Infrastructural weakness, irregular medicine supply, a lack of monitoring and negligence in duties of caregivers are the major barriers to delivering expected healthcare services from community health clinics, according to a study.

Besides, inadequate training for service providers and their limited capacity to deal with things during emergency situation and critical diseases are hindering the optimal services, says the study report.

World Vision Bangladesh, and the Centre on Budget and Policy jointly conducted the research on 25 community clinics--12 from Muktagachha upazila and 13 from Fulbaria upazila in Mymensingh--in July this year. The Daily Star got a copy of the report.

None of the community clinics has electricity connections and in most of those, tubewells do not work and the toilet facility is not available, the report said.

About the skills of the service providers, the report says only 30 percent of the chief health care providers (CHCPs) have completed post-graduation, 44 percent graduation, and 74 percent higher secondary education.

As the caregivers are from diverse fields of education like humanities, business, and science, one-time, short term training do not make them eligible enough for delivering the services.

Officially every community clinic should open at 09:00am every day, except Friday, of a week and it should close at 3:00pm.

But actually, the service is provided not more than three-and-a-half hours as they come to the clinics around 10:30am and leave much earlier than the legal timeframe. This situation prevails in almost all the clinics, the report adds.

Some residents said that in every visit to the clinics a patient suffering from fever can get one or two pieces of medicine as 34 percent of the clinics did not receive medicines on a regular basis.

The study team leader and CBP Director Abu Eusuf told The Daily Star, “Although we have conducted the research only in 25 clinics, it reflects the scenario of the other community clinics across the country.”

Dr Makhduma Nargis, additional secretary and project director of Revitalisation of Community Health Care Initiatives in Bangladesh, said, “We are trying to develop the infrastructure of community clinics and strengthen the monitoring mechanism to ensure better services to people.”