Healthcare in Bangladesh
Healthcare in Bangladesh is not as sophisticated as in more developed countries; however, the country is working to improve and provide further funding to its healthcare system. So far Bangladesh has made great strides in increasing healthcare access for its people, but there is still a long way to go. Here are seven important facts about healthcare in Bangladesh.

7 Facts About Healthcare in Bangladesh

  1. Bangladesh has a pluralistic healthcare system. This healthcare system is highly decentralized. As a result, it is regulated and controlled by for-profit companies, NGOs, the national government and international welfare organizations. This shared power has caused many problems, including unequal treatment programs between social classes. Even though the laws and overall system are spearheaded and steered by the Ministry of Health and Family Welfare, other organizations have considerable influence on the decision-making.
  2. There is a shortage of physicians, specialists and clinical equipment. In Bangladesh, the number of physicians per 10,000 people is only about 3.06, which is significantly low. The number of nurses per 10,000 people is even lower, standing at 1.07. Additionally, only 35% of health and clinical facilities in the country have more than 75% of sanctioned staff working and there is a 36% vacancy in sanctioned healthcare workers. There is also a 50% vacancy in alternative medicine providers. These numbers are one of the reasons that Bangladesh’s quality of healthcare is low compared to many other Asian countries.
  3. Non-communicable diseases are the leading cause of death in Bangladesh. Most deaths are caused by cardiovascular diseases, cancers, diabetes, chronic respiratory diseases and malnutrition. There are almost no alcohol-related deaths due to alcohol consumption and sale being illegal in the country. A 2016 study by the World Health Organization (WHO) found that tobacco usage has decreased for both men and women, with only 23% of the population using tobacco products. Obesity has remained low, rising slightly, but still only affected 2% of adolescents and 3% of the adult population. However, poor nutrition is still prevalent, leading to diabetes and high blood pressure.
  4. Most physicians and healthcare workers are concentrated in urban areas. Rural areas often do not have proper healthcare facilities. To remedy this, the national government has set up many government-funded hospitals in rural areas that provide cheaper treatment for rural citizens. However, these hospitals are often poorly funded, understaffed and overly crowded due to a limited number of healthcare options in rural areas.
  5. Enrollment in medical colleges and healthcare training facilities has increased. This will benefit the country by increasing the number of healthcare workers in proportion to the population. However, this is only a recent trend and these future healthcare workers must complete their education and training before being able to fully practice their professions. The HPNSDP (Health, Population and Nutrition Sector Development Program) have already begun drafting and implementing a plan to further increase the number of nurses and midwives through training and education facilities.
  6. Socioeconomic inequality affects healthcare in Bangladesh. One area this can be seen in is infant mortality. The infant mortality rate for the lowest income quintile is 35 deaths per 1000 births, while infant mortality for the highest income quintile is only 14 deaths per 1000 births. One of the main reasons for this inequality is that most poor Bangladeshis live in rural areas that do not have adequate hospital facilities. However, even in urban areas, socioeconomic inequality has a large impact. A person with more money is generally able to receive better healthcare than someone who is poorer and cannot afford certain treatments or services. This is due to the fact that the healthcare system is decentralized and partially run by for-profit healthcare and pharmaceutical companies.
  7. Limited government funding has led to high out-of-pocket payments. One of the other reasons poorer citizens in Bangladesh cannot afford certain treatments or services is high out-of-pocket costs. On average, Bangladeshi citizens must pay 63.3% of the total cost, while the government pays the rest. This system creates a significant financial burden for impoverished families, sometimes forcing them to either forego treatment or go into debt. To reduce this burden, the government must increase healthcare funding.

These seven facts about healthcare in Bangladesh illustrate some of the barriers that Bangladesh must overcome to provide high-quality healthcare across the nation. The Bangladeshi Government’s constitution upholds that all citizens will be provided with equal treatment, including in healthcare. To achieve this, the government needs to address the current inequality and continue to make healthcare a focus of its efforts.

Sadat Tashin
Photo: Flickr

Engineers Against Poverty
Engineers Against Poverty mobilizes engineers around the globe to fight poverty through more effective, transparent and equitable infrastructure development. Founded with an engineering focus, the U.K.-based group has expanded its work to improve ways of life in low- and middle-income countries by advocating for ethical working conditions, mitigating the effects of climate change and reducing poverty worldwide. As a massive infrastructure funding gap stands in the way of global poverty relief, Engineers Against Poverty works to empower a multi-sector network to improve infrastructure policy and practices.

Infrastructure and Global Poverty

Engineers and infrastructure development play a vital role in the fight against global poverty. According to the Asian Development Bank, poverty reduction requires not only well-governed economic development, but also improved infrastructure for irrigation, electricity, water and sanitation and other basic needs. In 2016, Our World in Data reported that 40% of the globe experienced water scarcity and 13% of the world did not have electricity. In 2015 and 2016, one-third of the global population did not have access to an all-weather road. Engineers Against Poverty explains that infrastructure will play a vital role in achieving the United Nations Sustainable Development Goals, which were released in 2015 to be achieved by 2030.

