Healthcare centres under local bodies: Even basic services not being delivered

Urban healthcare centres, run by the local government bodies, are failing to provide even the basic reproductive health and nutrition services due to a lack of human resources, found a study released yesterday

The local government healthcare centres cannot afford the necessary manpower due to fund shortages, which stems from the fact that the local government bodies have to spend from only their own earnings, said the study by the Institute of Health Economics of Dhaka University.

The study titled Role of Local Government in Facilitating Reproductive Health and Nutrition Services in Bangladesh claimed the local government bodies were struggling to pay for its existing staffers, not just healthcare staffers.

The city corporations and municipalities are responsible for delivering the primary health services to the urban population, according to the Local Government (City Corporation) Act, 2009, and the Local Government (municipalities) Act, 2009. Outside urban areas, the Ministry of Health and Family Welfare is responsible for providing the services.

Apart from vaccination campaigns, most of the healthcare centres under the local government institutions have no role in providing health services, said the study.

Researchers interviewed officials of 128 centres and 3,420 people between February and December of last year under the study supported by the National Institute of Population Research and Training (NIPORT).

"There is a problem with the existing structure of the health departments of the local government institutions in urban areas. It is depriving the urban people, especially the poor, of primary healthcare," Prof Syed Abdul Hamid, team lead of the study, told The Daily Star yesterday.

The study shows only Sirajganj and Feni municipalities, out of all 53 district-level municipalities, had a doctor each.

In 15 of the municipalities surveyed, 29-82 percent of posts for healthcare personnel were vacant.

Of the 30 upazila-level municipalities surveyed, the average vacancy rate was more than 80 percent and five of them provide no healthcare services, not even regular vaccinations.

Only one of the 30 provides family planning services, according to the study.

Of the 12 city corporations surveyed, only Dhaka south, Chattogram and Khulna city corporations deliver some healthcare services.

Dhaka south, for instance, had 24 percent and 66 percent of posts for doctors and nurses vacant.

The study recommended amending the existing system and putting the health ministry in charge of finance and operations of the centres. It recommended relegating local government officials to a supporting role.

Abdul Hamid said, "No healthcare staffers from the health ministry should be engaged here. Rather, doctors and nurses and other staffers would be appointed on contract basis."