Bangladesh Info
Joined: 15 Jan 2007
Posts: 17
Home Country: bangladesh
|
 Posted: Mon Jan 15, 2007 5:33 pm Post subject: HEALTHCARE IN BANGLADESH |
 |
|
HEALTHCARE IN BANGLADESH
GENERAL
An estimate for mid-1998 suggests a population of 125.5 million, making Bangladesh the most densely populated country in the world.
Bangladesh is a very poor country. The maintenance of its economy depends in part on foreign aid and the remittances of Bangladeshis working abroad. Production in the form of agriculture and manufacturing contributes 30% and 8.9% of GDP respectively. Poor infrastructure and insufficient reserve allocation together with political instability are major obstacles to sustained growth.
Gross life premium income in 1998 amounted to BDT 4.9bn (USD 106mn) an increase on a BDT basis of 26% over the previous year. More up-to-date statistics are not available. The total 1998 premium income (life and non-life) totaled BDT 8.7bn (USD 187mn) or USD 1.50 per capita.
As one of the poorest countries in Asia, it is understandable that Bangladesh has a small insurance market. With an adult literacy rate of only 37% of the population and 80% classified as poor, that is those living on or below an internationally recognised poverty line, the insurance industry has an uphill battle in selling its products.
As a result of legislation in 1984, the door was opened for the re-admittance of private insurers. Since then 10 life and 34 non-life insurers have been granted operating licenses. Many market practitioners are of the opinion that there are too many companies in a market where there is limited potential for the development of new business. However the controller of insurance considers that increased competition should be welcomed as a stimulant to the markets' development. At the present time the Government is preparing new insurance legislation based on the recommendations of international consultants sponsored by the Asian Development Bank. The proposed law includes increased minimum paid up capital, larger deposits and the admittance of foreign shareholders.
Bangladesh has insufficient resources to support a proper social security system. State-funded facilities are limited to the provision of around 600 hospitals where patients pay for treatment. The only benefits funded by the government are pensions paid to retired workers who are chosen on merit by local authorities. It is understood that scarcely 400,000 people receive a retirement pension in this way.
Social Security
Bangladesh is a very poor country with insufficient resources to support a proper social security system. Indeed state-funded facilities are limited to the provision of around 650 hospitals whose patients pay for treatment. The only benefits funded by the government are pensions paid to retired workers who are chosen on merit by local authorities. It is understood that scarcely 400,000 people receive a retirement pension in this way.
A number of labour laws covering voluntary provident funds, occupational accidents and disease, sick leave and gratuities are in force but none involves mandatory contributions or the payment of benefits by the state except in the case of civil servants and public sector employees.
Social security amounts have been shown in local currency. At the time of writing the rate of exchange was BDT 50.85=USD 1.
The government's expenditure on health and planning, the only area where the state makes some contribution to social security, amounted to BDT 13.6bn in 1998/99 which represents a 16% increase over the previous financial year.
Besides the government-funded hospital system and the selective old age pension scheme, there is no social security system.
There are no plans to move the cost and service provision of the state's very limited involvement in social security to the private sector.
No obligatory social security contributions are payable by either employers or employees to state-sponsored schemes.
Many private sector companies have established their own provident fund to which both the employer and employee typically contribute 10% of earnings, although up to 12.5% is permitted by law.
Expatriates
Most expatriates employed in Bangladesh are likely to be recompensed by their employees for healthcare, disability and sickness. Those working for multinationals are probably included in their head office pension schemes.
State Healthcare
The majority of Bangladeshis lead a singularly impoverished life. Indeed according to the United Nations Human Development Index based on life expectancy, literacy and income indicators, Bangladesh is in the 146th position out of a total of 173 countries. Understandably the public health service is inadequate with limited hospital and medical facilities, and shortages of trained staff. The private sector is supported by wealthier Bangladeshis and is said to be growing in response to a demand from a developing middle-class.
Healthcare insurance is in its infancy but market practitioners are fairly optimistic about its future growth.
The government is the main provider of healthcare services to the population and has developed a network of primary, secondary and tertiary healthcare facilities. The services are mainly curative, rather than preventive. Furthermore they are urbanised and inadequate, and all treatment must be paid for. There are some 650 government hospitals, and one doctor for every 4,500 people. Long queues at hospitals are the norm, doctors frequently exhibit a marked lack of care, and medical facilities and standards of hygiene are poor.
There is no formal documented health policy in Bangladesh. Successive "5-Year Plans", which are vague and bureaucracy laden have so far guided health sector programmes. Expenditure on healthcare and family planning is said to be less than 2% of GDP. There are no plans to pass responsibility for public healthcare to the private sector, which is in any case ill prepared to receive it.
Whilst it might be assumed from the foregoing that there would be a substantial market for private medical plans, in fact the opposite is true. This is due to the lack of buying power from a population where the majority is struggling to do no more than subsist. Were private medical insurance to be developed, considerable care would be needed to control potential fraud e.g. issuing of false medical bills, individuals posing as family members etc. Furthermore there are serious underwriting considerations, in that illness and disease are endemic in a country where diarrhea diseases claim some 30% of the deaths of those under five years old, and 60% of the population do not have access to proper sanitation facilities.
Private Healthcare
There are some 300 private hospitals, clinics and diagnostic laboratories in Bangladesh, mostly in urban areas. The number is increasing. However, even these facilities frequently have poor services and standards of hygiene, and are often set up purely with financial gain in mind. Wealthy Bangladeshis and expatriates use private facilities, but generally only for basic diagnostic consultations.
