Health services in bad shape
Public health services across the country are being severely hampered by a staggering shortage of health professionals.
According to officials from the Directorate General of Health Services (DGHS), there are currently 33,000 vacant posts, which is more than a fifth of the total workforce.
The Health Bulletin 2009, published by the Ministry of Health and Family Welfare, revealed that 7,090 posts of Class I employees, including 6,861 doctors and 229 non-doctors remain vacant.
There are also 345 Class II positions vacant, 16,707 Class III positions vacant and 6,101 Class IV posts vacant.
The total number of posts in the health sector is 173,000.
Government sources expressed doubt that health services could be rendered smoothly with so many posts being vacant.
Prof Rashid E Mahbub, former president of Bangladesh Medical Association (BMA), said that the health sector will collapse if the workforce isn't made more robust.
Prof Mahbub said, "The government took steps to recruit manpower, which was certainly a good decision.
“But this has been halted due to corruption in the recruitment process."
He added that the process of recruiting should be decentralised, saying, "The supremacy of the secretariat should be reduced and decision making power should be increased at the divisional and district levels -- along with increased accountability and monitoring."
The former pro-vice chancellor of Bangabandhu Sheikh Mujib Medical University (BSMMU) said the population has increased greatly over the last two decades and it is the government's responsibility to increase the number of health professionals accordingly.
Meanwhile, health services at the district and upazila level hospitals have been deteriorating day by day.
Experts have said that many people travel to the capital for the treatment of simple eye, lung or chest diseases because they are unhappy with the service at local hospitals.
Health Watch's report, “The State of Health in Bangladesh 2007,” recommends that Bangladesh recruit 60,000 additional doctors, 280,000 nurses and 483,000 technologists.
Bangladesh has around five physicians and two nurses per 10,000 people.
Director General of the Directorate General of Health Services (DGHS) Prof Shah Monir Hossain said, “Obviously the health service is hindered by a lack of manpower.
“But it is difficult and time consuming to get administrative approval for manpower recruitment and it also involves the finance and establishment ministries."
However he said that the government has already taken steps to recruit around 14,000 health professionals, including 4,133 doctors, 2,639 nurses and 6,391 health assistants.
“The institutions themselves are able to recruit some manpower on an emergency basis," he added.
As well as hindering health services, the shortage of manpower breeds corruption.
Prof Muzaffer Ahmed, trustee of Transparency International Bangladesh, said,
"The work has piled up due to a lack of manpower.
“And when we want the work done quickly, it needs 'speed money' and that leads to corruption."