WELCOME HEALTH PROFILE BANGLADESH. MINISTRY OF HEALTH & FAMILY WELFARE (MOHFW)-BANGLADESH MOHFW is responsible to ensure basic health care to the people.

WELCOME WELCOME HEALTH PROFILE

BANGLADESH

MINISTRY OF HEALTH & FAMILY MINISTRY OF HEALTH & FAMILY WELFARE (MOHFW)-BANGLADESHWELFARE (MOHFW)-BANGLADESH

MOHFW is responsible to ensure basic MOHFW is responsible to ensure basic health care to the people of the country ; health care to the people of the country ;

At present the population is nearly 150 At present the population is nearly 150 million million

with a per capita GDP–US$ 421with a per capita GDP–US$ 421

MOHFW is the sector leader asMOHFW is the sector leader as It provides most of the HNP servicesIt provides most of the HNP services It manages & coordinates services of It manages & coordinates services of

non-govt. & private sector non-govt. & private sector

MANAGEMENT STRUCTUREMANAGEMENT STRUCTURE

Management structure follows the general Management structure follows the general administrative setting of the country;administrative setting of the country;

Secretariat –responsible for policy planning Secretariat –responsible for policy planning and decision making at macro-level. Headed and decision making at macro-level. Headed by Hon’ble Minister & staffed by civil by Hon’ble Minister & staffed by civil servants.servants.

Directorates –implementation wings staffed Directorates –implementation wings staffed by professionals and technical manpowerby professionals and technical manpower

• -Directorate of health services-Directorate of health services• -Directorate of family planning-Directorate of family planning• -Directorate of drug administration-Directorate of drug administration• -Directorate of nursing services-Directorate of nursing services• -CMMU-CMMU

Divisions -Divisional Directors office of Divisions -Divisional Directors office of (Six) health and family planning (Six) health and family planning responsible for support and HRD responsible for support and HRD function function

Districts-Civil Surgeons for district Districts-Civil Surgeons for district health (64) management & DD(FP) for health (64) management & DD(FP) for MCH-RH-servicesMCH-RH-services

Upazilas:Upazilas:

-UHFPO –Preventive & clinical -UHFPO –Preventive & clinical (460)health service (460)health service

-UFPO -FP & RH service-UFPO -FP & RH service

MANAGEMENT STRUCTURE MANAGEMENT STRUCTURE (continued)(continued)

STRUCTURE at PRIMARY STRUCTURE at PRIMARY LEVELLEVEL

RuralRural One HA for 8000-10000 populationOne HA for 8000-10000 population One FWA for 4000 populationOne FWA for 4000 population MA, FWV and Paramedic works in Fixed sitesMA, FWV and Paramedic works in Fixed sites

UrbanUrban FWs are not available according to the FWs are not available according to the

populationpopulation Vaccinator and Paramedic works in Fixed sitesVaccinator and Paramedic works in Fixed sites NGOs are taking part a major roleNGOs are taking part a major role

Source: HPSP Manual, Bangladesh: 2001Source: HPSP Manual, Bangladesh: 2001

HEALTH ORGANIZATION OF HNP HEALTH ORGANIZATION OF HNP SERVICE DELIVERY SERVICE DELIVERY

Public sector health system is Public sector health system is structured as a hierarchical structured as a hierarchical pyramid with 5 layers;pyramid with 5 layers;

3 at Primary3 at Primary

1 at Secondary1 at Secondary

1 at Tertiary1 at Tertiary

Level of Health Care SystemLevel of Health Care SystemTertiary level

Medical college hospitalPost graduate/specialized hospital

Secondary levelDistrict hospital; Maternal and Child Welfare Centre

Upazila health complex

Union sub centerHealth & family welfare center

Community clinic (for 6000 people)

Primary level

HEALTH SERVICE DELIVERYHEALTH SERVICE DELIVERYPRIMARY LEVELPRIMARY LEVEL

FacilitiesFacilities ServicesServices

Community Community clinic & home clinic & home visitationvisitation

FP, MCH, immunization, communicable FP, MCH, immunization, communicable disease control, treatment of common disease control, treatment of common problems & referral.problems & referral.

Union health Union health & family & family welfare centre welfare centre (4300)(4300)

Out patient services : FP, MCH, Out patient services : FP, MCH, communicable disease control, clinical communicable disease control, clinical care, normal delivery & adolescent health care, normal delivery & adolescent health care.care.

