Bangladesh has made remarkable progress in human health and well-being in recent decades, however, there has been stagnation in the last decade, as reflected in various surveys conducted for assessing, e.g., maternal and neonatal health (MNH). These surveys also identified shortfalls in the quality of care (QoC) offered at Bangladesh’s primary health care (PHC) level. Globally, QoC is of concern as “more deaths in low- and middle-income countries are now occurring as a result of poor-quality care than owing to a lack of access to care”. Also, the rapidly changing socio-economic conditions in Bangladesh, urbanisation and population ageing have led to a shift in disease patterns and increased the burden of NCDs, another emerging public health problem in the country.  NCDs like hypertension (HTN) and diabetes mellitus (DM) put enormous pressure on health systems and society and risk congesting primary care and referral facilities while causing high out-of-pocket (OOP) expenditure for patients. PHC has been positioned as the cornerstone of the universal health coverage (UHC) movement. It emphasizes a “whole-of-government” and “whole-of-society” approach to health and combines “multisectoral policy and action, empowered people and communities, and integrated health services.

 

Blood transfusion (whole blood and components of blood) has become a critical healthcare service and has gained the status of essential medicine, especially in the LMICs. Blood transfusions are critical for treating severe anaemia, maternal haemorrhage, trauma-related injuries, supporting surgeries, managing chronic conditions, and improving overall healthcare quality. Despite their importance, there is a significant global shortage of blood and blood products, particularly in LMICs like Bangladesh, which requires over 900,000 units of blood annually. Currently, there are 204 BT centres in the public sector and 164 in the private sector in Bangladesh . These BT centres provide screened whole blood; only 24 centres provide blood components (e.g., packed blood cells, platelets and plasm concentrates).

Delivering non-communicable disease services through primary health care in selected south Asian countries: are health systems prepared?

In the South Asian region, delivering non-communicable disease (NCD) prevention and control services through existing primary health-care (PHC) facilities is urgently required yet currently challenging. As the first point of contact with the health-care system, PHC offers an ideal window for prevention and continuity of care over the life course, yet the implementation of PHC, to address NCDs is insufficient. This review considers evidence from five South Asian countries to derive policy-relevant recommendations for designing integrated PHC systems that include NCD care. Findings reveal high political commitment but poor multisectoral engagement and health systems preparedness for tackling chronic diseases at the PHC level. There is a shortage of skilled human resources, requisite infrastructure, essential NCD medicines and technologies, and dedicated financing. Although innovations supporting integrated interventions exist, such as innovations focusing on community-centric approaches, scaling up remains problematic. To deliver NCD services sustainably, governments must aim for for increased financing and a redesign of PHC service. (abstract).

1.                Ahmed SM et al. Delivering non-communicable disease services through primary health care in selected south Asian countries: are health systems prepared? Lancet Glob Health 2024;12: e1706–19. Published Online August 20, 2024.  https://doi.org/10.1016/2214-109X(24)00118-9

Just Transitions to mitigate antimicrobial resistance

 

Antimicrobial resistance (AMR) is among the most significant global health concerns of our time. In 2019, 1.27 million deaths were attributed to resistant bacterial infections, and by 2050, it is predicted AMR will cost upwards of $100USD trillion, accounting for 10 million deaths worldwide.  Antimicrobial resistance transcends borders, affecting communities in every region of the world. Poor and marginalized populations are among the most impacted by AMR, yet global discourse on policies and solutions often overlooks the challenges faced in these settings. Containing the spread of AMR, and avoiding a future where antimicrobials no longer work and common infections become potentially lethal, will require urgent and system-wide change. 

Just Transitions for AMR brings together social science and humanities researchers from diverse backgrounds and differentially affected regions to discuss what a just and equitable transition will mean for containing and mitigating AMR. The Just Transitions for AMR programme will explore how it could be adapted and used in the context of AMR.  The Just Transitions framework represents a different way of approaching systemic change, placing importance on effective social dialogue as a way to minimize challenges and maximize social and economic opportunities .