Crisis of doctors at upazila hospitals

We thank the prime minister for highlighting a major concern in the healthcare sector at a physicians' conference recently: absence of doctors at upazila-level hospitals. The problem of inadequate number of doctors at upazila hospitals has been plaguing the healthcare sector for a long time.

For instance, as of the first week of June this year, there were only four doctors for half a million people in two upazilas in southern Barguna district, according to a leading Bangla daily. A similar scenario was found in Shyamnagar upazila of Satkhira, where 30 out of 34 posts remained vacant. As per Directorate General of Health Service's (DGHS) data, more than half of medical officers' posts at the upazila level in the country—55.2 percent—are vacant. This is simply unacceptable. Due to an acute shortage of physicians, people at the grassroots are being deprived of essential healthcare services.

Unfortunately, doctors overwhelmingly opt for transfers to cities—lured by the more lucrative alternative of private practice—leading to the absence of specialised physicians at upazila health complexes for prolonged periods of time. Many doctors officially occupy medical officers' posts at upazila hospitals but are willingly refraining from showing up and providing their service which can only be described as unethical.

The fact is that healthcare services have become Dhaka-centric which defeats the purpose of universal health coverage—a commitment the government has made in accordance with the 2030 Global Agenda. Thus there is an urgent need to decentralise the healthcare sector and think of ways to incentivise doctors to serve hospitals at the upazila level. The DGHS should also play a more prominent role in ensuring that medical officers' posts are filled up by qualified, ethical physicians.