Upazila health Upazila health complex, complex,

(414)(414)

Out patient services, impatient services Out patient services, impatient services (31-50 beds) with diagnostic and (31-50 beds) with diagnostic and operative treatmentsoperative treatments

HEALTH SERVICE DELIVERY HEALTH SERVICE DELIVERY SECONDARY LEVELSECONDARY LEVEL

FacilitiesFacilities ServicesServicesDistrict District Hospitals Hospitals (64)(64)

Out door & Indoor Services Out door & Indoor Services (50-250 beds) with (50-250 beds) with laboratory, radio graphic & laboratory, radio graphic & ambulance servicesambulance services

Maternal Maternal & Child & Child welfare welfare Centre Centre (64)(64)

EOC and other related EOC and other related servicesservices

INSTUTUTIONS FOR HEALTH INSTUTUTIONS FOR HEALTH MANPOWER DEVELOPMENT MANPOWER DEVELOPMENT

1 Medical University 1 Medical University 15 Medical College 15 Medical College 8 Post graduate institute 8 Post graduate institute 2 Institute of Health Technology 2 Institute of Health Technology 8 Medical Assistant Training 8 Medical Assistant Training

School School 1 Nursing College 1 Nursing College 38 Nursing Institute 38 Nursing Institute

Major Health Programme-BangladeshMajor Health Programme-Bangladesh

Health Education and

Promotion

Communicable Disease Control

Mycobacterial Disease (TB,

Leprosy) Control

National AIDS Control Programme and

Safe Blood Transfusion Programme

Public Health Interventions

& Non-Communicable Disease Control

Essential Services Delivery

(ESD)

Health Programmes

Reproductive Health

Child Health (EPI, ARI, CDD,

IMCI, School Health Programme

Limited Curative

Care

Emerging & Re-emerging

Diseases

Filariasis Eliminatio

n

Vector Borne Disease Control

(malaria, Kala-Azar, Dengue)

Prevention and Management of

Non-communicable Disease

Emergency Preparedness & Response

Interventions relating to

Arsenicosis and other PH

interventions

Health of senior citizens, adolescent

& young peoplesInjury prevention,

management & violence against

women

Environmental and

occupational Health

Country reported Data for Country reported Data for Basic Health IndicatorsBasic Health Indicators

IndicatorIndicator Latest Latest available available

datadata

YearYear

Number of hospital bedsNumber of hospital beds 51,64851,648 20052005

Population per hospital Population per hospital

bedbed 25712571 20052005

Hospital beds per 10,000 Hospital beds per 10,000 populationpopulation

3.433.43 20052005

Number of physiciansNumber of physicians 4288142881 20052005

Population per physicianPopulation per physician 31693169 20052005

Physicians per 10,000 Physicians per 10,000 populationpopulation

33 20052005

Population per nursesPopulation per nurses 64426442 20052005

MAJOR HEALTH INDICATORS

Bangladesh has made considerable progress over the last decade in improving the health status;

Life expectancy at birth -65.1 yrs

IMR per 1000 live births -52

U-5 Child mortality rate per 1000 live births -65

MMR per 1000 births -3.65

Total Fertility Rate -2.7

Contraceptive Prevalence Rate -56%

Full vaccination coverage (12-23 months children) -82%

Attained and sustaining “Polio-free” status

Trends in Total Fertility Trends in Total Fertility RateRate

3.4 3.3 3.33

2.7

1993-94 BDHS 1996-97 BDHS 1999-2000 BDHS 2004 BDHS 2007 BDHS

Source: BDHS 2007

Trends in Childhood Mortality Trends in Childhood Mortality RatesRates

41

65

24

88

37

52

14

65

NeonatalMortality

Infant Mortality Child Mortality <5Yrs Mortality

2004 2007

Deaths per 1,000live births

Source: BDHS 2007

RISKS AND CHALLENGES

1. Relatively high MMR due to lack of antenatal & obstetric care.

2. High level of malnutrition from both –Protein energy malnutrition–Micro-nutrient deficiencies

3. Emerging and Re-emerging diseases-HIV/AIDS, TB, Malaria, Arsenicosis, Accidents & Injuries

4. Demographic & epidemiological transition accelerates-Non-Communicable diseases

5.5. Low utilization of HNP servicesLow utilization of HNP services