation criteria, appointment process, qualifications, probation, transfer, deputation, promotion criteria, nomination for study/training, salary and benefits, insurance, retirement, gratuity, pension, conduct rules, security of service, and punishments. The act governs administration, appointments, promotions, transfers, salaries and pensions for Nepal's public health service employees.
Understanding the concept of Universal Health Coverage (UHC) and how can we reach it, both globally and also in India. The presentation also includes HLEG report , which is the proposed architecture for India's guide to reach UHC.
Universal health coverage as a concept was born in 1883 when Germany introduced health coverage for achieving health status of its young population.India, is still attempting to find a way for providing appropriate, affordable and accessible health care to its population.
This document discusses the history and principles of primary health care. It began in 1978 with a conference that defined primary health care as health care that is accessible to all individuals through their participation and affordable for the community. The key aspects of primary health care are preventative services like immunizations, maternal/child care, and treatment of common diseases. It also emphasizes equitable access, community participation, coordination between sectors, and appropriate technology.
*Health Insurance in India and Genesis of the Ayushman Bharat PMJAY Pradhan Mantri Jan Arogya Yojana
*Critical review of the health insurance schemes
*SWOCh analysis of Ayushman Bharat PMJAY
Created - July 2019
Author- Dr. Madhushree Acharya, Academic Junior Resident, Community & Family Medicine, AIIMS Bhubaneswar
This document discusses public health. It defines public health as "the science and art of preventing disease, prolonging life and promoting human health through organized efforts and informed choices of society, organizations, public and private, communities and individuals." The core functions of public health programs are listed as providing leadership on critical health matters, shaping research agendas, setting and monitoring norms and standards, articulating ethical and evidence-based policy, and monitoring the health situation. Public health applications in healthcare include assessing current services, identifying interventions, considering resource effects and cost-effectiveness, informing decision-making, and educating the public. Health indicators and determinants are also outlined.
Shreejeet Shrestha provides an overview of sociology and its application in public health. Sociology developed from 19th century theoretical writings and emphasizes social structures and processes over individuals. Key concepts in sociology like social fabric, conflict, and social systems are highly relevant to public health. While psychology has traditionally dominated social sciences in public health, sociology is increasingly important for understanding large-scale social determinants of health like inequality, social capital, and health systems. Sociological methods involving both quantitative and qualitative data are valuable tools for public health research and evaluation.
The document summarizes a term paper on public health surveillance in Nepal. It discusses the objectives, methodology, findings and conclusions of the paper. The key points are: public health surveillance involves ongoing collection and analysis of health data to guide public health practice; Nepal has integrated disease surveillance within its health management information system; and the country was commended for its efficient AFP surveillance and polio eradication efforts while still needing to address potential wild poliovirus circulation.
The health care system in Pakistan consists of public and private sector providers that deliver services through primary, secondary, and tertiary levels of care. The public sector system is primarily the responsibility of provincial governments and includes hospitals, basic health units, and community health workers. However, it suffers from issues like high population growth, uneven workforce distribution, insufficient funding, and limited access to quality care. As a result, the private sector has expanded to help meet demand, though most private hospitals are small and run as sole proprietorships. Overall spending on health care is increasing but remains lowest in Balochistan and highest in Punjab.
The document discusses the health care system in Nepal under its new federal democratic republic system. It provides an introduction to federalism and describes how power is divided between the central, provincial, and local governments in Nepal. It then outlines the major components of Nepal's health system including its structure for health service delivery, governance structure at different levels, and key organizations. It also discusses some of the major health initiatives in Nepal and provides organizational charts and the Public Service Act relating to regulating health institutions.
Health systems, goals of health system,
Leadership and Governance
Human Resource for Health
Health Financing
Medicines and Technologies
Service Delivery, and
Health Information System
Chronic non-communicable diseases (NCDs) such as cardiovascular disease, cancer, and diabetes now account for over half of deaths in India and place a large economic burden. The National Programme for Prevention and Control of Cancer, Diabetes, CVD and Strokes (NPCDCS) aims to address NCDs through health promotion, screening, diagnosis, management, and capacity building integrated into primary healthcare. Current programs have had limited implementation; a comprehensive and widespread approach is still needed to reduce the growing NCD burden in India.
The document provides background information on Nepal's health system. Some key points:
- Nepal is transitioning to a federal democratic republic after a period of political instability and has set a goal to graduate from least developed country status by 2022.
- It faces challenges of poverty, inequality, and a high burden of disease. The health system provides services through a three-tier structure at the federal, provincial, and local levels.
- Financing comes from various sources including government spending which allocates a portion of its budget to health but this share has declined in recent years despite overall spending increases. Out-of-pocket costs remain high.
Current Health System Nepal After health reform 2018Jahirul Hussein
The health system of Nepal faces several challenges due to its mountainous terrain and diverse population. It has a public health care system that is decentralized across three levels - central, provincial, and local. At the local level, rural municipalities now govern health facilities. The government aims to provide universal health coverage through initiatives like free basic health services and delivery care. However, resource constraints and geographical barriers limit equitable access to quality care, especially in rural areas. The system also works to control diseases while promoting traditional and alternative medicine practices.
The document provides an overview of the concept of public health, its history and challenges. It discusses:
- The definition of public health as promoting health through organized community efforts like sanitation, disease control, health education and access to care.
- How the "great sanitary awakening" in the 19th century identified filth as a cause of disease, leading to a focus on cleanliness and prevention over reacting to outbreaks.
- The work of Edwin Chadwick who documented poor living conditions and their impact on health, and proposed sanitary reforms be addressed through engineering and public boards of health.
- The core functions of public health as assessment, policy development and assurance to collect data,
Healthcare Delivery System in Federal Context of NepalSonali Shah
The document summarizes Nepal's health care system under its new federal democratic republic system. Some key points:
- Nepal transitioned to a federal system in 2015 to reduce disparities between rural and urban areas. Health care is now organized at the federal, provincial and local levels.
- The constitution guarantees citizens the right to free basic health services and emergency care. Health care provision and financing are managed at the federal level according to federal legislation.
- Nepal's health care system includes public, private, traditional and voluntary sectors. It has a primary, secondary and tertiary level referral system with health posts, primary health centers, district/zonal hospitals and central/regional hospitals.
- Key health programs
This document provides an overview of public health and the structure of Pakistan's healthcare system. It begins with definitions of key terms like health, public health, and healthcare systems. It then describes the main functions and objectives of public health, including health promotion, disease prevention, and treatment. The document outlines Pakistan's three-tiered public and private healthcare system consisting of primary, secondary and tertiary levels of care. It also discusses issues like inadequate funding, reliance on out-of-pocket payments, and an understaffed and underequipped public system. In conclusion, it presents statistics on Pakistan's health infrastructure and workforce.
India has a decentralized healthcare system, with states largely independent in delivering healthcare. Each state has its own healthcare delivery system, while the central government is responsible for policymaking, planning, guidance, and coordination. Healthcare is delivered through a three-tiered system - central, state, and district level. At the district level in rural areas, community healthcare is delivered through subcenters, primary health centers (PHCs), and community health centers (CHCs).
Social medicine is concerned with how social and economic factors impact health and disease. It aims to understand these relationships and create conditions for a healthier society. Socialized medicine describes universal healthcare systems funded through taxation where medical care is available to all at low cost. Pros include affordability, uniform access to care regardless of income, and healthcare for all citizens. Cons can include potentially lower quality care, decreased medical innovation, and increased tax burden. Some countries with socialized medicine systems are described. In India, various state-run health insurance schemes have been launched to provide socialized care.
