WELCOME HEALTH PROFILE BANGLADESH

MINISTRY OF HEALTH & FAMILY WELFARE (MOHFW)-BANGLADESH MOHFW is responsible to ensure basic health care to the people of the country ;  At present the population is nearly 150 million  with a per capita GDP–US$ 421 MOHFW is the sector leader as  It provides most of the HNP services  It manages & coordinates services of non-govt. & private sector

MANAGEMENT STRUCTURE Management structure follows the general administrative setting of the country;  Secretariat –responsible for policy planning and decision making at macro-level. Headed by Hon’ble Minister & staffed by civil servants.  Directorates –implementation wings staffed by 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 (Six) health and family planning responsible for support and HRD function  Districts-Civil Surgeons for district health (64) management & DD(FP) for MCH-RH- services  Upazilas: -UHFPO –Preventive & clinical (460)health service -UFPO -FP & RH service MANAGEMENT STRUCTURE (continued)

STRUCTURE at PRIMARY LEVEL Rural  One HA for population  One FWA for 4000 population  MA, FWV and Paramedic works in Fixed sites Urban  FWs are not available according to the population  Vaccinator and Paramedic works in Fixed sites  NGOs are taking part a major role Source: HPSP Manual, Bangladesh: 2001

HEALTH ORGANIZATION OF HNP SERVICE DELIVERY Public sector health system is structured as a hierarchical pyramid with 5 layers; 3 at Primary 3 at Primary 1 at Secondary 1 at Secondary 1 at Tertiary 1 at Tertiary

Level of Health Care System Primary level

HEALTH SERVICE DELIVERY PRIMARY LEVEL FacilitiesServices Community clinic & home visitation FP, MCH, immunization, communicable disease control, treatment of common problems & referral. Union health & family welfare centre (4300) Out patient services : FP, MCH, communicable disease control, clinical care, normal delivery & adolescent health care. Upazila health complex, (414) Out patient services, impatient services (31-50 beds) with diagnostic and operative treatments

HEALTH SERVICE DELIVERY SECONDARY LEVEL FacilitiesServices District Hospitals (64) Out door & Indoor Services ( beds) with laboratory, radio graphic & ambulance services Maternal & Child welfare Centre (64) EOC and other related services

INSTUTUTIONS FOR HEALTH MANPOWER DEVELOPMENT  1 Medical University  15 Medical College  8 Post graduate institute  2 Institute of Health Technology  8 Medical Assistant Training School  1 Nursing College  38 Nursing Institute

Major Health Programme-Bangladesh 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 peoples Injury prevention, management & violence against women Environmental and occupational Health

Country reported Data for Basic Health Indicators Indicator Latest available data Year Number of hospital beds 51, Population per hospital bed Hospital beds per 10,000 population Number of physicians Population per physician Physicians per 10,000 population Population per nurses

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 Rate Source: BDHS 2007

Trends in Childhood Mortality Rates Deaths per 1,000 live births Source: BDHS 2007

RISKS AND CHALLENGES Relatively high MMR due to lack of antenatal & obstetric care High level of malnutrition from both –Protein energy malnutrition –Micro-nutrient deficiencies Emerging and Re-emerging diseases -HIV/AIDS, TB, Malaria, Arsenicosis, Accidents & Injuries Demographic & epidemiological transition accelerates-Non- Communicable diseases 5. Low utilization of HNP services