Health care delivery system in Bangladesh – This book covers the entire syllabus of “Community Health Nursing” prescribed by the Universities of Bangladesh- for Basic and diploma nursing students. We tried to accommodate latest information and topics.
This book is examination friendly setup according to the teachers’ lectures and examination’s questions. At the end of the book previous university questions are given. We hope in touch with the book students’ knowledge will be upgraded and flourished. The unique way of presentation may make your reading of the book a pleasurable experience.
Health care delivery system in Bangladesh
Definition of Health care
Health care or healthcare is the maintenance ог improvement of health via the prevention, diagnosis, and treatment of disease, illness, injury, and other physical and mental impairments in human beings.
Health care system:
A health system, also sometimes referred to as health care system or as healthcare system, is the organization of people, institutions, and resources that deliver health care services to meet the health needs of target populations.
Or
Health care system refers to complex of facilities, organizations, and trained personnel engaged in providing health care within a geographical area.
Health care level:
Health care level refers to providing health care in different level (from home and community level to national level and/or primary level to referral level) to maintenance or improvement of health via the prevention, diagnosis, and treatment of disease, illness, injury, other physical and mental impairments in human beings.
Health care delivery:
Healthcare is delivered by health professionals (providers or practitioners) in allied health professions, physicians,physicianassociates, dentistry, midwifery, nursing, medicine, optometry, audiology, pharmacy, psychology, and other health professions. It includes the work done in providing primary care, secondary care, and tertiary care, as well as in public health.
Health care delivery system in Bangladesh:
Health care delivery system in Bangladesh is based on primary health care (PHC) concept that has got various levels for service delivery. These are:
- Home and community level.
- Union level: Union sub-centers (USC)/Health and welfare centre (HFWC).
- Upazilla level: Upazilla Health Complex (UHC). This is the first referral level. The first referral level extends up to Thana level
- District Hospital: This is the secondary referral level.
- National level Tertiary referral.
Tease levels are:
- Primary level;
- Secondary level;
- Tertiary level;
- Referral level.
1. Primary level:
Primary level health care is delivered through USC/ H& FPWC with one in each union, domiciliary level integrated Health and Family Planning services through field workers, one for approximately every 3000-4000 population and 31 bed hospitals (with beds for MCH & FP) at the Upazilla level. Care is provided by professionals, paraprofessionals and other supporting staff.
2. The secondary level
The Secondary level health care is provided through 100 beds district hospitals. Those having 50 beds presently will be gradually raised 100 beds. These facilities provide specialist services in medicine, surgery, gynaenocology and obstetrics. Eye, clinical pathology, blood transfusion and public health laboratory. Care is provided by health professionals & supporting health personnel.
3. Tertiary level:
Tertiary level health care is available at the medical college/post graduate hospitals, public health and specialist hospitals at the National level where a much wide range of specialized as well as better laboratory facilities are available.
4. The referral system:
The referral system within the health care establishment was not well defined nor has it functional properly. In the health care delivery system the referral arrangement plays a vital role in providing quality services to the rural masses.
The vital roles are:
A clearly spelt-out linkage between the specialized national institutes, the medical college hospitals and the district hospitals to ensure proper care and treatment of patients from the rural areas served by lower level facilities.
The system will be a two-way process under which patients from the rural areas will be sent up to higher institutions while at the same time specialists from the district hospitals.
Common community health problems in Bangladesh
1. Communicable disease problems:
a) Malaria
b) AR1
c) Tuberculosis
d) Diarrheal diseases.
2. Nutritional problems:
a) Protein energy malnutrition (PEM)
b) Xcropthalmia (Nutritional blindness)
c) Nutritional anemia
d) Low birth weight
3. Environmental sanitation:
a) Lack of safe drinking water,
b) Inadequate facilities of waste disposal,
c) Poor sanitation,
d) Housing problem/ Poor housing with poor ventilation.
4. Gastro intestinal diseases:
a) Diarrhea,
b) Dysentery
c) Enteric fever
d) Hepatitis
e) Warm infestation
5.Medical care problems:
a) Economical problem
b) Inadequate staffing
c) Scarcity of certain essential drugs and medicine
d) Overcrowding in hospitals
e) Inadequate pathological facilities e g. x-ray, investigations.
f) Inadequate proper referral system
6. Population problems:
a) High unemployment
b) Poverty
c) Poor housing
d) Inadequate health care facilities( e,g MCH&FP)
e) Illiteracy
f) Early marriage.
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