Nusrat Jahan Maha - Followers Questions

The MDGs, or Millennium Development Goals, were a set of eight goals established by the United Nations in 2000, with a target deadline of 2015. Several of these goals were related to health, including:

Goal 4: Reduce Child Mortality – the target was to reduce the under-five mortality rate by two-thirds between 1990 and 2015.
Goal 5: Improve Maternal Health – the target was to reduce the maternal mortality ratio by three-quarters between 1990 and 2015.
Goal 6: Combat HIV/AIDS, Malaria and Other Diseases – the targets included halting and reversing the spread of HIV/AIDS, achieving universal access to treatment for HIV/AIDS, and halting and reversing the incidence of malaria and other major diseases.
Other health-related targets included achieving universal access to reproductive health, reducing the prevalence of malnutrition, and improving access to safe drinking water and sanitation.

Since the deadline for the MDGs has passed, the United Nations has established a new set of goals, called the Sustainable Development Goals (SDGs), which build on the progress made under the MDGs and aim to address new challenges. Many of the SDGs also include health-related targets.

Bangladesh healthcare systems are mentioned below:
1. In Ward Level:
-Community Clinic,
-Family Welfare Centre (FWC).

Manpower:
-Family Welfare Visitor (FWV),
-Family Welfare Assistants (FWAs),
– Medical Assistant (MAs),
-Skill Birth Attendance (SBA),
-Village Health Volunteer (VHV),
-Community Midwife (CMW).

Services:
-Establishing referral linkage with higher facilities,
-Family planning,
-EPI (Expanded Programme on Immunization),
-Primary health care,
-Oral rehydration therapy,
-Sanitation,
-Nutrition.

Role and Activities:
-Creating awareness going door to door,
-Immediate refer system,
-Home visit of pregnant women,
Normal delivery conduct.

2. In Union Level:
-Family welfare center (FWC),
-Community clinic,
-Union sub-center,
-Rural dispensary.

Manpower:
-MBBS doctor,
-Medical assistant,
-Nurse,
-Word boy or patient care attendance.

Services:
-Maternal and neonatal health care services,
-Integrated Management of Childhood Illness (IMCI),
-Reproductive Health and FP services,
-Registration of newly married women, pregnant women,
-Birth & death, preservation of EDD (Expected Date of Delivery),
-Nutritional education and micro-nutrient supplements,
-Health, Nutrition and FP Education & counseling,
-EPI (Expanded Programme on Immunization),
-Delivery conduct,
-Primary health care,
-Outpatient service for injuries, wound, and minor alignment,
-Identifications of emergency & complicated cases & refer to higher facilities,
-Treatment of Common diseases & first aid.

Role and Activities:
-Immediate refer system,
-Home visit,
-Create awareness and monthly meeting with union council,
-Delivery of some essential drugs.

3. In Upazilla Level:
-Upazilla Health Complex (UHC),
-TB Clinic.

Manpower:
-Upazilla health family planning officer(UHFPO),
-Maternal child welfare officer(MCWO),
-Consultant doctor,
-Residential medical officers (RMO),
-Medical officers (MO),
-Nurse,
-Laboratory technician,
-Pharmacist,
-Traditionally trained birth attendance,
-Family panning officers.

Services:
-Comprehensive emergency obstetric care,
-Facilitate services of gynecology, anesthesia,
-Nursing service and basic laboratory facilities,
-Admission and discharge,
-General health problem treatment,
-Normal Delivery conduct,
-Cesarean delivery,
-TB treatment,
-Leprosy treatment,
-Maternal child care,
-EPI (Expanded Programme on Immunization),
-Family planning.

Role and Activities:
-Trained union-level health care staff,
-Create awareness,
-Referral system,
-Control communicable disease,
-Pre-service education,
-Health education and health promotion.

4. In District Level:
-District hospital with the nursing institute,
-General hospital,
-Medical college with the nursing institute,
-Chest disease clinic,
-Leprosy clinic,
-Medical assistant training institute,
-Private clinic.

Manpower:
-Civil Surgeon,
-Consultant doctor,
-RMOs (Residential Medical Officers),
-MOS (Medical Officers),
-Superintendent of drugs,
-Family Planning supervisor,
-Public health nurse,
-FPO (Family Planning Officer),
-EPI supervisor,
-MCW officer,
-Pharmacist,
-Technicians,
-Recordkeeper.

Services:
-All general healthcare,
-Operative care,
-Rehabilitation center,
-Support to Upazila health complex,
-Supplements materials to UHC,
-Co-ordination with all health care center,
-Training of health care personnel and Capacity building,
-Nursing education and service,
-Hospital service management and safe blood transfusion.

Role and Activities:
-Development and administration of care service at the district level,
-Specialist, diagnostic and laboratory service,
-Strengthening of drug administration and management,
-Training, research, and development,
-Referral system.

5. In Divisional Level:
-Medical College and Hospital, with Nursing Institute,
-General Hospital with Nursing Institute,
-Infectious Disease Hospital,
-Institute of Health Technology.

Manpower:
-Divisional director,
-Civil surgeon,
-Consultant doctor,
-Resister medical officers,
-RMOs,
-MOs,
-Superintendent of drugs,
-Family Planning supervisor,
-Public health nurse,
-FPO,
-EPI supervisor,
-MCW officer,
-Pharmacist,
-Technicians,
-Recordkeeper.

Services:
-Provide care of all complicated disease,
-Rehabilitation care,
-Training, research, and development,
-Provide care of infectious and communicable disease,
-Ensure nursing care.

Role and Activities:
-Responsible for policy formulation and decision making in health care sectors.
-Planning and implementation of programs and projects and technical guidance to the health sector.

6. At National level:
-Public health institute,
-Postgraduate medical institute and hospital with the nursing institute,
-Specialized health institute.

Manpower:
-Director of the institute,
-The principal of the medical college,
-Consultant doctor,
-Registered medical officer,
-RMOs,
-MOs,
-Public health nurse,
-Recordkeeper.

Services:
-Facilitate opportunity for higher education,
Provide super-specialty care.

Behind these elements lies a series of basic objectives that should be formulated in national policies to launch and sustain primary healthcare (PHC) as part of a comprehensive health system and coordination with other sectors.

1. Improvement in the level of health care of the community.
2. Favorable population growth structure.
3. Reduction in the prevalence of preventable, communicable, and other diseases.
4. Reduction in morbidity and mortality rates especially among infants and children.
5. Extension of essential health services with priority given to the underserved sectors.
6. Improvement in basic sanitation.
7. Development of the capability of the community aimed at self-reliance.
8. Maximizing the contribution of the other sectors for the social and economic development of the community.
9. Equitable distribution of health care– according to this principle, primary care and other services to meet the main health problems in a community must be provided equally to all individuals irrespective of their gender, age, and caste, urban/rural, and social class.
10. Community participation-comprehensive healthcare relies on adequate numbers and distribution of trained physicians, nurses, allied health professions, community health workers, and others working as a health team and supported at the local and referral levels.
11. Multi-sectional approach-recognition that health cannot be improved by intervention within just the formal health sector; other sectors are equally important in promoting the health and self-reliance of communities.
12. Use of appropriate technology- medical technology should be provided that accessible, affordable, feasible, and culturally acceptable to the community.