AN ACUTE shortage of human resources and essential facilities at healthcare institutions in rural areas, especially at upazila and district public hospitals, shows the systemic neglect that has rendered rural health services inadequate. The situation also disproportionately burdens the poor and low-income people as they primarily depend on these hospitals. Ill-equipped and poorly maintained healthcare facilities at upazilas and districts leave patients without timely treatment, compel them to travel to cities and push them towards costly private healthcare providers. While all upazila and district hospitals struggle to cope with the large number of patients, most of the facilities are severely understaffed. A 抖阴精品 report finds that all upazila hospitals it contacted are operating with half or less than half of the required human resources, especially physicians. The government has upgraded many upazila hospitals without updating the organogram or recruiting physicians and other staff members. The Jibannagar upazila health complex in Chuadanga, for instance, was upgraded in 2018 from a 31-bed to a 50-bed facility in response to public demand. The organogram was, however, not revised accordingly and the facility continues to run with only a half of the physicians sanctioned in the previous 31-bed organogram.
The situation at Bagherpara upazila health complex in Jashore is even worse. The 50-bed facility has only four full-time physicians against the 29 sanctioned positions. Health officials note that many physicians posted at upazila and district hospitals are deputed to various facilities in and around Dhaka or other urban areas. They add that the physicians are often reluctant to remain in rural areas in order to pursue other opportunities, including private practice, further education for themselves or their children and the benefits of a more comfortable way of life. While upazila health complexes face an acute shortage of physician, upazila healthcare facilities in Dhaka, by contrast, often have a surplus of physicians. For example, the Tejgaon thana health complex in Dhaka has 17 physicians in service against eight sanctioned positions, most of them deputed from rural facilities. In addition to the shortage of physicians, upazila and district hospitals are also unable to run even basic diagnostic procedures, largely because of a shortage of technicians. X-ray and ultrasonography machines remain mostly unused or fall into disrepair, causing financial losses and depriving poor people of essential services. Such a dismal state of rural health services reflects the government鈥檚 failure to deliver on its promises and to act upon the many recommendations made by the health sector reforms commission.
The health managers should, therefore, address the long-standing problems 鈥� especially the shortage of human resources 鈥� that have left rural healthcare facilities ineffective and inadequate. The authorities should recruit the required staff members to ensure the proper functioning of the facilities and physicians appointed to rural hospitals should demonstrate their commitment by serving the people who rely heavily on them.
