The Ministry of Health & Family Welfare (MOHFW) in collaboration with CARE Bangladesh and GlaxoSmithKline (GSK) organized a round table titled “Human Resources for Health: Foundation for Universal Health Coverage and the post-2015 development agenda” on November 3, 2013. Md. Zillar Rahman, Additional Secretary & Line Director Human Resource Management (HRM), Ministry of Health & Family Welfare presided over the discussion. Two papers were presented on the discussion topic. First one was presented by A.K.M Zafar Ullah Khan, former Secretary MOHFW on behalf of CARE and GSK. Again the second paper was presented by Md. Asadul Islam, Director General, Health Economics unit (HEU), MOHFW. A. K. Keynote papers showed the present scenario of health service facilities and health professionals in Bangladesh. M. Zafarullah Khan moderated the round table discussion. Participants expressed that though Bangladesh has developed a comprehensive network of government health facilities to provide maternal, neonatal and child health services down to the community level, there is severe shortage of skilled health workers in the places where they are most needed. The workshop and the round table discussion identified the major issues and challenges like shortage of skilled workers, skill-mix imbalance and mal-distribution of human resource for health, inadequate educational and training facilities, low quality of human resource for health, inefficient allocation of resources, lack of incentives and proper remuneration, absence of monitoring and information, lack of regulatory arrangement for private provider, migration of Health Workforce, absence of the development plan and week governance. In the third Global Forum about Human Resources for health (HRH) hosted by Brazil on November 2013, Bangladesh Government will raise voice for increasing awareness about health workforce issues and elicit new HRH commitments to build the health workforce needed to achieve Universal Health coverage.
Experts prescribe more aid for poor expectant mothers
In a seminar on ‘Evaluation of the Impact of the Voucher and Accreditation Approach on Improving Reproductive Behavior and Reproductive Health Status: Bangladesh’, jointly organized by Population Council and the Ministry of Health and Family Welfare at the BRAC Center INN in the capital. Experts expressed that more upazilas need to be brought under the ‘Demand-side Financing’ project to render financial support to extreme poor pregnant women to ensure safe motherhood. They pointed out that if a poor pregnant mother gets facilities to receive antenatal and postnatal cares, including free caesarian as per their physical complications, maternal and child mortality will come down in the remote areas of the country. Three final reports on demand side, supply side and voucher programmes were presented by Population Council during the function. The chair of the event Dr. Ubaidur Rob, Country Director of Population Council stated that Bangladesh has made significant progress in several demographic and economic indicators in the recent years. He also noted that the Health ministry has introduced Demand Side Financing (DSF) program to address some issues related to mother and child care and now the DSF program is being expanded in phases. Speaking as chief guest, MM Neaz Uddin, Health and family Welfare Secretary appreciated the evaluation reports which will help government to revise the project in a very efficient way so that poor pregnant mother feel encourage being a recipient of Voucher and Demand Side Financing card. Director-General of the Directorate of Family Planning A. K. M Amir Hossain, Dr. Mohammad Sharif and Director, MCH, of the Directorate of Family Planning as the special guests, were present in the event. The programme was moderated by Dr. Syed Abu Jafar Md. Musa, Director – Primary Health Care and Line Director of Directorate General of Health Services.
