Evaluation of Healthcare Development in Bangladesh

Muntasir Murshed

DSCF8979 01The conceptual framework of ‘a healthy nation being a wealthy one’ has received global recognition. In the past, economies strived in achieving development without much emphasis on improving its social indicators. However, as time progressed the concept of development had undergone multidimensional transitions whereby development was gradually perceived to be a socioeconomic variable with utmost preference to both economic and social improvements within the economy. The paramount significance of improving health indicators has also been acknowledged in SDG3 (Good health and well-being). Bangladesh, adhering to its remarkable performances in achieving the Millennium Development Goals (MDGs) way ahead of neighbouring countries, has also expressed its willingness to do the same with regard to achieving the SDGs as well. As part of the nation’s commitment in achieving the SDGs, the current government took the agenda of healthcare development with utmost importance and has adopted relevant policies to improve the national health indicators. Although the fiscal allocations to health have shrunk in recent times, the health sector indicators of Bangladesh have portrayed significant improvements as compared to its post-independence phase.

Bangladesh over the course of its post-independence period has come a long way in stimulating healthcare development within its economy. A country which once had a huge portion of its population being malnourished has somewhat reversed the scenario at present. The life expectancy at birth has surged by more than 53% over the last 45 years revealing remarkable development in healthcare facilities over time. According to the World Health Organization (WHO), Bangladesh is ahead of most of its neighbouring nations when it comes to its national life expectancy at birth. For instance, the life expectancy at birth in the country is 72 years on average where India and Pakistan have a life expectancy at birth figures of 68.5 years and 67 years respectively. Moreover, the country displayed impressive performance in safeguarding and improving maternal and infant lives. The maternal mortality rate in Bangladesh has also experienced a declining trend as the rate was curbed by more than 70% over the last 30 years. At present, maternal mortality rate in the country is estimated to be around 176 per 100,000 live births. According to the WHO, the maternal mortality ratio between 2000 and 2015 in Bangladesh dropped from 339 to 176 maternal deaths per 100,000 live births while the corresponding lifetime risk of maternal death declined from 1.49% to 0.421%. The country has also taken effective initiatives in ensuring praiseworthy infant and neonatal heath protection as reflected by sharp declines in the associated death rates. Infant mortality rate in the country has gone down by almost 75% over the last three decades or so. At present, infant mortality rate in Bangladesh hover around 31 deaths per 1000 live births as compared to India and Pakistan having corresponding rates of 38 and 66 per 1000 live births respectively. The current neonatal death rate in Bangladesh, according to UNICEF, is around 23 deaths per 1000 live births which is 50% and 17.86% less compared to that in Pakistan and India respectively. Furthermore, loss of lives due to communicable diseases and maternal, prenatal and nutrition conditions has also reduced in the country by more than 33% in between 2000 and 2012.

Despite such progresses made in the fields of health and nutrition in Bangladesh, the country is yet to match global standards which would have potentially aided the nation in leapfrogging into the elite list of upper middle income countries in near future. This can partly be attributed to the inefficiencies attached to the heal sector of the country and also to the reduction in fiscal allocations aimed at development of this sector.

Thus, in order to achieve the SDG3 and also to comply with the commitments of the current government for ensuring improved quality and access to healthcare facilities in the country, it is high time to get over the existing inefficiencies and irregularities engulfing the health care sector of Bangladesh. It is ideal for the government in leaving no stones unturned in ensuring greater access to safe drinking water, sanitation and nutritional commodities for betterment of public health in the country. Moreover, the disparity in the urban and rural health services on offer should also be mitigated in order to enhance the overall health standards.

Muntasir Murshed, MS in Economics, School of Business and Economics, North South University

Email: muntasir.murshed@northsouth.edu





Promoting Youth Employment through SDGs

Andilip Afroze

The 2030 Agenda for Sustainable Development Goals is in its third year of implementation. The agenda commits to leaving no one behind by recognizing youth as its “critical agents of change”. Young generation is defined by UN as individuals aged from 15 to 24 years. There are in total 169 targets under 17 goals in SDGs. More than one third of these targets refer implicitly or explicitly to young people.

Youth receives the highest priority in the 2030 Agenda as eventually they are the one to experience its success or failure after 15 years. Also, this generation of youth is the largest ever in human history. Global youth population stands at 1.1 billion in 2018 that is 18 percent of the world’s population. Among them Asia and the Pacific region alone contains 60 percent of youth. (Advocates for youth)

Despite being such an important part of the world demography, this generation is facing global challenges like poverty, health risks, lack of quality education, unemployment and lack of decent work higher than the adults. A major challenge is the youth unemployment. The Report ‘Global Employment Trends for Youth 2013’ identifies youth as a generation at risk. In the context of young people facing prolonged job crisis, temporary and informal employment, and discouragement, the report states that it is not easy to be young in the labour market today. To solve this global crisis, 2030 Agenda puts great emphasis on promoting employment for youth.

There are four youth employment specific targets under two key SDGs: Decent Work and Economic Growth (Goal 8) and Quality Education (Goal 4). Under goal 8 three relevant targets are: achieving full and productive employment, decent work and equal pay for work of equal value for young people by 2030 (8.5), reducing the proportion of youth not in employment, education or training (NEET) substantially by 2020 (8.6), and developing and operationalize a global strategy for youth employment and implement the Global Jobs Pact of the International Labour Organization by 2020 (8.b). Relevant target under goal 4 is to increase the number of youth who have relevant skills, including technical and vocational skills, for employment, decent jobs and entrepreneurship substantially by 2030 (4.4). (ILO)

Targets have been set. However, satisfactory progress towards achieving the related targets is yet to come. According to ILO reports, overall condition of youth employment today has either deteriorated or remained similar to the launching year 2015. From 12.9 percent in 2015, global youth unemployment rate has increased to 13 percent in 2017. The rate is three times higher than the adult unemployment rate (4.3%). In fact, the ratio of youth unemployment to adult unemployment has been consistently close to three since 1995. In 2017, the highest rate is in North Africa (almost 30%), followed by Arab states (25.6%), Europe and central Asia (18%), Latin America and Caribbean (18%), Asia and Pacific (10.4%) (World Bank data). Secondly, the incidence of informal employment among youth remains stuck at 76.7 percent in 2017. In the case of NEET, roughly 25% of youth were NEET in some 28 countries in 2015, whereas in 2017 globally 21.8% of youth are NEET. This target 8.6 should be fulfilled by 2020. However, there has not been any substantial change till now. NEET young people are mostly female with rate of 34.4% globally.

Therefore, a long way to go before achieving the SDG targets for youth employment. International organizations are working relentlessly in this regard. However, global initiatives at best can assist rather than achieve the ambitious goals. Rapid action at national level is required as the underlying causes and solutions for these global challenges are actually country specific. Focusing on overall unemployment alone will not solve the problem either. Because globally youth unemployment has increased while unemployment rate has decreased. Related issues such as school to work transition, decent work, skill mismatch, young entrepreneurship, entry level constraints should receive priority in policy making. Another notable issue is data is unavailable for a large number of countries. For measuring progress towards SDGs, all related indicators in each country should be traced. A strong national statistical system is inevitable to solve this issue. Also progress reports need to present status of all 169 targets to point out where we stand and where we need to proceed. Recently published Sustainable Development Goal Report 2018 does not cover this. Also, the report has not focused much on youth. Regarding Global Jobs Pact, there is no recent progress report on implementation status.

Andilip Afroze, Senior Research Associate, SANEM.

E-mail: andaleep.afroze@yahoo.com

First published in the Thinking Aloud, 1 October 2018