Health Care in Bangladesh
Bangladesh is a country in South Asia that borders Myanmar, India, Nepal and Bhutan. In 2019, the country’s estimated population was about 163 million people. Additionally, the country’s economy has shown an increase in exports and remittances in 2019. According to the World Bank, the country’s extreme poverty rate has reduced by half but people still consider it a developing nation. The country’s under-five mortality rate has declined in recent years as well as its maternal mortality rate. There has been an increase in malnourished children and lung diseases, however. There has also been an increase in health and safety in workplaces. Organizations both in the country and worldwide are helping to increase health care in Bangladesh.

5 Organizations Improving Health Care in Bangladesh

  1. World Health Organization (WHO): Based in Switzerland, WHO is a United Nations agency that focuses on international public health. In Bangladesh, the company provides medical aid such as vaccinations, medical research and alerts on medical outbreaks and emergencies. It also helps develop health policies, as well as monitor illness and disease trends in an attempt to prevent outbreaks. By offering these resources, the World Health Organization is improving Bangladesh’s health faster than before, which the organization’s research shows. The organization’s research shows that in 2018, 94 percent of new or relapse Tuberculosis cases received treatment, compared to around 60 percent in 2008. By introducing advanced medical techniques to the country, vaccinations and monitoring, WHO has been able to decrease the number of individuals who die from the illness.

  2. Bangladesh Department of Inspection for Factories and Establishments (DIFE): Bangladesh’s Ministry of Labor and Employment runs this organization and is responsible for the safety of factories, workplaces and their employees. Its job is to ensure the welfare, safety and health of all workers in Bangladesh. It ensures this by enforcing the country’s labor laws, as well as constantly updating policies to ensure employee safety. The organization has three departments including the Labor Department, the Department of Inspection for Factories and Establishments and the Department of Trade Union Registration. By breaking the organization into smaller departments, workplace health and safety has improved, as well as the number of businesses in the country. This increases jobs as well as job security because there is less fear of injury or illness from the workplace.

  1. Public Health Foundation of Bangladesh: The World Health Organization has established the Public Health Foundation of Bangladesh, which is a volunteer-based organization. HR experts, researchers, scientists, clinicians, nurses, sociologists and other health science experts lead this group. The goal of the group is to conduct research and provide education that will develop the Bangladesh health in both society and health care systems. The organization aims to improve health care access to Bangladesh citizens by making health care more affordable and easily accessible for individuals below the poverty line.

  1. World Lung Foundation: Established in 2004, the World Lung Foundation aims to increase global response to lung disease, an illness that kills around 10 million individuals annually. In 2017, lung disease made up 8.69 percent of the country’s deaths, which equals up to 68,462 people. The organization is decreasing the number by providing programs in Bangladesh, as well as emphasizing tobacco control, the negative effects of air pollution and how lung disease leads to illnesses such as Tuberculosis and acute respiratory infections. By educating Bangladesh citizens, Tuberculosis, maternal and infant mortality rates have dropped.

  1. USAID: A U.S. based agency, USAID has set up programs to help improve health and nutrition in Bangladesh. Because of this, the organization has helped decrease the under-five mortality rates, as well as maternal mortality rates. USAID has also expanded the use of family planning, improved and integrated health systems into Bangladesh, as well as strengthen the health care system and government. This leads to overall better access to health care, healthcare policies and better health practices.

Bangladesh’s extreme poverty rate has reduced by half, but the country’s population has been rising. With an undesirable health care system, organizations such as WHO and USAID have helped the country’s overall health improve, and has also decreased mortality rates. The DIFE and Public Health Foundation of Bangladesh have ensured the safety and health of individuals in the workplace and in society. Also, organizations such as The World Lung Foundation bring awareness to some of the leading mortality rates.

– Destinee Smethers
Photo: Flickr

Treating Tuberculosis in Bangladesh
Every hour, nine people die from tuberculosis in Bangladesh. High rates of poverty, overcrowding and a lack of information about the disease combine to make treating tuberculosis in Bangladesh particularly difficult.

As of 2017, 244,201 Bangladeshis were suffering from tuberculosis. Nearly 6,000 of these patients were infected with drug-resistant tuberculosis.

The Problem of Drug-resistant Tuberculosis

Improper tuberculosis treatment has led to the occurrence of drug-resistant tuberculosis. When physicians prescribe the wrong drug or dose, or when patients do not finish their entire course of treatment, the tuberculosis bacteria evolve to become resistant to that treatment. Multidrug-resistant tuberculosis (MDR-TB) poses a unique challenge in Bangladesh.

While regular tuberculosis is entirely curable with proper treatment, the cure rate for MDR-TB is only 50 percent. Treatment for regular tuberculosis takes as little as six months, while the treatment for MDR-TB takes up to two years. The extra treatment time hits poor families the hardest since more time in the hospital bed means less time at work. Tuberculosis, especially MDR-TB, can deepen the cycle of poverty.

Bangladesh Innovates Treatment Plans

Bangladesh doctors have pioneered a new treatment course that uses a combination of drugs at different doses and they have been able to reduce the MDR-TB treatment time to nine months. This new treatment lowers the cost of treatment from $4,000 down to below $1,000. Since health care resources are scarce, this improvement means that more lives can be saved. New community-based approaches have also been successful in treating tuberculosis in Bangladesh.

Community-based Approach

The new community-based approach has also been successful in treating tuberculosis in the country. In Bangladesh, treatment of MDR-TB was generally confined to a few national hospitals. But in 2012, the Ministry of Health, with support from the National Tuberculosis Program, launched a new approach: community-based programmatic management of drug-resistant tuberculosis (CPMDT). Although it has a long name, this approach has a very simple goal: to shift the focus of treatment away from national hospitals and toward a decentralized, community-based approach. Treatment is now supervised by Upazila-level health centers. An Upazila is a type of administrative region or sub-district.

Instead of staying in a hospital for the entire course of treatment, patients will only spend brief stints there before moving either home or to outpatient Upazila health centers.

DOT Providers Play a Crucial Role

Directly-observed therapy (DOT) means that a health care worker regularly observes the tuberculosis patient, prescribes the proper dosage and actually watches the patient take the proper dose. In the CPMDT intervention, DOT providers visit patients daily, taking the opportunity to screen family members for tuberculosis as well.

The new model also places more emphasis on psychosocial support. DOT providers counsel the patients, focusing on providing nutritional support and even vocational training. The Bangladeshi government even provides patients with a monthly nutrition stipend.

Overall, the intervention has increased the proportion of MDR-TB patients enrolled in treatment, reduced treatment delay and improved outcomes. Following this intervention in Bangladesh, researchers measured a 76 percent cure rate which is much higher than the global average of 56 percent.

Thanks to a dedicated government and devoted community health care workers, treating tuberculosis in Bangladesh has become a more manageable feat. The success of these decentralizing government interventions has promising implications and other governments can learn a lot from Bangladesh to improve their own health care outcomes.

– Ivana Bozic
Photo: Flickr