Call for new health policies
In Dhaka, analysts had a discussion on the final report of the Bangladesh Demographic and Health Survey (BDHS) 2011 and policy implications, giving thoughts to health policymakers who will soon review the ongoing sector development programme, HPNSDP. New projections show Bangladesh’s population for the first time is hovering below 200 million now and will reach 194 million in 2050. Analysts also added that Bangladesh’s health sector has come a long way but new issues are emerging that call for reforms with more targeted and innovative policies. With ‘exceptional’ progress in child health and survival, causes of under-5 deaths are changing in Bangladesh, which needs changing public health system to address the issue. But consistent economic growth could not improve the nutritional situation of the country that demands breaking the ‘vicious cycle’ of malnutrition with lifestyle approach. On the other hand, with the increasing trend of overweight, more people are now suffering from diabetes and high blood pressure than before. Health and Family Welfare Ministry’s Senior Secretary Md Humayun Kabir stated that the final BDHS report would help the government modify the ongoing health, population and nutrition sector programmes. He also noted that regarded as a ‘quality’ source of information by policymakers and researchers to plan, monitor and improve programmes under the health ministry, the periodic survey is being conducted every three to four years since 1993-94 with the support of USAID. Dr Ishtiaque Mannan, Chief of Party of USAID’s MCHIP project pointed that human resources issues should be addressed on a priority basis in the health sector. Dr Tahmeed Ahmed, Director of ICDDR,B’s Nutrition Division suggested promoting dietary diversity through nutrition-friendly agriculture as food being available does not necessarily imply good diet. As the BDHS also showed 25 million people aged above 35 years are hypertensive or pre-hypertensive that leads to development of hypertension and 17 million are diabetic or pre-diabetic, Dr Shamim Haider Talukder, CEO of Eminence, an NGO, suggested effective prevention strategies to avoid huge treatment costs.
Separate allocation required to improve nutrition of children
On 7th November in a seminar organized by the Bangladesh Breastfeeding Foundation at International Centre for Diarrhoeal Disease Research, Bangladesh Child health and nutrition experts suggested that the government should allocate separate funds for improving nutrition of children living below the poverty line. Director general of directorate general of health services Khandker M Shefaetullah while attending the event as the chief guest, expressed that the country is lagging behind in achieving nutrition level. He also emphasized on making nutrition related understanding clear among the mass people in the country..Khurshid Talukder, senior consultant of pediatric department and also the research coordinator of Centre for Woman and Child Health stated that Centre for Woman and Child Health conducted a study on a limited number of children living in Dhaka, Rangpur and Kurigram districts from March 2013 to August 2013 and it was found that there were some barriers which affect health seeking for the children with acute malnutrition. Many of the children were living in the families overburdened with microcredit loans. Again most of the families cannot afford food three times a day and even sometime they take one meal a day. They have to skip rice very often from their meal. SK Roy, chairperson of BBF, put emphasis on the necessity of using budget appropriately to increase the service at health facilities. Among others, M Lutfor Rahman, director of Institute of Public Health Nutrition was present in the occasion.
Fertilizer subsidy fixed at Tk 9,082cr for current fiscal year
The fertilizer subsidy for the current 2013-14 fiscal year has been estimated at Tk 9,082 crore, down by Tk 218 crore spent in the previous fiscal year as a stimulus to boost agriculture production in the country. Agriculture ministry and Bangladesh Agriculture Development Corporation (BADC) and senior officials from finance ministry recent meeting at the finance ministry, finalized the subsidy amount on fertilizer. Of the Tk 9,082 crore, Tk 1,975 crore will be carried forward from the previous fiscal year as outstanding subsidy demand. The meeting, based on the demand placed by the agriculture ministry, estimated Tk 3,111 crore as subsidy against urea fertilizer, Tk 1,359 crore against Triple Super Phosphate (TSP), Tk 1,260 crore for Muriate of Potash (MoP) and the rest Tk 1,403.52 crore to be borne as subsidy for marketing Diammonium Phosphate (DAP) fertilizer among farmers in the current fiscal year. As the country’s macro-economic policies are currently tied with the conditions of International Monetary Fund (IMF), a stringent system on state-subsidy mechanism is being finalized to have a sound macro-economic footing and outlook for subsidy amount for the current fiscal year. Having a broad-based subsidy outlook for whole of the year means inclusive control and monitoring from the finance ministry on the spending and budget deficit of the government. Agriculture ministry was asked not to exceed the subsidy estimation under any circumstances.
