Cooperation between public, private sectors suggested

Speakers at a roundtable yesterday strongly suggested strengthening of cooperation between public and private sectors to improve healthcare delivery system.

They said the state alone cannot ensure healthcare delivery for all and the private sector has already taken a lead in this field taking advantage of the government limitation.

The speakers also suggested forming laws and regulatory bodies to ensure quality healthcare services by forming local bodies to monitor the enforcement of the laws.

They were participating in a two-day international roundtable on 'Sustainable Health Systems in Developing Countries' organised jointly by Dhaka Community Hospital and the Institute of Community Health, Bangladesh in the city.

Senior health experts, economists, members of parliament, World Bank, UNICEF, DFID and representatives of government, non-government and other donor agencies took part in the roundtable.

Participants from the USA, the UK, India, Sri Lanka and Nepal demanded transparency in expenditure of all funds spent on the public healthcare system.

They suggested decentralisation of administration at all possible tiers and urged the policy makers to involve union parishads to supervise healthcare system in their respective areas.

Ill health, lack of access to healthcare, malnutrition, unsafe drinking water and poor sanitation - all these are directly related to people lacking ownership, participation and lack of their control on the healthcare delivery system, the speakers pointed out.

They said civil societies should be allowed to express their voices on their needs and the state should be a catalyst for private-public partnership and bring new success in healthcare delivery system.

World Bank's Country Director Frederick T Temple said "poor people can be given some sorts of voucher to purchase healthcare from private sector of their choice and we would like to see healthcare in Bangladesh moving in that direction".

He said many successes in health sector in Bangladesh have come from public - private partnership mostly between NGOs and the government.

On question of regulating the private providers, Temple said it is more practical to rely on a self-regulatory system rather than depending on the government to develop a regulatory mechanism for the private providers.

He said private service providers should focus on preventive side rather than curative.

Prof M S Akbar, MP, said without decentralisation we simply cannot make any progress in health sector. At the same time it is important to ensure accountability in the private sector.

He said most of the budget in health sector is allocated for development of infrastructure and it is an irony that despite having so many health centres even at union level people go to consult a village doctor or a quack and they pay for what they are prescribed for.

Dr Debapriya Bhattacharya, executive director of the Centre for Policy Dialogue (CPD), said access to health care facilities is very limited. Less than 20 per cent people have actual access to public healthcare delivery system.

The private sector is expanding but it is unregulated and there is hardly any accountability, he added.

Dr Neil Squires of DFID said, "We need long term vision in healthcare to stay above party politics so that things targeted for achievement in the sector remain largely undisturbed but in order to do that it really needs participation of the people at all level".

Professor Mahmudur Rahman, coordinator of DCH Trust, delivered the welcome speech while Prof David Christiani from USA convened the session.