In Bangladesh, the distinction between owning healthcare equipment and actually delivering healthcare is crucial. While there have been improvements in infrastructure and equipment, the focus now shifts to ensuring effective healthcare service delivery.
Recent Bangladesh Health Facility Surveys reveal progress in public facility connectivity to the national electricity grid, with a rise from 57% to 85% between 2017 and 2022. Upazila health complexes have shown an increase in average diagnostic test capacity and functioning X-ray machines. However, the key question remains: are we merely tallying health sector inputs or ensuring these inputs translate into quality healthcare services?
Public sector management often emphasizes counting inputs like machines, posts, medicines, and budgets, rather than service delivery. For instance, while many facilities possess X-ray and ultrasound machines, a significant percentage remain non-functional. A study highlighted issues like reagent shortages, non-functional equipment, and vacancies in trained medical technologist positions, impacting service delivery.
To address these challenges, a national medical equipment management system focusing on functionality rather than ownership is imperative. A comprehensive registry of major equipment in public facilities should be established, including details like operational status, maintenance history, and availability of trained operators. This system should align with the World Health Organization’s equipment management approach.
Moreover, addressing human resource issues is crucial. A coherent HR strategy should complement an HR information system to ensure timely promotions, adequate posts, and defined career progression routes. Vacancies, skills gaps, and promotion bottlenecks must be identified and managed effectively.
Efforts should also extend to managing medicines, reagents, and consumables through electronic logistics systems. Facility-level reporting on stock status, consumption, and replenishment needs is essential for efficient supply chain management.
Integrating equipment, human resources, and supplies information systems into a single management view can enhance healthcare service delivery accountability. The goal is to shift focus from inventory management to providing quality healthcare services in Bangladesh.
Dr. Rumana Huque, a professor at Dhaka University and executive director at ARK Foundation, emphasizes the need for this transformative shift towards quality healthcare service delivery in the country.
