Counting hospitals does not measure a city's health system, AKM Iqbal Bahar and Raihanul Jannat argue in a column in The Daily Star's Bangla edition. They ask three questions: can a critically ill patient get to hospital in time, is treatment affordable, and is care fairly spread across the city? The views are the writers' own.
On the first, they cite a 2019 study: in traffic, only 63 percent of people in Dhaka's slums can reach most emergency services within an hour, and for burn treatment the figure is 32 percent. Distance in health care, they write, cannot always be measured in kilometres.
On the second, they say the main barrier is often money rather than geography. Tests, medicine and admission costs put care out of many people's reach. Drawing on Amartya Sen's capability approach, they write that a service does not bring welfare merely by existing. People need the real ability to use it.
The third question is fair distribution. A 2015 study found 1,041 health facilities in six informal settlements, more than 80 percent of them private, while most affordable public tertiary hospitals were at least three kilometres away.
They give Dhanmondi as an example. With many hospitals and diagnostic centres in one area, huge numbers of people travel there each day, which strains the local roads and burdens residents, patients and other city dwellers alike.
The writers propose that, as the World Health Organization and UN-Habitat have long urged, health be planned together with transport, land use and city management, with decisions on new hospitals based on data. The same applies to fast-growing cities such as Gazipur and Narayanganj, they say.
They see the same problem nationally: a 2024 study found 16 of the country's 35 tertiary hospitals in Dhaka district, with about 41 percent of all tertiary beds. AKM Iqbal Bahar is an assistant professor at KPJ Nursing College in Gazipur, and Raihanul Jannat is an urban planner.
Source: The Daily Star
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