Monday, 7 November 2016
Key themes discussed in the orientation sessions for top policy makers, health managers, academia, professional bodies of doctors and non-doctors, and journalists under the Building Awareness for Universal Health Coverage (UHC) in Bangladesh: Advancing the Agenda Forward in 2016
These included the followings:
Level of commitment and awareness varies among different groups of stakeholders
“We need commitment for UHC first and it has to be within our capacity, affordability and limited budget.” [DGHS, 3 Oct 2016]
“We blindly can’t follow other countries path… we need to understand our situation and based on our country context create our own path for UHC.” [DGHS, 3 Oct 2016]
“ We feel shy to interact and discuss because of limited orientation in this regard… but we need to come out of our shyness and participate” [Professional Bodies of Doctors, 6 Sep 2016]
“Journalists are aware about UHC, mostly through different programs arranged by PIB. We expected to learn new thing through this session…specific and updated data on related issues can be helpful for health reporting.” [Journalists, 24 Oct 2016]
Health system preparedness in the context of epidemiological and disease transition
“Medicine provided from the government sector are mainly for communicable diseases but we need to think about the burden arising from the NCDs also...” [DGFP, 16 Aug 2016]
“…the government facilities are not well prepared to address people’s need. As an alternative, the care seekers are moving towards private facilities.” [DGHS, 3 Oct 2016]
“Health services are mostly focusing on curative care but less on preventive care…Government of Bangladesh should do the other way round, e.g., initiating mass awareness program on preventive care in our country.” [Journalists, 24 Oct 2016]
Health workforce motivation, career prospect, relationship between health and allied professionals
“We need to have highly motivated health workforce and it is mainly their responsibility to take forward UHC..” [Senior government official, 11 Aug 2016]
“Career planning for professionals need to be specified in the public sector. Career prospect of allied medical professionals in the private sector is not clear…” [Professional Bodies of Non-Doctors, 27 Sep 2016]
“Mutual respect among health professionals such as between doctor-nurses, doctor-physiotherapists ,etc., could help to achieve UHC.” [Professional Bodies of Non-Doctors, 27 Sep 2016]
Wednesday, 31 August 2016
There is a saying that “life is not a bed of roses”, and who else other than the PhD student knows it best…especially if he is a late starter, have a full-time job to manage and a full-fledged family with three grown-up children! Yes, I am speaking about myself and my challenging journey in pursuance of knowledge and fame and all of its joys and pains! But it is a long story and I don’t want to bore you with that. Rather, I am going to tell you how I managed the most strategic and critical part of the process i.e., how I managed my PhD supervisor and got the work done. This I am doing because I think that this may be of help to those of you who are dreaming of doing it, and also because ‘To know the road ahead, ask those coming back’ (a Chinese proverb)!
But let me begin at the very beginning. First, what is a PhD and why bother about it? Practically speaking, it is an academic qualification which shows your worth as a researcher, is necessary for building career in academia, is recognized by the learned community the world over, and yes, it also helps in getting you a higher salary (Rugg and Petre 2; ch. 1.)! Besides, parental expectations, competing with spouse or colleagues, going abroad etc. are some other reasons for doing a PhD (Bellare, “The PhD Experience”). It involves “[…] doing a decent sized chunk of research, writing it up and then discussing it with professional academics” (Rugg and Petre 2; ch. 1).
Role of supervisor and student-supervisor relationship
PhD training is carried out under the guidance of one or more supervisor(s) and as such, the relationship between the two is vital for the successful completion of the process. This student-supervisor relationship is sometime compared to that of adolescent-parent where a fine balance is to be maintained between adolescent’s need to be independent and the parents anxiety to guide them away from harm (Phillips 6 Sept. 2005). He suggested good communication, honesty, sincerity and punctuality as some of the key virtues needed for success in the process. These issues are discussed in detail by Phillips and Pugh (“How to get a PhD”) and summarized for quick referral (Gauntlett, “How to survive your PhD”).
