Quality treatment at primary level inadequate: speakers

Despite a rise in non-communicable diseases (NCD), quality treatment for such diseases at primary-level healthcare centres across the country is still largely inadequate, speakers at a roundtable said yesterday.

Currently, NCDs like diabetes, heart disease and cancer cause thousands of deaths each year due to “imbalanced lifestyle, insufficiently diverse diet and lack of awareness”, they added, referring to studies.

Under this circumstance, there is no alternative to strengthening quality care for NCDs at upazila health centres of the government as well as generating awareness through health education in schools, speakers said at the programme at Bangabandhu Sheikh Mujib Medical University (BSMMU) in Dhaka.

Clinical Research Platform -- a tripartite initiative of icddr,b, BSMMU and British Medical Journal -- organised the discussion on the first day of the two-day “1st Scientific Congress on NCD”.

In Bangladesh, there has been an 8.7 percent rise (from 58.3 percent to 66.9 percent) in deaths related to non-communicable diseases between 2010 and 2016, according to World Bank data.

One in four Bangladeshi adults -- 25 years and above -- are hypertensive, while one in 10 have diabetes, according to a 2015 estimate.

The prevalence of lung diseases is 13.5 percent.

Prevalence of cancer is also very high -- an estimated 1.3 to 1.5 million patients are suffering from cancer, with 200,000 newly diagnosed cases each year.

Kidney Foundation of Bangladesh estimates 18 million people suffer from kidney disease, of whom annually 35,000-40,000 patients develop chronic kidney disease, eventually leading to kidney failure.

Conducted by Dr Aliya Naheed, the discussion was attended by chiefs of major healthcare institutions and specialists.

Prof Sohel Reza Choudhury, head of the department of epidemiology and research at National Heart Foundation, talked about ensuring quality treatment for NCDs in upazila health complexes across the country. “At upazila-level health centres, patients come, physicians write prescriptions and provide some drugs, and the patients leave. There is no system of keeping records or following up.”

However, an effective intervention at primary-level healthcare could control hypertension and other NCDs, he said.

Prof Shahedur Rahman Khan, director of the National Institute of Diseases of the Chest and Hospital, spoke of government intervention in stopping tobacco use in all forms -- especially smoking, ensuring safe food,  health education in schools and so on.

He asked, “Our government allows tobacco plantation but we are speaking against tobacco. [Then] how will it be possible to control tobacco?”

Prof Mosharraf Hossain, director of National Institute of Cancer Research and Hospital, said, “Some 30 percent cancer patients could get better if the disease is detected early. But in reality, 80 percent of cancer patients come for treatment at advanced stage.”

He stressed on extending cancer treatment facilities up to district-level hospitals. “We have to think of prevention,” he said.

Earlier in the morning, Md Ashadul Islam, secretary of health services division of health ministry, inaugurated the event as chief guest.

Speaking at the session, he said, “NCDs are among the new challenges for us… However, we have been able to increase facilities in last 10 years.”

With participation of more than 400 clinicians and public health researchers and about 200 abstracts submitted, a total of four thematic sessions on NCDs were held on the first day.

Today, five sessions on different issues like mental health, neurological disorders and chronic kidney disease will be held at the conference.