The document summarizes the Nepal Health Service Act of 2053 (1997) and its amendments. It outlines the classes within the health service, how vacancies are fulfilled, restrictions on fulfillment, provisions for upgrade, upgradation criteria, appointment process, qualifications, probation, transfer, deputation, promotion criteria, nomination for study/training, salary and benefits, insurance, retirement, gratuity, pension, conduct rules, security of service, and punishments. The act governs administration, appointments, promotions, transfers, salaries and pensions for Nepal's public health service employees.
Understanding the concept of Universal Health Coverage (UHC) and how can we reach it, both globally and also in India. The presentation also includes HLEG report , which is the proposed architecture for India's guide to reach UHC.
Universal health coverage as a concept was born in 1883 when Germany introduced health coverage for achieving health status of its young population.India, is still attempting to find a way for providing appropriate, affordable and accessible health care to its population.
This document discusses the history and principles of primary health care. It began in 1978 with a conference that defined primary health care as health care that is accessible to all individuals through their participation and affordable for the community. The key aspects of primary health care are preventative services like immunizations, maternal/child care, and treatment of common diseases. It also emphasizes equitable access, community participation, coordination between sectors, and appropriate technology.
*Health Insurance in India and Genesis of the Ayushman Bharat PMJAY Pradhan Mantri Jan Arogya Yojana
*Critical review of the health insurance schemes
*SWOCh analysis of Ayushman Bharat PMJAY
Created - July 2019
Author- Dr. Madhushree Acharya, Academic Junior Resident, Community & Family Medicine, AIIMS Bhubaneswar
This document discusses public health. It defines public health as "the science and art of preventing disease, prolonging life and promoting human health through organized efforts and informed choices of society, organizations, public and private, communities and individuals." The core functions of public health programs are listed as providing leadership on critical health matters, shaping research agendas, setting and monitoring norms and standards, articulating ethical and evidence-based policy, and monitoring the health situation. Public health applications in healthcare include assessing current services, identifying interventions, considering resource effects and cost-effectiveness, informing decision-making, and educating the public. Health indicators and determinants are also outlined.
Shreejeet Shrestha provides an overview of sociology and its application in public health. Sociology developed from 19th century theoretical writings and emphasizes social structures and processes over individuals. Key concepts in sociology like social fabric, conflict, and social systems are highly relevant to public health. While psychology has traditionally dominated social sciences in public health, sociology is increasingly important for understanding large-scale social determinants of health like inequality, social capital, and health systems. Sociological methods involving both quantitative and qualitative data are valuable tools for public health research and evaluation.
The document summarizes a term paper on public health surveillance in Nepal. It discusses the objectives, methodology, findings and conclusions of the paper. The key points are: public health surveillance involves ongoing collection and analysis of health data to guide public health practice; Nepal has integrated disease surveillance within its health management information system; and the country was commended for its efficient AFP surveillance and polio eradication efforts while still needing to address potential wild poliovirus circulation.
The health care system in Pakistan consists of public and private sector providers that deliver services through primary, secondary, and tertiary levels of care. The public sector system is primarily the responsibility of provincial governments and includes hospitals, basic health units, and community health workers. However, it suffers from issues like high population growth, uneven workforce distribution, insufficient funding, and limited access to quality care. As a result, the private sector has expanded to help meet demand, though most private hospitals are small and run as sole proprietorships. Overall spending on health care is increasing but remains lowest in Balochistan and highest in Punjab.
The document discusses the health care system in Nepal under its new federal democratic republic system. It provides an introduction to federalism and describes how power is divided between the central, provincial, and local governments in Nepal. It then outlines the major components of Nepal's health system including its structure for health service delivery, governance structure at different levels, and key organizations. It also discusses some of the major health initiatives in Nepal and provides organizational charts and the Public Service Act relating to regulating health institutions.
Health systems, goals of health system,
Leadership and Governance
Human Resource for Health
Health Financing
Medicines and Technologies
Service Delivery, and
Health Information System
Chronic non-communicable diseases (NCDs) such as cardiovascular disease, cancer, and diabetes now account for over half of deaths in India and place a large economic burden. The National Programme for Prevention and Control of Cancer, Diabetes, CVD and Strokes (NPCDCS) aims to address NCDs through health promotion, screening, diagnosis, management, and capacity building integrated into primary healthcare. Current programs have had limited implementation; a comprehensive and widespread approach is still needed to reduce the growing NCD burden in India.
The document provides background information on Nepal's health system. Some key points:
- Nepal is transitioning to a federal democratic republic after a period of political instability and has set a goal to graduate from least developed country status by 2022.
- It faces challenges of poverty, inequality, and a high burden of disease. The health system provides services through a three-tier structure at the federal, provincial, and local levels.
- Financing comes from various sources including government spending which allocates a portion of its budget to health but this share has declined in recent years despite overall spending increases. Out-of-pocket costs remain high.
Current Health System Nepal After health reform 2018Jahirul Hussein
The health system of Nepal faces several challenges due to its mountainous terrain and diverse population. It has a public health care system that is decentralized across three levels - central, provincial, and local. At the local level, rural municipalities now govern health facilities. The government aims to provide universal health coverage through initiatives like free basic health services and delivery care. However, resource constraints and geographical barriers limit equitable access to quality care, especially in rural areas. The system also works to control diseases while promoting traditional and alternative medicine practices.
The document provides an overview of the concept of public health, its history and challenges. It discusses:
- The definition of public health as promoting health through organized community efforts like sanitation, disease control, health education and access to care.
- How the "great sanitary awakening" in the 19th century identified filth as a cause of disease, leading to a focus on cleanliness and prevention over reacting to outbreaks.
- The work of Edwin Chadwick who documented poor living conditions and their impact on health, and proposed sanitary reforms be addressed through engineering and public boards of health.
- The core functions of public health as assessment, policy development and assurance to collect data,
Healthcare Delivery System in Federal Context of NepalSonali Shah
The document summarizes Nepal's health care system under its new federal democratic republic system. Some key points:
- Nepal transitioned to a federal system in 2015 to reduce disparities between rural and urban areas. Health care is now organized at the federal, provincial and local levels.
- The constitution guarantees citizens the right to free basic health services and emergency care. Health care provision and financing are managed at the federal level according to federal legislation.
- Nepal's health care system includes public, private, traditional and voluntary sectors. It has a primary, secondary and tertiary level referral system with health posts, primary health centers, district/zonal hospitals and central/regional hospitals.
- Key health programs
This document provides an overview of public health and the structure of Pakistan's healthcare system. It begins with definitions of key terms like health, public health, and healthcare systems. It then describes the main functions and objectives of public health, including health promotion, disease prevention, and treatment. The document outlines Pakistan's three-tiered public and private healthcare system consisting of primary, secondary and tertiary levels of care. It also discusses issues like inadequate funding, reliance on out-of-pocket payments, and an understaffed and underequipped public system. In conclusion, it presents statistics on Pakistan's health infrastructure and workforce.
India has a decentralized healthcare system, with states largely independent in delivering healthcare. Each state has its own healthcare delivery system, while the central government is responsible for policymaking, planning, guidance, and coordination. Healthcare is delivered through a three-tiered system - central, state, and district level. At the district level in rural areas, community healthcare is delivered through subcenters, primary health centers (PHCs), and community health centers (CHCs).
