Globally, it is recognised that ‘educating children’ gives the next generation the most effective tools to fight poverty, prevent diseases, build resilience and create a progressive and peaceful society as ‘good health and well-being for all’ is the foundation of sustainable development. So, to protect and promote the universal rights to education and health are requisites for all aspects of social and economic development.
Two articles, 17 and 28, of the constitution entrench universal rights to education, especially free primary education, as well as rights to freedom of choice to get the higher education keeping to everyone’s potential and merit. Article 18 (1) highlights the state’s primary duty to raise the nutrition level and to improve the public health. So, the constitutional mandate and the given commitment to the several international conventions such as United Nations’ Convention on Child Rights and the International Covenant on Economic, Social and Cultural Rights oblige obligate Bangladesh to ensure free access to quality education and improved health services. Despite being the basic human right, the constitution does not recognise the health right as the universal human rights.
The global development framework, the Sustainable Development Goals, commits to leaving no one behind, which is a great premise to working together with international development partners to provide quality education and health services for all.
What is the ground reality in both sectors: education and health? National statistics show that 40.72 per cent of children and youths are out of education because of multifaceted causes as well as the maternal and under-five child mortality rates are 163 per 100,000 live births (maternal mortality) and 30.6 deaths under 1000 live births (under-five mortality) respectively. This clearly indicates the state could not protect the education and health rights as the universal human rights.
In addition, 51.4 per cent of girl children are married off they reach 18 and 11.3 per cent of children are engaged in labour. This is also a gross violation of children’s rights to development with their full potential.
The disparities between rural and urban education and health services in terms of access to and the quality of services are unimaginable. The people in several poverty pockets such as delta, coastal and haor areas do not have minimum level of access to health care services and to quality education. There are union health complexes and government primary schools, but they are almost completely dysfunctional for lack of resources, isolation, negligence of the national and local government authorities, overlooking and exclusionary approach and the frame of mind of the political and community leaders, prevailing rampant corruption, lack of transparency and accountability and people’s ignorance and lack of voice for their rights and entitlement.
However, only in some big cities, particularly in the capital city, a very few education and health facilities and institutions provide acceptable standards of health and education services. But that are expensive and completely out of reach of ordinary people. Only the affluent group of people, about 10 per cent of the population, can afford this good quality of health and education services. And, almost 90 per cent of the population and all of rural and marginalised people, who are penniless and powerless, receive education and health services from the dysfunctional and retrospective facilities and systems. As a result, not only individuals face the adverse impact of the dysfunctional health and education services, but also national development also suffers in all aspects. The health and education services have completely been turned into business through the hegemonic political systems and monopoly and manipulative business approaches.
Good quality of education and health service systems are the main engines of all kinds of development, economic and social. But keeping the majority portion of the population out of the quality services, a country cannot get on the development highway.
Research shows that one dollar’s investment in education and health sectors generates more than one dollar’s return; but in all other sectors, it creates less than one dollar’s return. It proves that the rates of returns on investment in education and health sectors are much higher than that of another sectors. The good quality of education and health services is also the most effective tools to achieve the sustainable development, including poverty alleviation and building resilience of individual, community and systems to climate change, natural and artificial shocks and disasters.
Definitely, the constraint of resources — financial and expertise — is a challenge to provide good quality of education and health services as the national budget allocation is much less than what is required. Along with this limited resource allocation, rampant corruption, lack of transparency and accountability, political engagement of professionals, monopoly business approaches, denial of human rights and the lack of the rule of law destroy the education and health systems.
A comprehensive, rights-based-approach is required to enable both parties, service recipients and providers, as rights holders and legal and moral duty bearers respectively so that they can effectively perform their duties in all kinds of businesses and services. The marginalised and excluded section of the population as rights holders need to be able enough to receive technical and non-technical supports to claim their rights and entitlement accordingly. A rights-based approach is complementary with humanitarian and democratic norms, the rule of law, transparency and accountability and it impacts well-being, progress and prosperity. It is imperative to create such an inclusive, integrated and rights-based business environment and platforms that help to attain the expected outcomes, promoting ethical business standards with humanity and prohibiting unethical and illegal business that only makes money.
So, improvement in the quality of education and health services requires some important policy and strategic actions. Demonstrating strategic, visionary and people-centric leadership would dismantle the hegemonic myths, bringing all actors together to the playground with the highest standard of professionalism, accountability and transparency. Business syndicates of rights-based services systems over the monopoly and manipulative business systems in education and health sectors should be eliminated. Primary and essential health care and services must be free for all people and specialised health services must be affordable for the rural poor and marginalised people with an equitable access to good public health.
Physicians must stay in community and union health complexes and provide specialised health services for rural people. Public and private partnership should be attempted at to address the challenges of resources constraints. The marginalised and excluded groups should be empowered to protect their rights to quality services.
The government implements social safety net programmes to support the extreme poor and people with disabilities, but that is not effective because of political bias, corruption, abuse, exploitation and exclusion. Rights-based, service-oriented education and health systems should be established.
It is essential to raise the floors of the extreme poor and marginalised people with education and empowerment programmes and initiatives so that they can raise their voice for their rights and entitlement. It is imperative that Bangladesh now should implement a comprehensive reform initiative, but no reforms will sustain in the long run if the reforms do not focus on education and health systems.
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Md Siddique Ali ([email protected]) is a former country director (interim) and programme manager, Education, BRAC International in Afghanistan.