Dr. Mushtaque Chowdhury, professor of clinical population and family health at Columbia University Mailman School of Public Health and founding dean of BRAC University’s James P. Grant School of Public Health in Bangladesh, has authored research in a Lancet Bangladesh series of papers. “Overall, there has been a shift from the priority of managing infectious diseases to where we are now – a focus on public health programs to mitigate the effects of natural disasters and the burgeoning of non-communicable diseases, especially in the country's urban areas.” Launch of the Lancet series on Bangladesh will be held at the United Nations on January 15.
In the article, “The Bangladesh Paradox: Exceptional Health Achievement Despite Economic Poverty,” and the first in the series of six papers, Dr. Chowdhury writes that Bangladesh has been commended as an exceptional health performer. Especially noteworthy is the country’s widespread deployment of community health workers, mostly female, to bring high-priority services to every household in the country including programs in family planning, immunization, oral rehydration therapy, maternal and child health, tuberculosis, vitamin A supplementation, and other activities. “However, while the country has achieved substantial health advances, evidence shows that these achievements are counterbalanced by steep and sustained reductions in birth rate and mortality, the persistence of child and maternal malnutrition and the low use of maternity-related services and some basic health services,” he says.
And, Bangladesh is likely to continue to face “the complex pushes and pulls” of many social determinants, and future health challenges are already becoming apparent, according to Dr. Chowdhury. While its health system was shaped to address poverty-linked infectious, nutritional, and maternity-related diseases, adjustments to the health system are needed to tackle chronic non-communicable diseases. Dr. Chowdhury addresses the need to overhaul Bangladesh's health system as a key first step in reducing inequality in the provision of health services andisconvinced that universal health coverage is the way forward for his country. The “call to action” in this Lancet Series proposes that universal health coverage (UHC) should be the ultimate goal for Bangladesh. Support from the Mailman School of Public Health helped launch BRAC University’s James P. Grant School of Public Health in Bangladesh in 2005. The School was one of only four schools of public health in South Asia.
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