Speech By Dr Bardan Jung Rana, WHO Representative to Bangladesh
Honourable Chief Guest Mr Lokman Hossain Miah, Senior Secretary, Health Services Division, Government of the People's Republic of Bangladesh; Special Guest Professor Dr Abul Bashar Mohammad Khurshid Alam, Director-General, Directorate General of Health Services; chairperson of the workshop, Mrs Sabina Yesmin, Additional Secretary (Admin) and Line Director-HRD, Health Services Division, Ministry of Health and Family Welfare, colleagues and friends from different organizations, very good morning to you all!
It's a great pleasure for me to attend this workshop on the dissemination of evidence on Human Resources for Health (HRH) to drive well-informed policies and decision-making. WHO is happy to have supported the government of Bangladesh in conducting these studies, and I congratulate the Ministry of Health and Family Welfare for organizing this dissemination programme.
The health workforce, which comprises doctors, nurses, midwives and many other categories, is the foundation of the health system and enables effective and quality health service delivery. The health system's overall performance primarily depends upon the health workforce quality, numbers, composition, and distribution, making it imperative to set adequate policies and strategies based on reliable and robust evidence to address health workforce production, inflows, and outflows maldistribution, inefficiencies, and regulation.
The COVID-19 pandemic has highlighted even more the strict correlation between the health workforce and health system performance. Before the crisis, there was an estimated shortage of about 18 million health workers worldwide. The highest shortage was registered in South-East Asia Region, with 6.9 million missing health workers. These figures were calculated based on the threshold density of 44.5 doctors, nurses and midwives per 10 000 population.
As of 2019, Bangladesh had a severe shortage of trained healthcare workers, with only 10 among doctors, nurses and midwives per 10 000 population. Despite this gap, Bangladesh has been successfully managing the emergency and is now recovering from the tremendous impact that the pandemic had on the national health service delivery system.
Still, in terms of health workers supply, Bangladesh currently presents an estimated total density of 49 health workers per 10 000 population, including 33.17 density of recognized workers and 15.83 unrecognized workers. These numbers are unequally distributed among the various geographical areas, with an average of 73.72 recognized health workers in urban areas and only 11.48 in rural areas. Furthermore, the country is also affected by a severe problem of low efficiency in the health workforce composition, with less than one nurse per doctor. In such a scenario, it is of the utmost importance to strengthen the national health system as soon as possible by adopting evidence-based policy reforms that specifically address the health workforce challenges and gaps.
As many countries worldwide face this sort of challenge, WHO has elaborated some specific guidelines, such as the "Global Strategy on Human Resources for Health: Workforce 2030", the "National health workforce accounts: implementation guide", and the "United Nations High-Level Commission on Health Employment and Economic Growth (2016)".
With technical support from WHO Bangladesh, the Ministry of Health and Family Welfare has already started the strategy reviewing process by conducting several studies and assessments. Some evidence has already been translated into implementation policies, such as approving curriculums, establishing and strengthening a central Human Resource Information System (HRIS) and an Education Management Information System (EMIS).
But we still have a long way to go, and we are here today to share findings from the studies on workload in public facilities, occupational health and safety of health workers, the assessment of health care providers and the health labour market survey in Bangladesh, and to seek opinions and suggestions from national HRH experts.
Evidence indicates the need for high-level intervention to align the health workforce quality, composition and distribution to the population needs. Addressing them would mean moving towards achieving the national strategic Vision 2041 and the Universal Health Coverage. I am confident that the panel discussions guided by expert opinions and empirical evidence today will focus on these issues and generate inputs to review the national long-term health workforce strategic plan and strengthen the primary healthcare-oriented workforce.
WHO is very committed to supporting the Ministry of Health and Family Welfare in this journey of strengthening the Human Resources for Health in Bangladesh. Our Regional Office in New Dehli has also played a significant role in this effort. Today, we have our Regional Advisor for HRH to share the regional and global perspectives and experiences. The Foreign, Commonwealth and Development Office (FCDO) has also been an essential partner to WHO and MOHFW on this subject, and our collaboration will continue in the coming years.
I reiterate WHO's commitment to supporting the government and people of Bangladesh in building a robust and efficient national health system that will eventually guarantee good health for all.
Thank you.