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]
“We can create health insurance fund
like collaborative fund in government sector for financial resource
mobilization. For private sector this can be made mandatory.” [Senior
government official, 11 Aug 2016]
“We spend 27 US$ per person per year and
do not have much scope to increase this. We need to be strategic in maximizing
the use of existing resources.” [Professional
Bodies-Doctor, 6 Sep 2016]
“We need no more medical colleges, no
more hospitals… rather better use of what we have” [Senior
government official, 11 Aug 2016]
“The service package can be divided into two
parts. There will be one basic part which will include the cost of basic
services like lab/diagnostic, medicine, operation. The second part will cover
the other costs like room rent.” [DGHS, 3 Oct 2016]
Efficiency of providers, responsiveness, timely
delivery of needed services, & appropriate referral
“If the doctor has to see 500 patients in
one working day obviously the quality of service will be hampered and there
will be hardly any client satisfaction.” [DGHS, 3 Oct
2016]
“We may see that doctors are referring
patients to upper-level hospitals without examining him or her. Behavior of
doctors is also an important factor to implement UHC in Bangladesh.” [Journalists,
24 Oct 2016]
“Minimum quality of doctors for proving
services should be standardized and provision for upgrading doctors’ quality
should be ensured.” [DGFP, 16 Aug 2016]
Governance and regulation
“UHC can be implemented if all the
services are being provided by the government sector, where a huge private
market is doing their business. Formulation of laws is necessary to have a
control over the private sector.” [Journalist,
24 Oct 2016]
“Capitalist approach does have some
benefits but we failed to ensure good governance, transparency in health
sector. Media is playing a role by covering service news, corruptions and we
can discuss more about the role of journalists.” [Journalist,
24 Oct 2016]
“The private sector has to be
regulated. A complete package of common
diseases/ healthcare services can be fixed such as a complete package for
appendectomy (operation cost, bed rent, diagnosis, drugs including all costs)
as per government hospital cost.” [DGHS, 3 Oct
2016]
Pharmaceutical
sector regulation
“The
health sector of Bangladesh needs strong regulation, especially in
pharmaceutical sector. Drug price has to be controlled to check high
out-of-pocket expenditures.” [Professional Bodies of
Non-Doctors, 27 Sep 2016]
“Streamlining
the regulations both for government and non-government sector will increase
efficiency of human resource for health.” [Professional
Bodies of Non-Doctors, 27 Sep 2016]
“By
opening a drug shop people are prescribing even acting as a doctor and we do
need a strong regulation to stop this in our country. If we failed to do this,
all the efforts will be wastage of resources as a total generation is growing
up with drug intolerance and this is like a ticking time bomb for our future.” [DGFP,
16 Aug 2016]
Inter-ministerial collaboration
“We
need a separate entity that will work on target based preventive initiatives,
inter- ministerial coordination, safe drinking water, food contamination and
relevant concerns” [Senior government officials, 11 Aug
2016]
“To
avoid fragmentation, duplication and wastage, awareness and sensitization of
both public and private sector is necessary. We can do it block wise, different
ministries can work on different blocks.”
[Senior
government officials, 11 Aug 2016]
“There are 105 safety net programme under
National Social Security Strategy. In 5
clusters Ministry of Finance, banking sector and others are working for the
programme. In our country, many other ministries are spending on health. We can
bring them all under the same umbrella.” [DGFP, 16 Aug
2016]
Data
& information system
“In Bangladesh there are no records of doctors’
professional activities, quality improvement or any disputes…no clinical record
available to rectify or improve. Data in this regards is essential to maintain
high standard.”
[Professional Bodies of Doctors, 6 Sep 2016]
“We took
different initiatives through community clinics, we are providing free drugs, both cash and kind to reduce
OOP and we need to get updated data on recent OOP status in the country to
formulate our strategy accordingly.”
[DGFP, 16
Aug 2016]
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