The document discusses the recommendations of various committees related to development of healthcare services in India. Some of the key recommendations include:
- Integration of preventive and curative services at all levels of administration.
- Establishment of a three-tier primary healthcare system with primary health units, regional health units, and district hospitals.
- Training of community health workers to deliver primary healthcare services and act as a link between the community and primary health centers.
- Creation of a unified health services cadre with common terms of service.
- Involvement of medical colleges in rural healthcare delivery through programs like Reorientation of Medical Education.
The National Rural Health Mission (NRHM) was launched in India in 2005 to address the lack of accessible and affordable primary healthcare, especially in rural areas. It aims to provide universal access to public health services through community health workers like ASHAs. Key strategies include strengthening subcenters, primary health centers, and community health centers. It works to reduce maternal and child mortality rates and aims to make primary healthcare services available within one kilometer of every village. The NRHM is overseen by committees at the national, state, and district levels to monitor progress and outcomes.
A presentation on health care delivery system in indiarohini154
The document summarizes the health care delivery system in India at various levels from national to community. It describes the administrative and organizational structure at each level, including the roles of different government bodies and private organizations. The national level is led by the Union Ministry of Health and Family Welfare. States have their own health departments and are divided further into regional, district, subdivision, and community levels. Primary health centers, sub-centers, and community health centers deliver services at the community level. Both public and private sectors provide health care across this multi-level system in India.
The National Rural Health Mission was launched in 2005 to improve rural health care in India. It focuses on 18 states with weak public health. The goals of NRHM are to reduce infant and maternal mortality and provide universal access to public health services. It aims to do this through community health centers, primary health centers, and accredited social health activists (ASHAs) who work in villages to increase awareness and utilization of health services like immunizations and institutional deliveries. ASHAs and anganwadi workers play important roles in promoting public health in rural communities.
The presentation is regarding the public health nursingShipraMishra30
Public health nursing promotes and protects the health of populations using nursing and public health sciences. Public health deals with groups rather than individuals. Its goals include health promotion, disease prevention, early diagnosis and treatment, disability limitation, and rehabilitation. Over time, committees in India have recommended developing public health systems based around primary health centers (PHCs) and community health centers (CHCs) to serve populations of 30,000-120,000 respectively. However, implementation has been partial and the system remains hospital-focused rather than public health-focused, neglecting important areas like epidemiology, statistics, and public health regulation.
The document discusses India's Ministry of Health and Family Welfare, which oversees national health programs and policies. It oversees departments on health, Ayurveda, health research, and AIDS control. The ministry works through state health infrastructure like community health centers and aims to improve access through new facilities. Major programs address cancer, mental health, emergencies, and diseases like diabetes. The Central Government Health Scheme provides services to government employees. Other discussed topics include rural health services, food safety policies, and national health policies aiming to improve standards.
This document is a dissertation submitted by Suresh R Makwana to K.S.K.V.Kachchh University for the degree of Master of Public Administration. The dissertation examines the role of primary health centers in public health administration. It includes an acknowledgement, list of abbreviations used, statement by the student and guide, table of contents and introduction. The introduction provides background on India's public health system and goals, describes primary health centers and the government health department structure, and discusses the health scenario in Gujarat and Kachchh districts.
The document summarizes India's health care delivery system. It has three main levels - central, state, and local peripheral. At the central level, the Ministry of Health and Family Welfare is responsible for policymaking and coordination. It oversees various departments like the Directorate General of Health Services. States each have their own health care systems within this framework. Primary health services are delivered through sub-centers, primary health centers, and community health centers at the local level. The public sector delivers most primary health care alongside some private services.
The document summarizes India's health care delivery system. It has three main levels - central, state, and local peripheral. At the central level, the Ministry of Health and Family Welfare is responsible for policymaking and coordination. It oversees various departments like the Directorate General of Health Services. States each have their own health care systems within this framework. Primary health services are delivered through sub-centers, primary health centers, and community health centers at the local level. The public sector delivers most primary health care alongside some private services.
The document discusses Pakistan's public health care system, which provides services through a three-tiered structure of primary, secondary, and tertiary care facilities. It also describes the roles of various health care professionals and teams within the system. Finally, it outlines the Devolution Plan of 2000 that decentralized governance and empowered districts to develop their own health strategies.
The National Health Mission aims to improve health outcomes in rural and urban India through various programs and initiatives. It encompasses the National Rural Health Mission and the National Urban Health Mission. The NRHM focuses on improving access to primary healthcare in rural areas by strengthening infrastructure like subcenters and PHCs and promoting community health through Accredited Social Health Activists. The NUHM similarly focuses on improving access for urban poor populations, particularly in slums, through urban primary health centers and community health workers. Both missions aim to reduce infant and maternal mortality and improve health indicators.
The document provides an overview of India's health care delivery system, including its evolution, structure, and key components. It describes the three-tier system consisting of primary, secondary, and tertiary care. Primary care is delivered through subcenters, primary health centers, and community health centers. The public sector delivers most primary care, while the private sector and indigenous systems also play roles. National health programs address specific diseases. Reforms aim to strengthen primary care and increase access through public-private partnerships.
The document summarizes Bhutan's health system. It describes the vision and mission to provide quality traditional and modern healthcare. Bhutan offers free universal healthcare through 32 hospitals. The largest hospital has 350 beds. Basic health services are provided through clinics and subposts. Challenges include physician shortages and rising public expectations for advanced care. Public health aims to prevent disease and promote community health through health education and disease prevention programs.
The document provides an overview of health policy and the health system in India. It discusses the history of public health in India from traditional Ayurvedic approaches to modern Western influences. The health system is described as having a complex mix of public and private sectors. Key aspects covered include the administrative structure from central to local levels, service delivery network from sub-centers to hospitals, and health financing relying heavily on out-of-pocket payments. While India produces many medical professionals and medicines, health indicators remain poor and inequitable across socioeconomic groups.
The document summarizes the National Health Mission in India, which includes the National Rural Health Mission and the National Urban Health Mission. The key goals of the NRHM are to reduce infant and maternal mortality rates and ensure universal access to public health services. It aims to achieve these goals through strategies like strengthening primary health centers and deploying Accredited Social Health Activists. The NUHM was launched in 2013 to improve health outcomes for urban poor populations, with a focus on slum residents and other vulnerable groups.
Past present health status of community health of pakistanyasmeenzulfiqar
The document summarizes Pakistan's healthcare system. It describes the healthcare system as having a three-tiered structure consisting of primary, secondary, and tertiary levels of care. The primary level includes dispensaries, basic health units, and rural health centers. The secondary level includes tehsil hospitals and privately run clinics and hospitals. The tertiary level includes district and large urban private hospitals. The healthcare system has both public and private sector components, with the majority of households utilizing private providers.
Similar to The health services policy in Upazila Health Complex: (20)
Internal Structure of The Earth? Major Structural unit of the earthUday Kumar Shil
The document summarizes the internal structure of the Earth in 3 main layers - the core, mantle, and crust. The core is divided into a solid inner core and liquid outer core, mostly composed of iron and nickel. The mantle, making up most of the Earth's mass, is solid but can slowly deform and is composed of silicate compounds. The crust is the coolest and thinnest layer, composed of silicate minerals.
What is Solar system? FORMATION OF SOLAR SYSTEM. SOLAR SYSTEM: StructureUday Kumar Shil
The document summarizes the structure and components of the solar system. It describes:
1. The solar system formed from a large rotating cloud of gas and dust called the solar nebula approximately 4.6 billion years ago. As it contracted, the nebula flattened into a disk and kilometer-sized protoplanets began to form.
