Status Of Health Workforce And Service Coverage For Under-Five Chindren In Bangladesh.

Abstract

Introduction: Despite the implementation of the Integrated Management of Childhood Illness (IMCI) in 1998, the quality of care for children in Bangladesh remains inadequate. The country faces a severe human resource for health (HRH) crisis, which impacts the standard of care for children younger than five years old. This study assesses the quality of care and service coverage for children in private and government hospitals across six subdistricts of Bangladesh. Methodology: This cross-sectional study was conducted from October 2023 to May 2024 in six randomly selected subdistricts, including 102 private hospitals and 7 government hospitals. Data collection involved face-to-face meetings with senior hospital staff, direct observations, and the use of adapted WHO hospital assessment tools. Hospitals were scored on various dimensions with respect to WHO guidelines, and data analysis was performed via descriptive statistics. Result: Out of the 109 hospitals surveyed, 86.27% of private hospitals and all government hospitals had separate pediatric outpatient departments. However, compared with all government hospitals, only 39.22% of private hospitals had separate pediatric inpatient departments. Neonatal intensive care units were present in 6.86% of private hospitals, with none in government hospitals. The employment of pediatricians was significantly lower in private hospitals (10.78%) than in government hospitals (71.43%). Emergency services for children were available 24/7 of 33.33% of private hospitals and all government hospitals. Conclusion and Recommendation: This study highlights substantial disparities in the availability of healthcare professionals and facilities for children between private and government hospitals in Bangladesh. The findings underscore the need for strategic interventions to improve the HRH crisis and enhance the quality of pediatric care, particularly in private hospitals. Ensuring equitable access to essential healthcare services for children under-five years age is critical for improving child health outcomes in Bangladesh.