April 15, 2021

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Inequality inhibition of health improvement

Maternal health experts say that if the delivery is at home, then the risk of death of the newborn and maternity mother is higher. In other words, if the delivery is in a health center, hospital or clinic, then the risk of death is less. According to the latest Bangladesh Demographic and Health Survey (2016-17), 83 percent of deliveries in the city take place in health facilities. In rural areas this rate is 45 percent.
In other words, the risk of death of newborn and mother during childbirth is higher in rural areas than in urban areas.

This inequality and inequality has been reported in several Bangladesh Demographic and Health Surveys, Maternal Health and Maternal Mortality Surveys. There is such an inequality in health in the villages and cities of Bangladesh, there is in the case of men and women, it is seen between the rich and the poor. There are regional disparities. Children in all sections of Bangladesh do not receive the same life-saving vaccine. No matter what society the mother belongs to, if she is illiterate, then her child’s health risks are higher.

It is not clear that any effective initiative has been taken by the health department to eliminate various inequalities and inequalities in the health sector. In this regard, the Director General of the Department of Health, Prof. Abul Basar Mohammad Khurshid Alam told Prothom Alo, ‘Government health services are available almost free of cost. In our country, the public health system extends to the marginal stage. Absolutely there is an opportunity to get health care at all levels from union level to upazila, district and division. This is done to prevent all forms of discrimination and to ensure universal access to health care for people from all walks of life. ‘

In such a context, World Health Day is being celebrated on Wednesday, April 8. Due to the corona epidemic, the Ministry of Health has not organized any event to mark the day this year. This year’s theme is ‘Building a Fair, Healthy World for All’.

Ahmed Mostaq Raja Chowdhury, convener of Bangladesh Health Watch, a public health expert and civic organization, told Prothom Alo, ‘Some of the causes of inequality or inequality are deeply rooted in our society or health system. There must be a desire to eliminate these inequalities. It is not possible for the government alone to eliminate this inequality. Although some inequalities cannot be completely eliminated, they can be reduced. The media needs to be vocal about this. ‘

Inequality in child health
The Extended Immunization Program (EPI) has played an important role in improving child health in Bangladesh. EPI, which started in 1986, is being implemented across the country. But children in all departments are not getting vaccinated at the same rate.

The lowest vaccination rate is for children in Sylhet division. After reviewing the data on vaccination of children aged 12 to 23 months, the Dhaka office of the World Health Organization found that 85.9 percent of children in Sylhet division get vaccinated. Children of Rajshahi division get the highest rate of vaccination, 93.1%. Children of Khulna, Rangpur and Dhaka divisions are ahead after getting vaccination. And the children of Barisal, Chittagong and Mymensingh divisions are behind.

According to the Maternal Health Survey, Sylhet has the highest infant mortality rate (per thousand live births). If 1,000 children are born in this department, 75 children are dying before the age of five. On the other hand, in Rajshahi division this rate is 48.

Inequality in child health is also seen in other cases. An important indicator of child health is the height and weight of a child under five years of age. According to the latest Demographic and Health Survey, 25 percent of urban children are taller than their age. In rural areas this rate is 33 percent. Again this rate is highest among children in urban slum areas.

Poverty is the enemy of health
Poverty creates health risks for people of all ages. No matter where the village or town is, the height of children from poor families is low. Public health experts and economists try to analyze the situation by dividing rich and poor families into five categories. It found that the rate of stunting (lower than age) among children born in the richest families was 18 percent. And among the children of the poorest families, this rate is 40 percent.

According to government data, the death rate among children from poor families is also high. Of the 1,000 children born into the poorest families in the society, 72 die before the age of five. The infant mortality rate in the richest families of the society is 30. In other words, a child born in a rich family is twice as likely to survive as a child born in a poor family.

Not only children but also mothers who are victims of discrimination. As of 2016, 82 percent of the poorest pregnant mothers receive antenatal care. In that respect, the richest pregnant mothers are in a better position. 99% of pregnant mothers in this category are getting antenatal care.

Women are at higher risk
The incidence of high blood pressure and diabetes is increasing in the country. The prevalence of diabetes is highest among the affluent women of the city.

Population and health surveys have highlighted the situation of high blood pressure in the country. It shows that 36 percent of men over the age of 35 are suffering from high blood pressure. The rate is higher among women of the same age, 45 percent.

This tendency of high blood pressure is more prevalent among women in both urban and rural areas. 47.5% of women over the age of 35 in the city are suffering from high blood pressure. Among urban men of the same age, the rate is 36.6 percent.

As seen during the ongoing epidemic, its adverse effects on women are comparatively greater. On the other hand, the slum dwellers of the city have reduced the registration for corona vaccination.

The World Health Organization says these inequalities in the health sector are not only unfair or biased, but also in the health sector for so long.The acquisition of can also be at risk. It is possible to prevent such injustices by adopting specific strategies.

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