2. The solar system consists of the Sun and celestial objects bound to it by gravity, including eight planets composed of rock/metal or gas/hydrogen that orbit in nearly circular paths within the ecliptic plane.
3. Most planets have their own moons, and the gas giants have rings composed of tiny particles orbiting them. The solar system can be divided into
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This document provides an introduction to the field of geoscience/geology. It discusses key topics like the formation of rocks through igneous, sedimentary, and metamorphic processes. It also covers plate tectonics theory and how the motion of tectonic plates generates earthquakes. The objectives of the course are to understand rock and mineral formation, Earth's structure and composition, sea floor spreading via plate tectonics, landforms, and natural hazards like earthquakes.
This chapter provides a literature review of previous research on Hijra communities. One study used ethnographic research to show that Hijras in Bangladesh live in extreme social exclusion without recognition as a separate gender beyond the male-female binary. This social exclusion damages their self-esteem and prevents effective safer sex interventions. Another study examined how Hijras are excluded from schools, families, work and social institutions their whole lives, putting them at risk for risky sexual behaviors due to limited access to information and resources. The literature recommends addressing structural exclusion of Hijras and working with mainstream society, policymakers and civil society to create an environment where Hijras can live fulfilling lives on equal footing with men and women.
This document discusses the history and development of urban sociology. It begins by defining urban sociology and its goals of studying urban structures, processes, changes, and problems to inform planning and policymaking. It then discusses some of the early contributors to urban sociology in Europe in the late 19th century, including Ferdinand Tonnies, Emile Durkheim, and Friedrich Engels, who examined the social impacts of industrialization and urbanization. The document also highlights the influential work of George Simmel and his examination of how urban life transforms individual consciousness. A major section focuses on the development of urban sociology at the University of Chicago in the early 20th century, led by Robert Park and Ernest Burgess,
The document discusses the role and activities of USAID in Bangladesh. It notes that USAID has been a development partner in Bangladesh since its independence in 1971, providing over $6 billion in assistance. USAID supports programs in health, education, food security, economic opportunity, democratic institutions, and climate change resilience. Over the next five years, USAID will help Bangladesh achieve its goal of becoming a middle income country by 2021 through strategies focused on health, education, and other sectors. Key programs include family planning and reproductive health, health systems strengthening, education, and food security.
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This document provides an overview of e-governance in Bangladesh, including definitions of key terms, objectives, challenges, the current situation, and state policies. It discusses the types of e-governance (G2E, G2C, G2G, G2B) and how e-governance can promote transparency, reduce corruption and bureaucracy. While e-governance provides benefits like increased convenience, establishing the necessary infrastructure is costly and cybersecurity presents ongoing challenges.
Max Weber's theory of social stratification analyzed how social class, status, and political power interacted to determine people's life chances. Weber argued that social class was based on economic interests and wealth, while status groups were communities linked by shared lifestyles and prestige. Weber also identified three ideal types of authority: traditional authority based on longstanding tradition, charismatic authority based on personal attributes, and legal-rational authority based on bureaucratic rules and procedures. Overall, Weber emphasized analyzing stratification through multiple, interrelated factors beyond just economic class like Marx had.
The document discusses the history and current state of industrialization in Bangladesh. It begins with definitions of industrialization and outlines the key factors that facilitate industrial development. It then discusses Bangladesh's history of industrialization during the British period, Pakistan period, and after gaining independence. Currently, Bangladesh has experienced growth in small and medium industries like garments and textiles. The government aims to develop policies to attract foreign investment and improve infrastructure to further industrialization. Overall challenges include lack of capital, weak investment, poor infrastructure, and lack of skilled labor.
This document discusses environmental pollution in Bangladesh. It begins by defining pollution and environmental pollution, noting that pollution occurs when pollutants contaminate the natural surroundings and disrupt ecosystems. The major causes of environmental pollution are identified as industries, transportation, agricultural activities, trading activities, and residences. The effects of environmental pollution are outlined, including impacts on humans, animals, plants, and ecosystems. Bangladesh is ranked among the worst countries for urban air quality. The document concludes by outlining some governmental steps taken in Bangladesh to control pollution, such as establishing environmental laws and banning certain pollutants.
The document summarizes the anti-globalization movement in Seattle in 1999 and the Occupy Wall Street movement that began in 2011. Tens of thousands of protesters from various groups attended the Seattle protests to advocate for fairer international trade and less corporate exploitation. The Occupy Wall Street movement emerged in response to growing wealth disparity and the outsized influence of large corporations on the political process. The movements aimed to address issues like corporate greed, lack of accountability for institutions that caused economic crises, and growing social injustices between economic classes.
A policy is a set of principles that guides decision making and achieving rational outcomes. Policies are generally adopted by governance bodies and implemented as procedures by senior executives. Policies can assist both subjective and objective decision making, such as work-life balance policies or password policies. Policies differ from rules or laws in that they guide rather than compel behavior. Social welfare refers broadly to conditions like economic resources, contentment, and lack of threats that contribute to well being. A welfare state is a society where the government funds and provides a substantial part of citizens' welfare, such as through social programs, though there is debate around what qualifies.
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NURSING MANAGEMENT OF PATIENT WITH EMPHYSEMA .PPTblessyjannu21
Prepared by Prof. BLESSY THOMAS, VICE PRINCIPAL, FNCON, SPN.
Emphysema is a disease condition of respiratory system.
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Hypertension and it's role of physiotherapy in it.Vishal kr Thakur
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Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
The health services policy in Upazila Health Complex:
1. The health services policy in Upazila
Health Complex:
A Case Study of Chandpur Sadar Hospital.
SUBMITTED TO :
Mr. Sayeedul Huq
Course InstructorPolicy Analysis SOC-422
Dept. of Applied Sociology
Presented By:
K. M. Asaduzzaman; 12-1-20-0023
Farjana Akter Eti; 111-20-0010
Yeanur Hossain Khan; 12-3-20-0004
Aklima Akter; 12-3-20-0005
Umme Salma; 12-3-20-0009
Antora Saha; 12-3-20-0015
Uday Kumar Shil; 12-3-20-0025
Sohaly Akter; 12-3-20-0031
Khing Khing May; 12-3-20-0036
Rasel patuary; 12-3-20-0044
Rakiba Rahman; 12-3-20-0045
Date of Submission: 26-12-2015
2. INTRODUCTION:
Bangladesh is a mostly rural, developing country of South Asia, located on the northern shore of
the Bay of Bengal, covering 147,570 square km. People of this country are known as
hardworking, with proven capability to preserve mental strength in the event of unexpected
extensive loss due to natural calamities, such as floods, cyclones, epidemics, etc. But, their basic
needs have remained unfulfilled.
Health is a basic requirement to improve the quality of life. National economic and social
development depends on the status of a country’s health facilities. A health care system reflects
the socio-economic and technological development of a country and is also a measure of the
responsibilities a community or government assumes for its people’s health care. The
effectiveness of a health system depends on the availability and accessibility of services in a
form which the people are able to understand, accept and utilize. The Government of Bangladesh
is constitutionally committed to “the supply of basic medical requirements to all levels of the
people in the society” and the “improvement of nutrition status of the people and public health
status” (Bangladesh Constitution, Article-18).
The study explores people’s participation in health services through personal interview as well
as case studies for which Chandpur Sadar Upazila health complex had been provided through
govt.
