We’d like a referral system that works| The Day by day Star


Within the vibrant tapestry of Bangladesh’s healthcare panorama, the city sector faces a urgent concern: a disjointed referral system. The three-tier healthcare construction—main, secondary, and tertiary—is grappling with a essential flaw: the city main healthcare companies are sometimes neglected, prompting sufferers to bypass them and immediately search help from tertiary-level hospitals. This phenomenon locations an undue burden on establishments like Dhaka Medical School Hospital (DMCH), Bangabandhu Sheikh Mujib Medical College (BSMMU) and others, leading to a compromised service high quality as a result of an amazing variety of sufferers.

City areas, the place the demand for healthcare is powerful, discover themselves hindered by a non-functional reference system. The three-tier mannequin, designed to channel sufferers via main and secondary care earlier than reaching tertiary amenities, falters as sufferers go for direct entry to superior healthcare, sidestepping main companies.

The DMCH, BSMMU, and affiliated institutes, regardless of their capabilities, are stretched skinny as a result of an inflow of sufferers searching for take care of points that could possibly be effectively dealt with on the main stage. This overcrowding poses a problem for docs who discover themselves unable to ship optimum companies amid the affected person surge.

The weak point in city main healthcare stems from its oblique governance construction. In contrast to amenities immediately managed by the well being ministry, city main healthcare amenities function beneath the jurisdiction of metropolis companies and municipalities, typically in collaboration with NGOs via contractual agreements. This association, whereas well-intentioned, has led to an absence of visibility and recognition for these main care companies.

To navigate this essential juncture, a strategic method is crucial.

Acknowledging the present pressure on the reference system is step one. An in-depth evaluation of affected person behaviour, coupled with focused consciousness campaigns, is crucial to deal with misconceptions and illuminate the importance of city main healthcare. Advocating for a shift in governance construction can be essential. Direct oversight of city main healthcare by the well being ministry would align these amenities with nationwide well being priorities, fostering standardisation and a extra cohesive healthcare method.

Redefining collaboration between metropolis company and municipalities, NGOs, and the well being ministry is paramount. Clear governance fashions that facilitate efficient communication and useful resource allocation can improve the effectivity of city main healthcare.

Implementing incentives to encourage sufferers to stick to the reference system is important. Whether or not via diminished ready instances or different patient-friendly measures, incentivising correct utilisation of main healthcare can alleviate the pressure on tertiary hospitals.

Within the difficult panorama of city healthcare in Bangladesh, understanding the pressure on the reference system is pivotal. By addressing affected person behaviour, advocating for structural shifts, fostering collaboration, and incentivising correct utilisation, we are able to chart a course in the direction of a extra balanced and efficient city healthcare system. The main target have to be on acknowledging the scenario’s intricacies earlier than implementing strategic options for a more healthy city future.


Mahir Al Asif Masrur is a pupil of the Institute of Well being Economics, College of Dhaka.


Views expressed on this article are the authors’ personal. 


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