In the event of serious disease or injury, the preference of those who can afford it is to travel overseas for treatment, to India or Bangkok, rather than take their chances in local private hospitals. Overseas trips may be less frequent if the proposed new private Continental Hospital in Dhaka, with 450 beds and due for completion in 2002, lives up to expectations as a thoroughly modern facility.
The healthcare insurance market is expected to grow. Currently there are few products available. Business is currently mainly in the hands of non-life insurers, but life companies plan to enter the market.
There are no separate statistics for this underdeveloped class of insurance.
One Bangladeshi life insurer is testing medical coverage for individuals on a very selective basis.
Coverage is offered to the existing insured by way of a rider to the life policy, which provides coverage for in-patient costs and treatment for the insured and family members, up to 20% of the basic life sum assured, or a maximum of BDT 100,000 (USD 1,967) per year. Some 2,500 policies are said to have been extended in this way.
Overseas Mediclaim insurance, which is aimed at Bangladeshis studying or temporarily employed overseas, is readily available. This plan provides cover for up to USD 75,000 in respect of medical services, supplies and treatment in the event of sickness or accident occurring outside Bangladesh.
Other principal features of the coverage are:
* Cover for mental, emotional and nervous disorders is limited to 30 days continuous in-patient treatment, with 50% coinsurance.
* Should the insured have to be repatriated to Bangladesh, the policy pays up to USD 5,000 to the insured and USD 5,000 for family members, in respect of travel costs etc.
* Funeral expenses and/or costs of transporting remains to Bangladesh are covered for up to USD 8,000.
* In the event of a study course being curtailed due to death, loss of sight, permanent total disability or medical evacuation, the policy will pay USD 750 to the insured's overseas sponsor for each month of study completed.
One insurer has introduced a group hospitalisation product, which covers in-patient treatment for employees in approved private hospitals and clinics. The scheme is not profitable. In 1998 premiums amounted to BDT 4.9mn (USD 104,928) against claims of BDT 5.1mn (USD 108,719).
Rates for the most popular product, the overseas Mediclaim policy, range from BDT 778 - BDT 1,714 (USD 15 - USD 34) per month for students, and for those in employment outside Bangladesh from USD 40 - USD 65 per month.
Most insurers, both the state-owned non-life insurer Sadharan Bima Corporation (SBC) and the private companies, offer overseas Mediclaim but take up has been slow.
The overseas Mediclaim programme is reinsured by SBC on behalf of itself and the market. A 90% quota share is placed in the London market.
Insurers market overseas Mediclaim policies through their branch and agency networks. It is understood that they are trying to involve travel agents in sales.
DIRECTORY OF HOSPITALS & CLINICS
Al- Helal Specialised Hospital
150 Rokeya Sarani,
Senpara Parbota,
Mirpur,
Dhaka-1216,
Bangladesh
Tel: 900 6820, 900 8181
Fax: 9008181
Aysha Memorial Specialised Hospital
74F/74F Peacock Square,
New Airport Road,
Mohakhali,
Dhaka,
Bangladesh
Tel: 912 2689-90
Fax: 913 1742
Email: aysha@rub@bttb.net
Bangladesh Medical College Hospital
House 35, Road 14/A (new)
Dhanmondi,
Dhaka,
Bangladesh
Tel: 911 8202, 811 5843
Fax: 912 5655
British High Commission Clinic
Elizabeth House,
House 23, Park Road (Corner of Road 6),
Baridhara,
Dhaka,
Bangladesh
Tel: 882 4345
Central Hospital
House 10/A, Road 5,
Dhanmondi,
Dhaka
Bangladesh
Tel: 966 0015-19
Fax: 8619321
Chittagong Metropolitan Hospital
948, O. R. Nizami Road,
Chittagong,
Bangladesh
Tel: 031- 651 242
Continental Hospital
Plot 15, Road 71,
Gulshan-2,
Dhaka 1212,
Bangladesh
Tel: 882 9373, 881 6048, 881 0258
Fax: 989 3445-6
Email :chi@dominox.com
Dr. Wahab's Medical Centre
House 3,
Road 12,
Baridhara,
Dhaka,
Bangladesh
Tel: 882 1454
Gonoshastaya Nagar Hospital
Plot 14/E, Road -6,
Dhanmondi,
Dhaka -1205.
Bangladesh
Tel: 861 7208, 861 7383
Fax: 861 3567
Email: info@gonoshasthaya.org
Web: www.gonoshasthaya.org
Ibrahim Iqbal Memorial Hospital
23/A M. M. Ali Road,
Mehedibagh,
Chittagong,
Bangladesh
Tel: (031) 636 548, 627 040-1
Email: ail@bol-online.com
Institute of Child Health & Shishu Hospital
6/2, Barabagh,
Mirpur-2,
Dhaka 1216
Bangladesh
Tel: 802 3894-5
Samorita Hospital
89/1 Panthapath,
Dhaka,
Bangladesh
Tel: 913 1901
Fax: 912 9971
Email: samorita@bangla.net
Web: www.samoritahospital.com
Z.H. Sikder Women’s Medical Collage & Hospital
Monica Estate,
Western Dhanmondi,
Dhaka,
Bangladesh
Tel: 811 5951, 811 3313
Fax: 811 5965 |
|
Register
Log in
FAQ
Search
Memberlist