.
3. LITERATURE REVIEW:
Mohammad Shafiqul Islam and Mohammad Woli Ullah*( Respectively, Assistant Professor,
Department of Public Administration, Shahjalal University of Science & Technology (SUST),
Sylhet-3114, Bangladesh; and M.S. in Public Administration, Department of Public
Administration, Shahjalal University of Science & Technology (SUST), Sylhet-3114,
Bangladesh.) studied about “People’s Participation in Health Services: A Study of
Bangladesh’s Rural Health Complex” in the Muradnagar Upazilla under the Comilla District.
According to this case study health services based on primary health services have been
expanding gradually in Bangladesh to improve the health status of the people, especially in rural
areas and maternal health where more than 85 percent of the people are living and are
underserved and underprivileged groups. The study focused on the degree of people’s getting the
public health services of Bangladesh. It suggests that the people’s getting the health services is
not satisfactory.
Salahuddin, Ali, Alam and Ali (1988) stated that Bangladesh, being a poor country with scarce
resources, cannot afford to provide sophisticated medical care to the entire population. Emphasis
is therefore given to primary health care covering the unnerved and undeserved population with
the minimum cost in the shortest time.
Mahmud (2004) explored people’s perceptions and reality about participation in newly opened
spaces within the Bangladesh public health care delivery system. The empirical findings suggest
that the effectiveness and ability of community groups to function as spaces for participation and
provide the means for developing capabilities to participate is limited, being constrained by
poverty, social inequality and dependency relationships, invisibility, low self-esteem and absence
of political clout.
HEALTH INDICATORS:
CDR – 5.2 /1000
Annual Growth rate – 1.48%
MMR – 1.94 /1000 live births (BMMS 2010)
IMR – 43 /1000 live births
Under 5 MR – 83 /1000 live births
Total Fertility Rate – 2.9
CPR – 53.8%
Life expectancy at birth – 68 (m) and 69 (f)
Fully immunized children – 52%
TB (smear positive new) detection rate – 31.2%
4. HEALTH CARE INFRASTRUCTURE:
UHFWC – 3375
31–50 bed UHC – 397
Various types o district level hospitals – 80
Government medical college hospitals – 13
Postgraduate hospitals – 6
Specialised hospitals – 25
Doctor to population ratio – 1:4,3660
Nurse to population ratio – 1:8,226
Hospital beds – 40,773 (over 29,000 in GOB)
PROCESS FOR FORMULATION
The Ministry of Health and Family Welfare[3]
assembled a Committee in 1996 for the purpose of
preparing a health policy, with members drawn from civil society and professional bodies,
including technocrats and bureaucrats.
A further five sub-committees were formed to:
Evaluate the existing health services and determining the goals
Formulate policies to ensure essential services
Formulate policies to ensure hospital-based services
Design Strategies for HRD
Integrate NGOs and the Private Sector and plan for resources and utilisation of funds
The sub-committees worked for more than a year and submitted their efforts/recommendations.
A working group was formed and entrusted with the responsibilities for compiling the
recommendations contained in the reports. The working group also organised workshops in all
six Divisions to elicit opinions of cross-section of the society on these reports. Finally the
working group presented the proposals and recommendations to the National Health Policy
Formulation Committee. A report on the health policy was thus formulated on the basis of
consensus. The Cabinet on 14 Aug 2000 approved the National Health Policy.
5. HEALTH CARE SYSTEM:
The health care are designated to meet the health needs of the community through the use of
available knowledge and resources. The services provided should be comprehensive and
community based. The resources must be distributed according to the needs of the community.
The final outcome of good health care system is the changed health status or improve health
status of the community which is expressed in terms of lives saved, death averted, disease
prevented, disease treated, prolongation of life etc.
Health care delivery system in Bangladesh based on PHC concept has got various Level of
service delivery:
Home and community level.
Union level,
Union sub centre (USC) or Health and family welfare centre; This is the first health
facility level.
Thana level, Thana Health Complex (THC): This is the first referral level.
District Hospital: This is the secondary referral level.
National Level: This is the tertiary referral level.
A) Primary level health care is delivered though USC or HFWC with one in each union
domiciliary level, integrated health and family planning services through field workers for every
3000–4000 population and 31 bed capacities in hospitals.
B) The secondary level health care is provided through 100 bed capacities in district hospital.
Facilities provide specialist services in internal medicine, general surgery, gynecology,
paediatrics and obstetrics, eye clinical, pathology, blood transfusion and public health
laboratories.
C) Tertiary Level health care is available at the medical college hospital, public health and
medical institutes and other specialist hospitals at the national level where a mass wide range of
specialised as well as better laboratory facilities are available.
The referral system will be developed keeping in view the following.
1. A clearly spent-out linkage between the specialised national institutes, medical college and
district hospitals to ensure proper care and treatment of patients from the rural areas served by
lower level facilities.
2. Patients from the rural areas referred by lower level facilities to district and Medical College
hospitals and specialised institutions should get preferential treatment after admission.
6. IMPROVEMENT OF HEALTH CARE SYSTEM IN BANGLADESH:
Among countries that provide free medical services to the people at the community level through
various public health facilities, Bangladesh has a top-ranking position in this regard. The primary
healthcare is provided through an
extensive network of health
facilities extended down to the
community level with upward
referral linkage and a set of
government funded permanent
community healthcare workers.The
community clinics are the lowest-
level static health facilities located
at the ward level. These have
upward referral linkages with
health facilities located at the union
and upazila levels. There are 467
government hospitals at the upazila
level and below, which altogether
have 18,791 hospital beds. At the
upazila level, there are 436
hospitals with 18,301 beds. At the
union level, there are 31 hospitals
with 490 beds and 1,362 health
facilities for outpatient services
only. So, at the union level, there are 1,393 health facilities. At the ward level, there are 12,584
community clinics in operation till date.
HEALTH CARE SYSTEM IN BANGLADESH:
The public healthcare network of Bangladesh is an intricate web of public health departments,
NGOs, and private institutions constitutes. Responsibilities and functions range from policy
planning, regulation, implementation, and healthcare delivery to medical education. The Ministry
of Health and Family Welfare (MOHFW) is responsible for formulating national-level policy,
planning, and decision-making in the provision of healthcare and education. The healthcare
infrastructure under the DGHS comprises six tiers: national, divisional, district, upazila (sub
district), union, and ward.
7. NATIONAL HEALTH POLICY OF BANGLADESH:
The Health Policy has 15 goals and objectives, 10 policy principles and 32 strategies.
