BANGLADESH

Prime Minister Sheikh Hasina seeks global support for community health care in developing countries

Prime Minister Sheikh Hasina on Tuesday said community based primary health care is the key to achieving universal health coverage, calling upon the global development partners to support the efforts in the developing nations to reach healthcare services to all.

She said, “We call upon our development partners, including multilateral financing institutions, to extend their support for the cause of community-centric health services in the developing world. We feel energized by your presence as we take an oath this year to accelerate our collective work on sustainable development and universal health,”  She said this in her closing remarks in the plenary session of the high-level side-event on “Sheikh Hasina Initiative of Community Clinics: Innovative Approach to Achieving Universal Health Coverage Inclusive of Mental Health and Disabilities” at the UN Headquarters, New York on the sidelines of the 78th UNGA session.

As an emerging voice of the Global South, the Premier said that Bangladesh would champion this issue as a possible avenue for meaningful international partnership. On our part, Bangladesh stands ready to share our insights and expertise with those interested. Health is at the root of all happiness. We wish to spread happiness all around through the community clinics.

The Prime Minister said she is profoundly grateful to the ministers and experts “who echoed their sentiments and pledged their support just now. We hope that this side event will remain yet another proof of our shared commitment to the health and well-being of all our people and communities.”

The Premier mentioned that they have realized that the revival and sustainability of community clinics would only depend on local people acting as their owners, stewards, and custodians. This model perhaps explains why 90% of service seekers express their satisfaction with community clinics.  In 2018, their parliament passed the Community Clinic Health Support Trust Act to further streamline operations and funding modalities.

The Prime Minister envisioned five priorities for the community clinics to take the healthcare services to the grassroots.

The five priorities included to make community clinics serve as gatekeepers at the grassroots to prevent huge out-of-pocket payments for health services; to enable community clinics to provide enhanced digital health and diagnostic services, especially for NCDs and to further develop the capacity of community clinics to address growing climate-induced health crises, like dengue outbreaks.

The remaining two are: to improve screening and treatment facilities for mental health and neurological disorders so as to provide accessible services to those affected and their families; and to use community clinics as the primary building block for a robust data-driven health and nutrition programme.

Sheikh Hasina pointed out that the community clinic is an idea that has stood the test of time in Bangladesh. It has now become an integral part of our primary health care system. The UN General Assembly has recognized the model as a best practice for the rest of the developing world.

She said she feels honored that the UN membership has recognized it as the “Sheikh Hasina Initiative”. In 1996, she said when she was first elected to office, community clinics were one of the innovative ideas they launched to promote ‘Health for All’.

She further said, “I was inspired by the vision of my father, our Father of the Nation Bangabandhu Sheikh Mujibur Rahman, to bring healthcare to our people’s doorsteps.”

Immediately after independence of Bangladesh in 1971, the Father of the Nation wanted to set up rural medical centres to provide a “minimum measure of medical relief” for the entire population. The community clinics are a realization of his dream and commitment.

She said that there are now nearly 14,500 Community Clinics that were designed to act as a one-stop centre for health, family planning, and nutrition-related services, are now operating around the country. The community clinics are playing a critical role in reducing infant, child, and maternal mortality.

She mentioned that around 3,000 community clinics offer facilities for skilled birth attendance. On an average, she said, there are 9.5 to 10 million visits to the clinics every month and among the service seekers, almost 80 percent are women and children. The community clinics have become the local hub for universal immunization and they played a crucial role in securing COVID-19 vaccination coverage.

There is also the scope for screening non-communicable diseases as well as mental health and neurological disorders, she continued.

Sheikh Hasina said, “We plan to use community health care providers to combat social stigma with mental health and extend psychosocial support where possible. It remains critical to update the training and competence of the community health workforce.”

At the community clinics, she said their government is providing 27 essential medicines and three family planning materials free of charge, adding, “We have decided to replace antibiotics with anti-diabetic and anti-hypertensive agents.”

The Prime Minister said, The community clinics act as a referral point for emergencies and complicated cases to higher medical facilities. The service providers are equipped with the internet and digital devices to record health data. They also engage in communication on social and behaviour change for health and disability-related issues.”

The community clinics are expected to cover 6,000 people each, she said, adding that they are based on a unique model of public-private partnership, with the local people providing the land and the government bearing the operational costs. They are managed by local representatives drawn from different segments of society, with the mandatory participation of women.

A video documentary on the role of community clinics in reaching healthcare services at grassroots level was also screened.

She said that in 2001, with the BNP-Jamaat government coming into office, the community clinics were abandoned and thrown into neglect for nearly seven years. Thematic Ambassador for Climate Vulnerable Forum (CVF) Saima Wazed addressed the event as keynote speaker.

Speaking at the event, Prime Minister of Sint Maarten Silveria Elfrieda Jacobs highly praised the community clinics model in Bangladesh to reach healthcare services to the every doorstep and achieve the Universal Health Coverage.

Deputy Minister of Health of Maldives Safiyya Mohamed Saeed said she was overwhelmed to address the event before such a strong female leadership Prime Minister Sheikh Hasina. She also highly praised the community clinic initiatives to make ways easier to reach healthcare services to all.

Foreign Minister Dr AK Abdul Momen, PM’s Energy Adviser Toufique-e-Elahi Chowdhury, ICT Division State Minister Zunaid Ahmed Palak, were present at the meeting. Permanent Representative to the UN Muhammad Abdul Muhith moderated the event while Bangladesh Ambassador to the USA Muhammad Imran was present.

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