Group: Rain Lily

Team Members are:

Arifa
Mst. Naznin Nahar
Tuly Sur
Tania Akter
Sadeya Ferdousee
Moinul Arefin
Rimon Chowdhury
 Urban Slum Health Care in
Bangladesh During Covid Time
 Introduction
As per “worldometers.info” Since March 2020, Bangladesh has seen total 2,010,748 cases
of Covid-19 and 29,320 death tolls

- Whole Bangladesh health systems impact.

- Affect was greater on Urban slum area in Bangladesh.
A Study on Urban Slum Health Care impact at the time of
Covid-19 was published on “BMJOPEN.BMJ.COM” on 23
February 2022.

Survey :
- Cross-sectional survey among 476 households .

Area of Survey:
- Five selected urban slums of Dhaka North, Dhaka South and Gazipur City
Corporation.

Time Of Survey:
- October–December 2020
 Methodology

SERVICE DELIVERY
Primary Secondary
Data Data
HEALTH WORKFORCE

HEALTH INFORMATION SYSTEM

ESSENTIAL MEDICINE

HEALTH FINANCING
Quantative Qualitative
GOVERNANCE
 Health service delivery:
- The study found that about 12% of the members
suffered from general illness.
Majority Suffered From-
Cough Fever Pain/Chest Pain Diarrhea
33% 32% 12% 4%

Sought Healthcare From-

local drug stores private hospitals public hospitals
64% 16% 14%
The survey also found that about 25% of individuals aged 40 years and above
reported suffering from a chronic illness. Most of them suffered from
diabetes (24%) followed by arthritis (20%), asthma (16%), cardiovascular
(13%) and hypertension (9%).

Treatment :
- Mostly people visit Local drug stores for the treatment and few visit
private and Public hospitals.

Exception :
- The study found that about 37% of the members suffering from chronic
illness did not seek care due to financial constraints.
- Around 18% refrained from seeking care due to fear of COVID-19 infection.
 Impact on healthcare provision:
- Government of Bangladesh has a regular provision to provide vaccine for
Oral Polio Vaccine (OPV), Measles & Rubella (MR) vaccine, Measles
vaccine etc.

Situation In Urban Slum area :

- From the healthcare providers, the study found that the number of home
deliveries in urban slums of Dhaka city increased.
- People were afraid of visiting local health complex.
 Challenges in health service delivery
during pandemic:
Both service recipients and service providers faced
challenges in accessing and providing services.
Initial Challenges :
- Shortage of PPE
- Challenges in maintaining proper safety measures
- Increased workload and stress

Other Challenges :
- Reduced hours of the formal health facilities
- Shortage of doctors
- Unavailability of specialists
- Lack of physical examination and requirement of COVID-19 tests
 Healthcare financing:
In terms of budget allocated to manage the pandemic, the government with
support from development partners was able to mobilize resources to
manage the pandemic. But there were challenges in ensuring efficient use of
the resources.

Affected area :
The inefficiency was more visible in urban slum area of Dhaka city where the
pandemic response strategy was rather rapid but unplanned. There were lots
of issues that are causes for inefficiency like -

Insufficient fund Mismanagement Proper Plane

Existing Rules
Out of pocket expense for healthcare during
pandemic:

The median total OOPE per patient for treating general illness was BDT 315 in
the 14-day preceding the survey. About 96% of the care seekers required
medicine for which the median expenditure on medicine was BDT 300.

For Chronic Illness For Maternal Care

OOPE Was BDT OOPE Was BDT
1750 1750
 Health information on COVID-19
prevention, management and treatment :
- The study found that around 51% of the respondents mentioned receiving
COVID-19-related messages in the 30 days preceding the survey. The rest
reported not receiving any message.
- Fifty-one per cent of the respondents were not aware of the national hotline
number that provides COVID-19- related treatment through telemedicine.
Major Source Of Covid-19-related Information:
 Health workforce:
Shortage Of Human Resources In Health

Public health Private health

sector sector

- Unavailability Of Senior Physicians

- Majority of the senior, experienced and specialized physicians did not
attend patients
- Frontline health workers had to face the battle.
 Medical products and technologies:
- The respondents from the slums stated that access to existing
COVID-19 test facilities was challenging for the urban slum
dwellers.
- The private diagnostic facilities have high charges for the test
which the poor patients cannot afford.
- There was a general lack of interest among slum dwellers to
get tested of COVID-19.
- Limited availability of tests in the early stages of the
pandemic.
- The lower-class people always experience discrimination.
 Leadership/governance:
- A lack of strong leadership was identified
- Lack of technical experts

Centralization of decision making was seen as a barrier to the

timely allocation and use of resources in managing local
challenges posed by the pandemic. One respondent said: all
decisions are made by one or two people.
 Conclusions:
- The health system of Bangladesh is overburdened and Urban slum
people are deprived of many facilities.
- Urban slum heath system is deprived of many facilities.
- Good governance and leadership are needed in managing urban
health care.
- The adverse effect of the pandemic has been acute on the health
system, particularly the urban health system.
- The government of Bangladesh should take initiatives to document
all challenges of the health system faced during the pandemic and
the best practices to overcome the challenges.
Thank You