Goal and objectives of the national health policy
First: To make necessary basic medical utilities reach people of all upazilla as per Section 15
(A) of the Bangladesh constitution and develop the health and nutrition status of the peoples as
per Section 18 (1) of the Bangladesh Constitution
Second: To develop system to ensure easy and sustained availability of health services for the
people, especially the poor communities in both rural and urban areas
Third: To ensure optimum quality, acceptance and availability of primary health care and
governmental medical services at the upazilla and union levels
Fourth: To reduce the intensity of malnutrition among people, especially children and mothers;
and implement effective and integrated programs for improving nutrition status of all segments
of the population
Fifth: To undertake programs for reducing the rates of child and maternal mortality within the
next 5 years and reduce these rates to an acceptable level
8. Sixth: To adopt satisfactory measures for ensuring improved maternal and child health at the
union level, and install facilities for safe and hygienic child delivery in each village
Seventh: To improve overall reproductive health resources and services
Eighth: To ensure the presence of full-time doctors, nurses and other officers/staff, provide and
maintain necessary equipment and supplies at each of the upazilla health complexes and Union
Health and Family Welfare Centers (UHFWCs)
Ninth: To devise necessary ways and means for the people to make optimum usage of available
opportunities in government hospitals and the health service system, and ensure satisfactory
quality management, cleanliness of service delivery at the hospitals
Tenth: To formulate specific policies for medical colleges and private clinics, and to introduce
laws and regulation for the control and management of such institutions including maintenance
of service quality
Eleventh: To strengthen and expedite the family planning program with the objective of
attaining the target of Replacement Level of Fertility
Twelfth: To explore ways to make the family planning program more acceptable, easily
available and effective among the extremely poor and low-income communities
Thirteenth: To arrange special health services for the mentally retarded, the physically disabled
and elderly populations
Fourteenth: To determine ways to make family planning and health management more
accountable and cost-effective by equipping it with more skilled manpower
Fifteenth: To introduce systems for treatment of all types of complicated diseases in the country,
and minimize the need for foreign travel for medical treatment ab Road.
POLICY PRINCIPLES:
The following policy principles have been adopted in order to attain the foregoing goals and
objectives:
i. To create awareness among the enable every citizen of Bangladesh irrespective of caste, creed,
religion, income and gender, and especially children and women, in any geographical region of
the country, through media publicity, to obtain health, nutrition and reproductive health services
on the basis of social justice and equality through ensuring everyone’s constitutional rights;
ii. To make the essential primary health care services reach every citizen in all geographical
regions within Bangladesh;
iii.To ensure equal distribution and optimum usage of the available resources to solve urgent
health-related problems with focus on the disadvantaged, poor and unemployed persons.
iv.To involve the people in various processes like planning, management, local fund raising,
spending, monitoring and review of the procedure of health service delivery etc. with the aim of
decentralizing the health management system and establishing people’s right and responsibilities
in this system
9. v.To tacilitate and assist in the collaborative efforts between the government and the non-
government agencies to ensure effective provision of health services to all
vi.To ensure availability of birth control supplies through integration, expansion and
strengthening of the family planning activities
vii.To carry out appropriate administrative restructuring, decentralization of the service delivery
procedure and the supply system, and to adopt strategies for priority-based human resource
development aimed at overall improvement and quality-enhancement of health service, and to
create access of all citizens to such services
viii.To encourage adoption and application of effective and efficient technology, operational
development and research activities in order to ensure further strengthening and usage of health,
nutrition and reproductive health services
ix.To provide legal support with regard to the rights, opportunities, responsibilities, obligations
and restrictions of the service providers, service receivers and other citizens, in connection with
matters related to health service; and
x.To establish self-reliance and self-sufficiency in the health sector by implementing the primary
health care and essential services programs, in order to fulfill the aspirations of the people for
their overall sound health and access to reproductive health care.
POLICY STRATEGIES:
In keeping with the purported goals, objectives and principles, the following policy strategies
will be adopted
i.An appropriate implementation of the Health Policy needs mass-scale consensus and
commitment that will facilitate socio-economic, social and political development
ii.Prevention of disease and health promotion will be emphasized to achieve the basic objective
of Health for All”. The Health Policy focuses on provision of the best possible health facilities to
as many people as possible using cost-effective methods, and will thus ensure effective
application of the available curative and rehabilitative services.
iii.A primary health care is the universally recognized methodology to provide health services;
this will be adopted as the major component of the National Health Policy in order to ensure
delivery of cost-effective health services
iv. The Drug Policy will be liberalized and improved in keeping with the Health Policy to fulfill
the overall needs for health services. There is need to ensure smooth availability of essential
medicines focusing on the current needs for such medicines and their efficacy, including their
affordability by all people. Necessary steps will be taken to maintain quality standards of the
marketed medicines and raw materials used therein, and to rationalize the usage of medicines. In
this line, the required number of skilled manpower will be acquired in the drug administration of
the country.
The health policy will ensure distribution of birth control supplies and make improvements in the
10. management of the domestic sources of the same, including encouragement of the domestic
sources of the same, including encouragement of the domestic entrepreneurs for production of
such commodities.
v.Epidemiological surveillance method will be integrated with the disease control programs. A
specific institution will be entrusted with the responsibility of such surveillance.
vi.The basic principles for ensuring quality standards in health care at various health centers will
be adhered to. Standard quality assurance guideline including monitoring and evaluation will be
provided to every health center
vii.A Health Services Reforms Body will be formed based on the Health and Population Sector
Strategy aiming at meeting the current demand. The role of the Health Services Reforms Body
will be the render the following services
Infrastructure reforms
Acquisition of human resources,
Planning and implementation of programs for development of human resources related
to the health sector,
Career planning of the staff,
Inspection of supplies and logistics,
Consultations on how to effect overall development of health services including its
management styles etc
Recommendations will be implemented in phases based on the availability of necessary
resources
viii.An appropriate and need-based approach to develop human resources will be designed in
order to maximize the utilization of the knowledge and skills of health-related personnel. A
number of posts will be created with a view to promoting the eligible staff at the grassroots level
on the basis of their seniority and skills acquired. Special care will be taken to ensure that no
staffs promotion is held up.
While a staff is sent for training outside his/her own organization, necessary replacement will be
put in place for the term of the training, that is, no training leave may be allowed without
replacement
ix.The people and the local government will be integrated with the health service system at all
levels
x.An Integrated Management Information System (IMIS) and a computerized communication
system will be installed countrywide, to facilitate implementation, action planning and
monitoring. The existing information system will be further strengthened by recruiting more
efficient and eligible incumbents. To this purpose, extensive and appropriate training will be
arranged, and the available manpower will be expanded and their skills enhanced.
xi.The Bangladesh Medical and Dental Council (BMDC) and the Bangladesh Nursing Council
(BNC) will be restructured and strengthened in order to ensure strict supervision of medical
practitioners registration, their quality of skills, and related ethical issues. With a view to
maintaining the required quality standards of the performance, education and training of the
pharmacists, medical technologists and other paramedics, the Pharmacy Council and the State
Medical Faculty will be restructured and organized.
11. xii.Various professional organizations, such as, Bangladesh Medical Association (BMA),
Bangladesh Private Medical Practitioners Association (BPMPA), and the unani, ayurvedic and
homeopathic societies etc. will be integrated with the country’s health service system.
xiii.Need-based medical education and training will be made more people- oriented and updated.
xiv.Arrangements will be mode for institutional training, on such issues as management and
administration, for improving the doctors’ management capabilities.
xv.Regular training will be provided to the medical practitioners, teachers, nurses, paramedics
and other staff at all levels in both public and private sectors through a specific institution. The
following types of courses will be offered from here:
- Reoriented Course,
- Continuing Medical Education Program,
- Administrative and Management Courses etc.
In order to create the required facilities for offering such training, a National Training Institute
will be established.
xvi.To ensure efficient health services, the management of the medical colleges/institutions and
related hospitals will be improved, and higher levels of financial and administrative power will
be delegated to them.
xvii.Nutrition and health education will be emphasized, as these are the major driving forces of
health and family planning activities. There will be one nutrition education unit and one health
education unit in each upazilla, so that they can reach every village of Bangladesh.