“For EAP, its goal is to scale up influence on global infrastructure policy and practice to promote sustainable social, climate and economic impacts that contribute toward the elimination of poverty,” Engineers Against Policy Senior Communications Manager Charlotte Broyd said.

The Infrastructure Funding Gap

One of the greatest barriers to global poverty reduction is a massive infrastructure funding gap. At the 2015 release of the United Nations Sustainable Development Goals (SDGs), the World Economic Forum reported the infrastructure funding gap would prove the biggest challenge to meet the SDGs. The World Economic Forum explained that there exists a $15 trillion investment gap between the money needed and the existing funding to reach “adequate global infrastructure by 2040.” This gap, Engineers Against Poverty explains, must be tackled as a “governance challenge.” Up to one-third of global investment in infrastructure is lost to mismanagement in governance, particularly in low-income countries.

Broyd commented, “There is a role for many stakeholders in addressing the infrastructure investment gap (governments, international organizations as well as donors). For donors specifically, they can help by recognising the importance of transparency and accountability in the infrastructure sector and the need for support to initiatives and others promoting these principles. This is particularly important in the coronavirus pandemic and the ensuing economic crisis where any economic loss must be minimized.”

The World Bank has identified collaboration between the private and public sectors as a key approach to closing the infrastructure funding gap. The former managing director of the World Bank explained at the release of the SDGs that to help mitigate these investment hazards, investors and donors must make more comprehensive investments in policy, insurance, regulation and more to make their investments effective.

Engineers Against Poverty’s Infrastructure Transparency Initiative

Engineers Against Poverty’s global Infrastructure Transparency Initiative (CoST) is key to closing this infrastructure funding gap. CoST, which currently works in 19 countries, encourages collaboration between civilians, engineers and policy-makers to work toward “improving transparency and accountability in public infrastructure” to reduce investment losses to mismanagement and corruption.

CoST has already seen success in many countries, including Thailand, where transparency, competitive bidding, decreasing contract prices and more efficient fund management have saved the country $360 million in infrastructure spending since 2015. In Afghanistan, CoST-prompted contract reviews saved the country $8.3 million in just one year for road-network maintenance.

The initiative focuses on increasing infrastructure project transparency by improving data disclosure, ensuring data is accessible to the public, creating social accountability for decision-makers and empowering civilians and communities to advocate for better infrastructure governance and delivery. By 2018, CoST had helped disclose data on around 11,000 projects through accessible platforms. CoST has also established legal mandates and disclosure commitments with governments in many countries.

“Our experience indicates that informed citizens and responsive public institutions help drive reforms that reduce mismanagement, inefficiency, corruption and the risks posed to the public from poor quality infrastructure,” the CoST website explains.

A key feature of CoST is citizen engagement and media attention, which enables civilians to hold their policy-makers accountable and make the infrastructure funding gap a priority for civil society. “CoST has enabled citizens to advocate for quality infrastructure through community events in several of its countries including Uganda, Ghana, Malawi and Thailand,” Broyd said. “Simply by raising the issues affecting them, citizens give the media powerful stories to report, which has generated much good publicity.”

CoST therefore illustrates the importance of involving citizens in solving poverty locally, nationally and globally. The combined efforts of engaged civilians and Engineers Against Poverty stand to make important headway in the fight against global poverty.

Emily Rahhal
Photo: Pixabay

Celebrities and Global Poverty
Many organizations focus on eradicating global poverty, which remains a persistent and important problem. Two-thirds of the world population lives on less than $10 per day, and one in 10 people live on less than $1.90 per day. One organization working to address this issue is the Global Poverty Project (GPP), which has partnered with other organizations such as the World Bank and the United Nations to create a movement aiming to eradicate global poverty by 2030. The GPP’s initiatives have helped increase global poverty awareness, and many celebrities fighting global poverty have supported the cause. Here are some campaigns that the GPP has headed, along with some of the celebrities that have helped fund them.

The Global Citizen Festival

The Global Citizen Festival is the project’s annual event, which draws over 60,000 people in attendance and over 20 million people tuning in via livestream. It is a music festival that raises money and awareness of global poverty issues, with the ultimate goal of removing global poverty by 2030. Through the festival platform, patrons (or “Global Citizens”) are able to learn about the causes of global poverty, as well as the part that they can play in reducing it.

In 2012, the festival helped the GPP raise over $1.3 billion in pledges toward the fight against poverty, in conjunction with other charities. Music stars such as Beyonce, Lady Gaga, Shawn Mendes and Rihanna have all participated in Global Citizen concerts over the years, cementing their status as celebrities fighting global poverty.

Becoming a Global Citizen

Global Citizen is the GPP’s individual campaign movement that allows people to engage with both the organization and its embedded community. Through an app, Global Citizens are challenged to make small actions, commitments and announcements about global poverty, which add up to significant change in areas such as education and sanitation. These actions come in the form of contacting leaders and signing petitions. The Global Citizens site also helps to inform people about the leading issues in global poverty.

