Prime Minister Sheikh Hasina on Tuesday said community-based primary healthcare is the key to achieving universal health coverage, calling upon the global development partners to support the efforts in the developing nations to reach healthcare services to all.
"We call upon our development partners, including multilateral financing institutions, to extend their support for the cause of community-centric health services in the developing world," she said.
She said this in her closing remarks in the plenary session of the high-level side event on "Sheikh Hasina Initiative of Community Clinics: Innovative Approach to Achieving Universal Health Coverage Inclusive of Mental Health and Disabilities" at the UN headquarters in New York on the sidelines of the 78th UNGA session.
"We feel energised by your presence as we take an oath this year to accelerate our collective work on sustainable development and universal health," she said.
As an emerging voice of the Global South, the prime minister said Bangladesh would champion this issue as a possible avenue for meaningful international partnership.
"On our part, Bangladesh stands ready to share our insights and expertise with those interested. Health is at the root of all happiness. We wish to spread happiness all around through the community clinics."
The prime minister said she is profoundly grateful to the ministers and experts "who echoed their sentiments and pledged their support just now."
"We hope that this side event will remain yet another proof of our shared commitment to the health and well-being of all our people and communities," she said.
Sheikh Hasina said they have realised that the revival and sustainability of community clinics would only depend on local people acting as their owners, stewards, and custodians. "This model perhaps explains why 90 per cent of service seekers express their satisfaction with community clinics."
In 2018, she said, their parliament passed the Community Clinic Health Support Trust Act to further streamline operations and funding modalities.
The prime minister envisioned five priorities for the community clinics to take the healthcare services to the grassroots.
The priorities included making community clinics serve as gatekeepers at the grassroots to prevent huge out-of-pocket payments for health services; enabling community clinics to provide enhanced digital health and diagnostic services, especially for NCDs; and further developing the capacity of community clinics to address growing climate-induced health crises, like dengue outbreak.
The remaining two are – improving screening and treatment facilities for mental health and neurological disorders so as to provide accessible services to those affected and their families; and using community clinics as the primary building block for a robust data-driven health and nutrition programme.
Sheikh Hasina said the community clinic is an idea that has stood the test of time in Bangladesh. "It has now become an integral part of our primary healthcare system. The UN General Assembly has recognised the model as a best practice for the rest of the developing world."
She said she feels humbled that the UN membership has recognised it as the "Sheikh Hasina Initiative."
In 1996, she said, when she was first elected to office, community clinics were one of the innovative ideas they launched to promote "Health for All."
"I was inspired by the vision of my father, our Father of the Nation Bangabandhu Sheikh Mujibur Rahman, to bring healthcare to our people's doorsteps," she said.
Immediately after the independence of Bangladesh in 1971, the Father of the Nation wanted to set up rural medical centres to provide a "minimum measure of medical relief" for the entire population. "The community clinics are a realisation of his dream and commitment," she said.
The prime minister said there are now nearly 14,500 community clinics which were designed to act as a one-stop centre for health, family planning, and nutrition-related services. "The community clinics are playing a critical role in reducing infant, child, and maternal mortality."
She mentioned that around 3,000 community clinics offer facilities for skilled birth attendance.
On average, she said, there are 9.5-10 million visits to the clinics every month and among the service seekers, almost 80 per cent are women and children.
The community clinics have become the local hub for universal immunisation and they played a crucial role in securing Covid-19 vaccination coverage.
There is also the scope for screening non-communicable diseases as well as mental health and neurological disorders, she continued.
"We plan to use community healthcare providers to combat social stigma with mental health and extend psychosocial support where possible. It remains critical to update the training and competence of the community health workforce."
At the community clinics, she said, their government is providing 27 essential medicines and three family planning materials free of charge, adding, "We have decided to replace antibiotics with anti-diabetic and anti-hypertensive agents."
The prime minister said the community clinics act as a referral point for emergencies and complicated cases to higher medical facilities. "The service providers are equipped with the internet and digital devices to record health data. They also engage in communication on social and behaviour change for health and disability-related issues."
The community clinics are expected to cover 6,000 people each, she said, adding that they are based on a unique model of public-private partnership, with the local people providing the land and the government bearing the operational costs.
They are managed by local representatives drawn from different segments of society, with the mandatory participation of women, she said.
In 2001, with the BNP-Jamaat government coming into office, the community clinics were abandoned and thrown into neglect for nearly seven years, she added.
Thematic Ambassador for Climate Vulnerable Forum (CVF) Saima Wazed addressed the event as a keynote speaker.
Speaking at the event, Sint Maarten Prime Minister Silveria Elfrieda Jacobs highly praised the community clinics model in Bangladesh to reach healthcare services to every doorstep and achieve Universal Health Coverage.
Deputy Minister of Health of Maldives Safiyya Mohamed Saeed said she was overwhelmed to address the event before such a strong female leadership Prime Minister Sheikh Hasina.
She also highly praised the community clinic initiatives to make ways easier to reach healthcare services to all.
Foreign Minister AK Abdul Momen, Prime Minister’s Energy Adviser Tawfiq-e-Elahi Chowdhury, and ICT Division State Minister Zunaid Ahmed Palak were present at the event. Permanent Representative to the UN Muhammad Abdul Muhith moderated the event while Bangladesh Ambassador to the USA Muhammad Imran was present.
A video documentary on the role of community clinics in reaching healthcare services at the grassroots level was also screened.