Thursday, 4 August 2016
Building awareness for Universal Health Coverage (UHC) in Bangladesh: pushing the agenda forward in 2016
Universal Health Coverage (UHC) means ‘every person, everywhere, has access to quality health care without suffering financial hardship.’ UHC has the potential to reduce the income-erosion effect of illness (high out-of-pocket expenditure, ‘catastrophic health expenditure’ ) and the risk of impoverishment for millions of people living in low and middle-income countries including Bangladesh. In recent times, Bangladesh has done remarkably well to improve the overall population health outcomes, which has been recognized globally. However, there is no scope for complacence as there still remain problems of taking health services to the door steps of people in the hard-to-reach areas, inclusion of vulnerable (women, children and ultra-poor) and hitherto left-out groups such as the LGBT population; adolescents, elderly and migrant population; and health system strengthening to ensure equity, quality and responsiveness.
UHC as a concept and a strategy for designing future health sector program is gaining momentum in Bangladesh, especially in the context of Sustainable Development Goals adopted by the global community in 2015. It can safely be said that Bangladesh has taken the first steps towards advancing the UHC agenda beyond 2015. Some key initiatives such as Health Care Financing Strategy 2012-2032, National Social Security Strategy 2015, and Communication Strategy for UHC 2014-2016 are testimony towards this commitment.
The non-government organizations (NGO), civil society organizations (CSO), and development partners have played an important role in initiating the discussion on UHC in Bangladesh since 2011-‘12. Experiences gained so far show that different stakeholders have different understanding of UHC including its meaning and scope, dimensions and priority setting processes. For mobilizing and consolidating stakeholder efforts in both the public and private sectors for UHC in Bangladesh, it is essential to come to a common understanding and broad consensus on the core concepts of UHC including its breadth (population and services to embrace) and depth (means and extent of financial protection).
Thus the general objective of the “Building awareness for Universal Health Coverage (UHC) in Bangladesh: pushing the agenda forward in 2016”programme is to build awareness on the core concepts of UHC including its scope and contents among different levels of stakeholders in the health, nutrition and population sector. The activities are expected to develop a ‘critical mass’ at the policy and practitioner level in the public and non-state sectors who can take an active role in making UHC a priority in GoB’s health policies and programs. The programme is funded by HFG Project of USAID and implemented by the James P Grant School of Public Health, BRAC University in partnership with the Health Economics Unit (HEU) of MOHFW and will leverage HEU’s already planned UHC communication strategy. To avoid duplication and build ownership and buy-in, this activity will also coordinate with other stakeholders such as WHO, GIZ, and the World Bank.
Monday, 29 February 2016
In September 2015, the UN General Assembly unanimously adopted the global Goals for Sustainable Development (i.e., SDGs), altogether 17 in number. Compared to the narrow, focused nature of the MDGs, the SDGs took a holistic view of development and put sustainable environment at its centre. The third goal is on health, stated as: ensure healthy lives and promote well-being for all at all ages. Beside Goal 3, other Goals e.g., Goal 1 (No poverty), Goal 2 (No hunger), Goal 4 (Quality education), Goal 5 (Gender equality), Goal 6 (water and sanitation), Goal 10 (Reduced inequalities), Goal 11 (Sustainable cities and communities), Goal 16 (Peace and justice), and Goal 17 (Partnerships) are linked to the health SDG 3.
Now, let us look closer to the targets. Under Goal 3, there are 9 programme targets and 4 implementation targets. Of the programme targets, 4 targets deal with the unfinished agenda of the MDGs, with some expansion. These are: reduce maternal mortality (3.1), end preventable neonatal and child mortality (3.2), end HIV/AIDS, TB and malaria +combat hepatitis, waterborne and other communicable diseases (3.3), ensure universal access to sexual and reproductive health services (3.7).
The new targets include reduction of mortality from NCDs and promote mental health (3.4), prevention and treatment of substance abuse (3.5), reduce deaths and injuries from road traffic accidents (3.6), and reduce mortality and morbidity from hazardous chemicals and air/water/soil pollution (3.9). The 4 implementation targets are: framework convention on tobacco (3a), access to, and research for, medicines and vaccines for all (3b), health financing and health workforce increase (3c), and finally, strengthen capacity for early warning, risk reduction and management of health risks (3d).
Now the question is: how to prioritise different activities which would have a bearing on advancing UHC in countries?