Health centres in bad shape

The walls of the delivery room are marked with black splotch. A table cum delivery bed, accompanied by a chair, is standing alone at one corner of a room of Churain Union Health and Family Welfare Centre (UHFWC) at Nawabganj upazila in Dhaka, operated by Directorate General of Health Services (DGHS).

There is a regular medical officer, family welfare visitor (FWV) and a sub-assistant community medical officer (Sacmo) on deputation and the centre, according to a report, was supposed to provide service to 25,300 people.

But there were no delivery service reported in 2014, says a report on the National Assessment of Union Level Facilities in Bangladesh for their Readiness to Provide Normal Delivery Care Services conducted by Directorate General of Family Planning (DGFP) with support from USAID's MaMoni Health Systems Strengthening project.

In its assessment done in January 18 this year, it is reported that its delivery, recovery, FWV and Sacmo rooms and two toilets need repair as there had been no repair works since 2008.

The assessment was conducted between April 2015 and February 2016 and its findings were shared yesterday at a hotel in the capital.

A total of 3,590 UHFWCs are functioning. Based on the cumulative scores, each facility was grouped into categories A, B and C. The categorisation indicated the overall readiness of the facilities to provide normal delivery and essential newborn care services and the level of inputs required to make them fully ready.

The Churain UHFWC falls in C category and there are 24 such centres out of 76 in Dhaka district. 

There are 621 facilities which are categorised in C group and needed major physical renovation, staffing, supplies and equipment.

There are 489 A category facilities that need minimum resources while 2,480 facilities are classified as B, requiring medium to moderate level of inputs.

Dr Ishtiaq Mannan, deputy country director of Save the Children, Bangladesh, said 90 percent of the deliveries was conducted at home in 2004, which was reduced to 63 percent in 2014.

“But, of the remaining 37 percent, 15 was conducted at the government and NGO facilities,” he said, adding, the rest took place at private facilities.

He said poor people do not have the capacity to bear the expenditure of private facilities where normal delivery is a rare practice.

He requested the government to take necessary measures to train skilled midwifery and make the union centres effective.

Health and Family Welfare Minister Mohammad Nasim said they will take necessary measures on the basis of the assessment. 

He asked the government officials to make field visits to know about the real scenario of the facilities.

Zahid Maleque, state minister for health; Prof Dr Deen Mohammad Noorul Huq, director general of DGHS; Melissa Jones, director, office of population health, nutrition and education of USAID; Dr M Iqbal Arslan, secretary general of Bangladesh Medical Association; and Syed Monjurul Islam, secretary to the health ministry, also spoke.