Bangladesh as an example of world food security
Food Minister Abdur Razzak in a press conference on 2nd November stated that food storage has increased from 14 million tons to 19 million tons due to the various initiatives taken by the government to increase agricultural production in Bangladesh. Thus Bangladesh has become one of the examples if food security in front of the whole world. However, farmers received lower prices for rice production for several years. If the current situation continues, within the next 2015 years food storage will exceed 1 million tons. The food ministry press convention was held in various highlighted government activities in the last five years. The food minister also noted that in the past five years, food production has increased by 50 million tons. Again, UN Millennium Development Goal (MDG) of halving extreme poverty within 2015 was planned for reaching the goal in Bangladesh. Regarding this, World Agriculture and Food Agency (FAO) Bangladesh has achieved a special award. Government ensured farmers that it would be better to collect amaneo and then farmers will get better prices. Government has to keep in control of food production and for the price it was available as Bangladesh is still lagging behind much of the world while producing nutritious food. The Director General of the Food Ministry secretary Ahmed Hossain Khan, Mushfeqa iphaphat and food and top officials of the Ministry were also present in the occasion.
40% of the Bangladeshis are the victims of iodine shortage
A national survey titled Anupusti survey (2011-13) has revealed that about 40 percent people of the country are suffering from shortage of iodine. The inadequacy is more in the city than in the village, and more in children and women. The survey was conducted by Institute of public health nutrition, the International Center for Diarrheal Disease Research, Bangladesh (ICDDR, B), UNICEF and GAIN. The survey data was presented through a workshop held in 6th November at a city hotel. The beneficiaries of the survey were 350 children and 15 women of the 49-year-old of six different areas of the country, where information was found in the urine sample analysis of iodine. The finding was that 75 percent of the salt sold in the market had the necessary levels of iodine. According the survey, about 69 percent of the family knows and only 64 percent of the benefits heard of iodized salt. If they put the intake of salt, they are less affected by iodine shortage. Analysts stated that at the evaporated salt not to be kept in open containers in the air as Iodized salt by applying heat and light decreases the amount of iodine. The participants recommended to add media in raising people's awareness about iodine and to give special emphasis on these matters. General people and policy makers should be made aware as salt iodine mixed so will improve the nutrition situation. Strict implementation of existing laws as well as the authority to increase surveillance is required also. Experts recommend the inclusion school textbooks. The workshop was attended by salt mill owners' association officers, NGO representatives, pharmaceutical officials and teachers of schools.
ACC employees to get food rations
The third and the fourth class employees of Anti-Corruption Commission will henceforth be entitled to get food ration like employees of other agencies of the government. The commission chairman M Badiuzzman noted that the ministry of finance has approved the ACC’s recommendation in this regard. Primarily, the commission sought the facility for all the officials, but later it was sought for limited facility for the third and fourth class employees as per instruction of the finance ministry. According to ACC officials, a total of 666 employees including 445 class three and 221 class four employees and their families will enjoy the food ration benefit. According to an office order, the ministry allocated 11 kilogram rice for signal member, 20 KG for two-member family, 30 KG for three-member, and 35 KG for four-member family. Ministry also allocated 12 KG of Ata for single member, 20 KG for two-member, 25 KG for three-member and 30 KG for four member family. The government also will provide 1.75 KG of sugar for single member, 3 KG for two-member, and 4 KG for four member family. Again 3.5 KG of Dal will be allocated for single member, 5.5 KG for two-member, 7 KG for three-member and 8 KG for four member family. The employees will also get 2.5 litters of Edible Oil for single member, 4.5 litters for two-member, 6 litters for three-member and 8 litters for four-member family. The ACC officials said that the ACC employees will take the food rationing from police line. NSI and more than half a dozen government departments and agencies including Bangladesh Army, Navy, Air Force, Police, BGB, Ansar, Coast Guard, SSF and DGFI receive food ration. The government has to spend a hefty amount of budgetary allocation annually to maintain the food ration under which a certain amount of rice, wheat, edible oil, pulses and sugar are supplied at much lower price than the market price.