Global Citizens’ actions help to influence policy and political leaders. Participants have taken over 25.2 million actions through the app, committed $48.4 billion to fight poverty and impacted more than 880 million lives thus far. Music artists and bands such as Clean Bandit have also held concerts to promote awareness and increase monetary commitments to these issues.

In addition to musicians and artists who contribute to the GPP, famous actors have funded anti-poverty causes and become representatives for certain issues. Idris and Sabrina Elba have spearheaded campaigns to help African farmers, raising awareness about the harmful impacts of climate change. By supporting the Elbas’ cause and contacting world leaders, fans are able to help over 100 million rural farmers.

Other celebrities fighting global poverty who have supported GPP’s campaigns and contributed to fundraising include The Weeknd, Usher, Bruno Mars and Janet Jackson.

A Global Impact

Overall, the work of the GPP has impacted over 800 million lives across the world so far. By including celebrities fighting global poverty, the GPP has seen astonishing results, and the organization stands ready to help achieve the international goal of eradicating global poverty by 2030.

Kiana Powers
Photo: Wikimedia

Healthcare in Nimiba
Namibia aims to improve the accessibility and quality of its healthcare system. Namibia is an upper-middle-income country located in southern Africa. Unfortunately, as it became an upper-middle-income country, Namibia’s healthcare fell behind. The country must overcome obstacles to continue improving its healthcare system. These obstacles include a shortage of doctors, inadequate funding and income inequality. The country also faces HIV/AIDS and tuberculosis crises. Despite its economic progress, Namibia has the sixth highest HIV prevalence rate in the world. This article covers this nation’s efforts to ensure its citizens have access to quality healthcare.

Healthcare Structure

Namibia gained independence in 1990. In its early years, the government declared healthcare a human right and made systemic changes to its healthcare system. The Ministry of Health and Social Services (MoHSS) formed. The MoHSS is responsible for implementing policy and delivering primary healthcare to Namibians.

Namibia has one of the lowest population densities in the world with about three people per square kilometer. According to The World Bank, 48.9% of Namibians live in rural communities. Therefore, providing access to healthcare is a significant challenge.

Namibia’s healthcare system consists of four distinct components: intermediate and referral hospitals, clinics, health centers and district hospitals. Each component has a unique role and specialized medical staff. For example, nurses staff clinics who provide basic care. People receive referrals to a health center or a district hospital for more serious cases. The most serious cases obtain treatment at intermediate and referral hospitals. Namibia houses “1150 outreach points, 309 health centers [and] 34 district hospitals.”

Namibia’s bed-to-population ratio is equivalent to that of higher-income countries including New Zeland and Norway. However, because of Namibia’s low population density, about 21% of Namibians live more than 10 km away from a health provider. The MoHSS partners with private organizations like USAID SHOPS to provide mobile health clinics. Mobile health clinics help reach rural communities in Namibia. They provide a range of services including immunizations, health education and HIV tests. Both the private and public sectors fund the mobile health network.

Funding Healthcare

In 2014, Namibia spent $200 million to prevent and treat HIV cases. Unfortunately, despite the work of the MoHSS, the leading cause of death is from non-communal diseases like HIV/AIDS and tuberculosis. In 2019, approximately 210,000 adults and children were living with HIV in Namibia; about 11.5% of these adults and children are between 14 and 49. Thankfully, Namibia is not alone in fighting against the virus; organizations including the U.S. Center for Disease Control and Prevention help with technical assistance and workforce recruiting.

The Namibian government aims to spend 15% of its GDP on healthcare. However, Namibia only spent about 8.6% of GDP on healthcare in 2017. Funding from donors has been declining since Namibia’s reclassification in 2009. The decrease is because of Namibia’s reclassification as an upper-middle-income country. In 2008, donors made up 22% of the country’s healthcare funding. In 2017, donors funded 7% of Namibia’s healthcare expenditure.

A variety of other sources fund Namibia’s healthcare system: 19% from the private sector, 11% from households and 63% from the government. Namibia needs additional funding to improve its healthcare system, especially as its GDP growth slows. Additionally, healthcare costs will increase as the country’s population ages.

Healthcare Workforce

Another of Namibia’s largest healthcare problems is the lack of public doctors. There are more private doctors than public doctors in many regions of the country. In Hardap, 80% of the doctors work in the private sector. A shortage of public doctors increases the cost of healthcare. According to The World Bank, there are approximately 1,222 doctors; 784 doctors work in the public sector and 438 work in the private sector. Half of Namibia’s physicians work in Khomas, the region containing Namibia’s capital. In 2018, there were approximately 0.33 doctors for every 1,000 people.

Namibia is working to address the shortage of public doctors; the Namibian government is supporting medical students’ education, hoping doctors and nurses will enter the public sector. In 2019, Namibia sponsored about half of its medical students.

Many issues persist within the Namibian healthcare system. Fortunately, groups like the Namibian government and the U.S. Center for Disease Control and Prevention have dedicated themselves to improving healthcare in Namibia. Hopefully, by making investments like supporting medical students’ education, Namibia will improve its healthcare system.

Joshua Meribole
Photo: Unsplash