Information on health education will be disseminated the people through incorporating the
community leaders and other departments or organizations of the government in the health
service system. One of the goals of the health service system will be to improve the nutrition
status of the people.
xviii. The government hospitals and clinics will charge a minimum fee from the patients, but
there will also be provision for cost-free medical treatment to the poor and the disabled.
xix.NGOs and other private organizations will be encouraged to perform a role complementary
to those of the government in the light of the governmental rules and policy.
xx.Infrastructure and transportation will be developed to minimize the disparity in access to
health services between rural and urban populations. In order to ensure presence of every officer
and staff of the health service system at their respective workplaces and their efficient services,
development of education facilities and improvement of the social environment in those
neighborhoods will be made.
xxi.Arrangements will be made to pay non-practicing allowances to the government
doctors/trainee doctors who act as full-time and resident doctor thus making them refrain from
private medical practice.
Doctors working at a government medical college, hospital or health center opting for private
medical practice using the facilities at the medical college, hospital or health center, will be
12. allowed to do so only under a clear policy.
xxii.Accountability of all concerned in the health service system will be ensured. An adequate
procedure will soon be designed to strengthen accountability and ensure quick and strict legal
disposal of cases relating to negligence of duties.
xxiii.A national level health-and-population council will be formed under the leadership of the
Head of the Government. This council will provide support and advice on the implementation of
the National Health Policy and will ensure effectiveness and accountability of the health service
system. The local and regional councils will monitor the health-related activities in their
respective areas, including review of composition, application and supervision of the primary
health care provided to the people
xxiv. Inter-sectoral coordination and linkages will be strengthened way of utilizing the resources
at the disposal of concerned sectors for quick solution of the health-related problems.
xxv.Research on various management styles and their effectiveness, clinical services, approach
to diagnoses, social and behavioral aspects of human beings, epidemics etc. will be encouraged
by the government.
Information dissemination system will be strengthened, especially by involving the private
organizations, in order to make IEC (information, education and communication) reach the
grassroots level.
A sound referral system will be designed and installed, and its usage will be strictly supervised,
so that a linkage can be established among primary health care activities at various tiers
ultimately increasing the efficacy of this system.
xxv1.Duplication of activities from different projects, programs and activities will be avoided. In
this connection, a policy-planning cell will be established in the Ministry of Health and Family
Welfare, through which effective and sustainable coordination may be ensured.
xxvii.To goal of the Health Policy will be to provide personal or client-centered health and
reproductive health service, so that an individual can have the opportunity to select services
according to his/her personal needs. This pattern of services-delivery will be considered an
important approach of the National Health Policy and will contribute to a reduction in the rate of
unwanted pregnancies.
xxviii..Governmental allocation of expenditure budget for health centers from the districts to the
community level may be redistributed within reasonable flexibility. This redistribution of
expenditure budget will provide increased benefits to the poor and destitute communities. As a
result, expenses will be optimized and health service will be easily available.
xxix.Alternative health service systems, such as ayurvedic, unani and homeopathic practices will
be incorporated into the National Policy. Encouragement will be given to the principle of making
these three
disciplines of medical science more scientific and time-worthy towards enabling the practitioners
in these disciplines to contribute to the country’s health service. Government will provide
appropriate support to these systems through enhancing grants and arranging proper training in
these areas, and ensure monitoring of the quality of services rendered through these systems.
13. xxx.The arrangement for delivery of Essential Services Package (ESP) among the people from a
single one-stop health service center will be considered the appropriate strategy for provision of
primary health care. This will be introduced throughout the country. For this purpose, well-
planned and useful training will also be arranged at the upazilla health complexes.
xxxi. All development activities in the health sector will be conducted through a sector-wide
management system.
xxxii.. In order to bring every citizen of the country under coverage of his health service system,
one community clinic will be established to serve every 6,000 persons. An MBBS-doctor will be
deployed in each Union Health and Family Welfare Center, and each of these centers will also
equip with residence facilities for the doctor.
Multi-dimensional problems at various tiers of the physical and technical infrastructures of the
health service system and among the manpower employed have been creating bottlenecks
towards effective provision of health services. These colossal problems accumulated over a long
period of time and cannot be solved in a day. Therefore, a comprehensive plan for efficient
solution of the existing problems must be formulated urgently after elaborate consideration of the
issues involved. Only way to an effective health service system lies in timely modification,
reform and correction of the country’s traditional health service through adoption and
implementation of a transparent health policy.
A CASE STUDY OF CHANDPUR SADAR POURASHAVA:
Organization at a Glance:
Name of the Institution : Chandpur Sadar Health complex, Chandpur
Location : Chandpur
Type of organization : Government
Date of establishment : 1897
Date of visit : 01.12.15
14. ACTIVITIES OF THE ORGANIZATION:
Existing health facilities in the Upazila
Facility Type
Upazila Health Complex
No. of Union Sub-Centres
No. of Union Health and Family Welfare Centres
No. of Rural Dispensaries
No. of Community Clinics
No of Trauma Centres
No. of MCWC
No. of Chest Disease Clinic (TB clinic)
No. of Private Clinics
No. of NGO Clinics
FOLLOWING SERVICES REGARDING FAMILY PLANNING ARE PROVIDE AT
HOSPITAL AND FIELD LEVEL:
Free distribution of family planning maternal like oral pill and condom.
Insertion of Cu.T.
Tubectomy and vasectomy
MR
Motivating people to take family planning methods antenatal services including
referring high risk mothers.
STUDY AREA:
Chandpur sadar pourashava (in Chandpur district)
was selected as the study area. It was established in
1897. It has an area of 8.77 sq km and bounded by
Tarpur Chandi union on the north, Ishali union on
the south, Baghadi union on the east and Meghna
River on the west. The town has a population of
94821 where male are 50.77% and female are
49.23%. Literacy rate of the town people is 66.4%
(BBS, 2011). Main rivers are lower Meghna and
Dakatia. There are substantial numbers of health
care centers in Chandpur sadar pourashava provided
by the government, non-government, private and
other organization. The number of doctors, nurses,
medical assistants, beds and staffs available during
the study in Chandpur sadar pourashava were 80,
ACTIVITIES OF THE ORGANIZATION:
Existing health facilities in the Upazila
Total No. of Beds
1 0
1 0
No. of Union Health and Family Welfare Centres 12 0
0 0
40 0
0 0
1 20
No. of Chest Disease Clinic (TB clinic) 1 0
19 210
3 30
FOLLOWING SERVICES REGARDING FAMILY PLANNING ARE PROVIDE AT
FIELD LEVEL:
Free distribution of family planning maternal like oral pill and condom.
Tubectomy and vasectomy
Motivating people to take family planning methods antenatal services including
referring high risk mothers.
Chandpur sadar pourashava (in Chandpur district)
was selected as the study area. It was established in
1897. It has an area of 8.77 sq km and bounded by
Tarpur Chandi union on the north, Ishali union on
the south, Baghadi union on the east and Meghna
on the west. The town has a population of
94821 where male are 50.77% and female are
49.23%. Literacy rate of the town people is 66.4%
(BBS, 2011). Main rivers are lower Meghna and
Dakatia. There are substantial numbers of health
sadar pourashava provided
government, private and
other organization. The number of doctors, nurses,
medical assistants, beds and staffs available during
the study in Chandpur sadar pourashava were 80,
No. of Beds
20
210
30
FOLLOWING SERVICES REGARDING FAMILY PLANNING ARE PROVIDE AT
Motivating people to take family planning methods antenatal services including
15. 162, 35, 392 and 725 respectively
OBJECTIVES:
The main objectives of this research are as follows:
To find-out the location pattern of health care facilities in the study area;
To determine the health care facilities provided by the study centers;
To find-out the utilization pattern of health care facilities in the study area;
Service provided by the health care centre in the study area are given below:
FIELD SERVICES:
This section is headed by UHFPO. Under his supervision there are health Inspector (HI),
Assistant Health Inspector (AHI) and health Assistant (HA).
