Health Systems and Access

Research IdeasDhaka

May 28, 2015

Bangladesh PrioritiesWORKING WITH 30-50 economists including Nobel Laureates, 100+ sector experts engaging major development organizations, NGOs, government, businesses, youths, rural and urban Bangladeshis to identify, analyze and prioritize interventions that will deliver greater benefit per taka spent, helping move Bangladesh towards Vision 2021 and a more prosperous long term future.

In cooperation with the Research and Evaluation Division of BRAC,

Copenhagen Consensus Center organized roundtable discussions with

an aim to figure out smarter solutions to the most problematic issues facing

Bangladesh.

These roundtables are one of several sources

for research ideas.

Sourcing ideas and solutions

Smarter solutions for Bangladesh

Complete set of papers on 30-50 solutions

PRIORITIZATION

Government NGOs

Academia Pvt sector

Think tanks Developmentorganizations

Eminent Panel Assessment

Government and donor seminars

Rural polls Newspaper pollsamong readers

Youth forums across the

countryPrivate sector

meetings

Social, economic and environmental benefit-cost

research by top Bangladeshi, and

international economistsExtensive peer review by

sector experts and academics

100+ ideas on policies & investments

2016

2015

Continuous engagement

with the public via electronic,

print and social media

Working with civil society, government and sector

experts

Widely advocating results of

prioritization exercises

OUTREACH

Research Ideas

Health Systems and Access;(1 of 8)

• Establishing a level of service delivery affordable by the poor through government regulations on private clinics/hospitals.

• Making private sector health service accountable to DGHS.

• Decentralization of health professional’s recruitment process – from doctors to nurses.

• Install and use MIS through central level for greater transparency and accountability.

• A structured referral system, starting with a prescription from the Community Clinic/Community Health Worker, linked with a national level health database.

Health Systems and Access;(2 of 8)

• Invest to establish the referral linkage – from Community Clinics to urban level public, private specialized hospitals.

• Access to quality healthcare through a digitized service delivery system.

• Quality assurance/monitoring of drug companies.• Creating a National Health Service database with

patients’ medical history to reduce the need for multiple diagnostic tests.

• Increase doctor-patient counseling hours.• Ensuring primary health care for the urban poor. • Subsidize primary healthcare.

Health Systems and Access; (3 of 8)

• Deal with malaria in Bandarban and other Hill Tract areas.

• Provide universal health insurance coverage.• Incentives for public doctors working in hard-to-reach

areas.• Health awareness campaigns through SMS.• Private clinics and hospitals to allocate a certain

percentage of free beds for the poor. • Private sector to allocate a certain percentage of their

profits for serving the poor.• Clarifying the roles of public and private sector as per the

middle-income country (MIC) vision.

Health Systems and Access; (4 of 8)

• Monitoring compliance of the village and district level hospitals/clinics with DGHS’s regulations.

• LGED and MoHFW to coordinate working on urban health care system.

• More public health specialists, not doctors, for better administration and coordination.

• Better primary healthcare - more and better doctors in rural areas, more front line health workers.

• Retaining service providers at the Upazila level through incentives for career development.

• Ensure accountability of doctors at the Union level through available means (e.g. mobile phones, social media, UDCs, etc.).

Health Systems and Access; (5 of 8)• Develop institutional health system arrangements for

respective Hill District Councils.• Financial support for Community Clinics to reduce donor

dependency. • Use of electronic records to supplement the national

health/medical database. • Utilizing existing informal sector of health service delivery

particularly for hard-to-reach areas.• For containment of population (i) focus on long acting

permanent method (LAPM); (ii) target newly-wed couples, particularly adolescents to delay the first birth.

• Continue and expand counseling on population control and reproductive health and behavior in health care centers.

Health Systems and Access; (6 of 8)• Make effective use of government trained Community

Skilled Birth Attendants (CSBAs) and deployment of newly trained midwives in newly created posts at union and upazila.

• Building strategic partnerships with NGOs and private sector for strengthening and expanding newborn care.

• Expansion of medical waste management to cover all medical installations.

• Tribal-friendly health services through appropriate initiatives.

• Incorporate counseling, health rights and ethics in all medical, nursing and other education curricula along with proper sensitization initiatives for the existing health service providers.

Health Systems and Access; (7 of 8)• Capacity building of health managers at district and sub-

district levels on data analysis, health planning and monitoring.

• A population based database for community health management information system.

• Strengthening Bangladesh Medical Research Council to steward and coordinate all health sector research.

• Strengthen BSMMU’s research capacity to make best use of its resources.

• Address maldistribution of health personnel across regions.• Steps for empowering women’s decision making over

reproductive health through proper education and information.

Health Systems and Access; (8 of 8)• A 'disability' budget for each ministry. • Increase public expenditure to US$ 54 per capita to

cover a basic package of services, including interventions targeting NCDs.

• Free healthcare for RMG workers.• A comprehensive mental health service delivery plan to

address the growing psychological needs.• Expand TB diagnosis and treatment.• Continue implementation of Health, Population and

Nutrition Sector Development Program (HPNSDP) to strengthen and expand nutrition specific interventions among pregnant and lactating women, newborn babies, under-5 children and adolescent girls.

Full List of Attendees and Interviewees Dr. Md. Yunus, Consultant/Senior Scientist, ICDDR.Dr. Abdul Kuddus, Project Manager, PCP, Diabetic Association of Bangladesh.Dr. Jahiruddin Ahmed, Interim Chair, DM&N, BRAC University.Dr. Mahbub Elahi, Scientist, ICDDR.Dr. Mohammod Abdus Sabur, Consultant, Freelance.Dr. Quazi Al Mamun Siddiqii, Senior Manager-TB, BRAC.Dr. Musarrat Parvin.Tahsin Ifnoor Sayeed, M&E Specialist, DNET.Dr. Fida Mehran, Head Content (Deputy Director), DNet.Dr. Mahfuzur Rahman, Program Head, BRAC.Dr. Bayzidur Rahman, Assistant Professor, UNSW.Anita Sharif, Research Fellow, RED BRAC.

Iqbal Anwar, Scientist, ICDDR.Md. Mahbubul Kabir, Senior Research Fellow, BRAC.Nusrat Khan, Research Associate, RED BRAC.Dr. Tariqul Islam, PD, URB.Mr. Mashreky, Director, CIPRB.Moktadir Kabir, TB & Malaria Program ,BRAC.Md. Akramul Islam, Director TB, WASH and DECC, BRAC.