Pregnant women, new mothers, children, people with chronic illnesses and the elderly worst affected by strain of pandemic on healthcare system
The delivery of essential healthcare services has been severely hampered by the Covid-19 pandemic, as most doctors are occupied with coronavirus cases while fear of the virus discourages patients from going to hospitals, according to a recent study.
Several areas of public health need swift reinforcement to maintain the progress made by Bangladesh before the arrival of the pandemic last year, the study recommends.
The study, titled “Impact of Covid-19 on Essential Health Services in Bangladesh: A Rapid Assessment,” was conducted by the Brac Advocacy for Social Change Department and Bangladesh University of Health Sciences (BUHS). The findings of the study were revealed at a virtual event organised by Brac yesterday.
The rapid assessment was conducted on 2,483 randomly selected households in 16 districts between April and August in 2020. The households have an average family size of 4.89 people.
According to the report, 54% of pregnant women could not avail necessary health services during the pandemic due to fear of Covid-19, financial problems, or the unavailability of doctors. A total 37.6% pregnant women received 4+ ANC services during the survey period, which is around 10% lower than the pre-pandemic national average.
About 20% of deliveries were conducted by untrained midwives and one in seven children were not taken to hospitals when they fell seriously ill due to high transportation costs and fear of Covid-19, the study found.
Pregnant women, mothers with newborns, children below five years of age, patients needing emergency care and those with chronic illnesses, the elderly and people with disabilities suffered most during the pandemic, it added.
As much as 60.8% of the households experienced some form of sickness (other than Covid-19), while 28.6% reported higher clinical costs. On the other hand, 10% of the households reported difficulty in availing health services from hospitals, and two fifths of households reported that their health status had deteriorated due to lack of proper healthcare.
Experts stress community mobilization
Dr Morseda Chowdhury, associate director of the Brac Health, Nutrition and Population Program, said: “The situation was particularly bad for women and children. Patients with chronic diseases also suffered significantly. Some 56.32% of the chronic disease patients reported that fear of coronavirus barred them from seeking treatment, while 54.51% reported financial difficulties. Overall, the situation was much worse in rural areas compared to the urban ones.”
Experts suggest that the crisis cannot be overcome without community mobilization and building up community healthcare systems.
Brac Executive Director Asif Saleh said: “The Covid-19 pandemic widened an already existing gap in the health sector. Community-centric health care services (Community Support Teams) played a major role last year. This community-based system needs to be strengthened more.
“Community health workers need more training and better equipment. Non-state actors can help by mobilizing the communities, especially for vaccination and awareness creation.”
He assures that Brac is ready to provide technical assistance to other NGOs in places where Brac does not operate. “Brac follows a three-pronged approach: prevention, protection, mobilization,” he added.
Dr Md Touhidul Islam, national professional officer at the World Health Organization, said: “There needs to be a shift in focus from infrastructural development to human development. The government needs to identify the places where investment is required. The health workforce also needs financial and non-financial support from the government. Special focus should be given on investment in the governance of the health system.”
Professor Dr Meerjady Sabrina Flora, additional director general (planning) at the Directorate General of Health Services (DGHS), said: “No service can be fully realized without the collaboration between the government and the non-government actors. Community participation is essential to tackle the crisis.”
She thinks that addressing acute and chronic diseases, as well as Covid-19 is equally important.
“Essential health services must be ensured. Otherwise, the non-Covid-19 patients will suffer from a lack of services. On the other hand, the Covid-19 transmission rate has to be curbed so that the non-Covid-19 patients do not suffer,” she added