Provided services are-
Health education
Control of communicable disease
Distribution of Vitamin-A capsule
Distribution of oral contraceptive pill (Shukhi) and condom.
Sanitation: Provided by a sanitary Inspector whose function is to supervise the hygienic
condition of food and drink, to send suspicious samples to the Institute of Public Health
(IPH), Dhaka.
Co-ordination with NGOs and other health related sector
Registration of births and deaths
Immunization of static clinics and outreach centers
Collection of blood sample from pt’s suffering from prolonged fever to detect material
parasite.
STATUS OF HUMAN RESOURCES (CATEGORY WISE):
Manpower
Community
Clinic
USC/UHFWC/RD UHC Others
IMCI
trained
Basic
EOC
trainedSanctioned
Filled-
up
Sanctioned
Filled-
up
Sanctioned
Filled-
up
Sanctioned
Filled-
up
Physician 0 0 14 12 3 2 0 0 0 0
Nurse 0 0 0 0 0 0 0 0 0 0
16. Medical
Assistant
0 0 1 1 13 13 0 0 0 0
SERVICE PROVIDED BY THE HEALTH CARE CENTRE IN THE STUDY AREA:
The hospitals of this area deal with comparatively more complicated diseases, which is beyond
the scope and capacity of the primary level. Most of the hospitals in the study area are curative in
nature. These hospitals are assigned to provide some specialist services particularly in internal
medicine, general surgery, obstetrics and gynecology and pediatrics.
SERVICE PROVIDED BY THE HEALTH CARE CENTRE IN THE STUDY AREA IS
GIVEN BELOW:
Type of Available diagnostics
Services provided
by the hospital
Hospital and other facilities
1.
Government
CT angiogram, USG.
stress
Child disease, General Surgery,
Gout, Fever,
Anemia,
Hospitals thaleum test,
Measles, Elderly disease, Circumcision,
Hypertension,
X-Ray,
Gastric, Diabetes, Chest pain, Tuberculosis,
Influenza,
Alta sonogram, E.C.G,
Diarrhoea, Hepatitis, ENI problem, Stroke,
Eyes
CT Scan, Therapy,
proble
m,
Gynecology obstetric
problem
,
Pathologicallab(Urine,
Headache, Skin problem, Accident
injuries
disease,
stool, cough, blood etc.)
Cytica, Rheumatic fever, Immunization,
Dental
disease etc.
2.
Organizatio
nal
Computer to determine
the
Eye disease injuries, Antenatal
postnatal care to
Hospitals eyes problem, Different
mother
s,
Child
disease,
General
surgery,
types of instruments
Gynecological
problem,
Immunization
etc.
related with eyes. Alta
sonogram, E.C.G,
17. Pathologicallab(Urine,
stool, cough, blood etc.),
3.
Private
Altra sonogram
Surgery, Child disease, Delivery, Gout,
Fever,
Clinic/Hospi
tals
E.C.G, Pathological lab
Scabies, Anaemia Measles, Elderly disease,
Asthma
(Urine, stool, cough,
blood
Circumcision, Hypertension, Gastric,
Diabetes, Chest
etc.)
pain, Influenza, Diarrhoea, Hepatitis, ENT
problem,
Stroke, Appendicitis, Headache,
Dysentery,
Chicken
pox, Cardiovascular disease etc
Chandpur sadar hospital arrange the Expanded Programme on Immunization (EPI) with the help
of Canadian International Development Agency (CIDA), United Nations Children’s Fund
(UNICEF), United States Agency for International Development (USAID), World Health
Organization (WHO), Government of Japan, Rotary International (RI). Some medicine is
provided free of charge. Food is also provided free for indoor patients. Matrimongol hospital
provides services for pregnant women (during Antenatal postnatal period). It provides services
under Emergency Operation Camp (EOC). Chandpur Tuberculosis (TB) Hospital provides
services only for Tuberculosis patients.
The diagnostic facilities provide services only for outpatients for laboratory (Urine, stool, cough,
blood, E.C.G, Alta sonogram, X-Ray, Therapy etc) tests. They have no surgical or bed facilities.
The diagnostic centers provide services under the supervision of Chandpur sadar hospital. After
the introduction of modern system of medicine the traditional system of health care has been
gradually decreasing. Now-a-days the old and comparatively less educated patients avail of the
traditional health care facilities.
HEALTH CARE UTILIZATION PATTERN IN THE STUDY AREA
Present study observed that 30.8 percent patients availed government hospitals for their
treatment due to its being free of cost and easy excess. Only 13.5 percent patients avail private
clinics / hospitals due the availability of expert and good behavior. About 25 percent patients
avail Allopathic pharmacy, 5.8 percent patients availed homeopathic Allopathic pharmacy and
kabiraj whereas only 1.9 percent patients used Unani. Occupations of the cases also have
influence in utilization of health care facilities. Among the Rikshaw-pullers 33.3 percent used
government facilities, kabiraj and homeopathic medicines. 100 percent driver/ transport labour,
fishermen and hotel boy usages government facilities whereas 20 percent service holder use it.
60 percent students availed government facilities whereas 75 percent housewives, 40 percent
18. advocates, 50 percent hawker and 16.7 percent day labourers use government facilities. 100
percent small business men /women, 60 percent government service holders, 60 percent private
employees, 66.7 percent teachers, 20 percent students and 25 percent housewives met private
doctors during the last 6 months, (all data given from Chandpur sadar hospital report book)
CONCLUSIONS:
There seems to be a distinct spatial variation in the patterns of attendance between low and high
income people, between low and high education level. The low income peoples mostly avail of
public health care facilities and they are experiencing much longer travel to primary care services
than other respondents. The high income people mostly use the private doctor’s facilities. The
poorer households have no choice to undertake frequently lengthy journey often to crowded
hospitals or public clinics. In the study area most of the respondents use Rikshaw as mode of
transportation. There are some high income respondents with private vehicles at their disposal.
Long waiting at the health centers discourages the people who consider it as potential loss of
wages or work hours. Many of the respondents did not be use the nearest facility due to reason
not explained. This is understandable in the context of Bangladesh, in mixed health care system,
spatial proximity does not necessarily equate with social or economic access. The reasons given
by respondents for not using the nearest facility are varied. If the poor class of patients do not use
public health facility nearby , they need to travel a long distance to get treatment which is many
case become impossible. The high income respondents traveled to doctors with whom a good
relationship is already established and who are situated either in the study area or outside the
study area.
19. Reference:
Frequently asked questions. World Health Organization. 2012. Retrieved 21
March 2012.
Jump up^ Staff (2011). Health Policy 2011 (PDF). Ministry of Health Family
Welfare, Government of the People's Republic of Bangladesh (in Bengali). Ministry of
Health Family Welfare, Government of the People's Republic of Bangladesh.
Retrieved 7 June 2012.
Jump up^ Staff (2007–2008). Home. Ministry of Health Family Welfare, Government
of the People's Republic of Bangladesh (in Bengali and English). Ministry of Health
Family Welfare, Government of the People's Republic of Bangladesh. Retrieved 7
June 2012.