Basic health service to breathe in, again
September 13, 2009
Roundtable praises govt's move to make community clinics functional
Staff CorrespondentThe project on community clinics, awaiting approval of Executive Committee of National Economic Council, will help ensure basic health services for the grassroots people, said Additional Secretary of the health ministry, Makhduma Nargis.
She was speaking at a roundtable titled "Community Clinic -- Effect on Health Services" jointly organised by The Daily Star and Health 21, a platform for health rights activists.
Health experts welcomed the Awami League government's move to make the community clinics functional.
The previous Awami League government started setting up community clinics for every 6,000 people in rural areas in 1998. About 11,500 such clinics had been established by 2001.
But they have remained non-functional since then. Now the present government has taken initiative to set up another 6,500 clinics and make the existing ones functional.
There is no alternative to making community clinics functional to provide people with door-to-door health service, said experts at the roundtable.
The project includes recruitment of permanent health workers for community clinics, which would remain open from 9:00am to 3:00pm, said Makhduma Nargis, also the project director, at the conference room of The Daily Star.
Health and family welfare ministry prepared the project titled “Revitalization of community health care initiatives in Bangladesh.”
Presenting the keynote paper, she elaborated on the purposes and principles of the community clinics and formulation of community groups that would run the clinics.
The project director said the community clinics would provide many services including primary health care, immunization, vitamin-A supplementation, treatment of diarrhoea, identification and treatment of anaemia among women and adolescent girls, antenatal and post-natal care, infant care, and birth and death registration.
The clinics would not have any doctors but health assistants and family welfare assistants who would refer patients to various hospitals for better treatment, she added.
Prime Minister's Health Adviser Prof Syed Modasser Ali said a demand for community clinics has to be created among people if the clinics are to survive in future.
"Community clinics are people's institutions, not government organisations. It's the people who own them," he said.
Modasser said they want the community clinics to become an asset to the people.
It is essential to make sure the community clinics function properly and the health and family welfare assistants deliver services to people uninterruptedly, said health experts.
They also suggested increasing the service coverage of the clinics through appointment of full-time health workers.
Dr Abu Jamil Faisel of Engender Health stressed the need for a policy to introduce a unified health service system at the grassroots level.
Dhiraj Kumar Nath, former adviser to a caretaker government, said the government must not make a political issue of the community clinics.
The speakers also discussed the issues of involving NGOs and local government with the process for smooth functioning of the clinics, budgets for the clinics and coordination between upazila health complexes, upazila parishads, community clinics and union sub-centres.
Dr Zeba Mahmud of Health 21 stressed the need for engaging female upazila vice chairmen with community groups.
Prof Abul Barakat of department of economics of Dhaka University (DU) in his speech said bureaucratic tangle has been a major problem in implementing such projects.
It would be a violation of the constitution if basic healthcare services are managed through public-private partnership, he said.
Community clinics are a must and the government has to find out ways to include those in the main health service system, he added.
Prof AKM Nurun Nabi of population science department of DU, Dr Shaheen Akhter of Health 21, Prof Dr Rubaiul Murshed, executive director of Health 21, Dr Rumana Dowla, Dr SM Kamal, Maj Gen (Retd) Dr M Shahjahan, Dr Muhammad Yunus of DGHS, Dr Lutfar Rahman, project director of Ahsania Mission Cancer and General Hospital, Runa Khan, executive director of Friendship, Dr Jahangir Hossain, programme director (Health) of Care Bangladesh, Dr Tofail Md Alamgir Azad, project director of Dustha Shastha Kendra (DSK), among others, were present.
Dr Mazharul Mannan of Health 21, Saqui Khandoker of Plan Bangladesh, Dr Rishad Robin, SM Mushfiqur Rahman, executive of Health 21, MA Qayyum, director general of Directorate General of Family Planning, Dr Mohammad Aminul Haque, health coordinator of DSK, ABM Jahangir Alam, former director of primary healthcare, DGHS, Mohammad Zobair Hasan of DORP, Jalaluddin Ahmed of BRAC and Dr Razzaqul Alam of Plan Bangladesh, among others, spoke.
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