The Sustainable Development Goals (SDGs) are a collection of 17 interlinked goals designed to be a "blueprint to achieve a better and more sustainable future for all". The SDGs were adopted in 2015 by the United Nations General Assembly and are intended to be achieved by 2030.

The third goal of SDG, or simply SDG 3, which has health at its core aims to "ensure healthy lives and promote well-being for all at all ages". Under this overarching ambition, the focus areas of SDG 3 include maternal, neo-natal and infant mortality, communicable and non-communicable diseases, tobacco use, universal health coverage, sexual and reproductive healthcare, R&D in health, increasing health financing, training and risk reduction capacities, etc.

The private sector healthcare providers do not only cover doctors and hospitals but also include all prevention, primary through tertiary care facilities, support organisations, and all the technicians, support staff, general employees, and volunteers who are engaged in delivering healthcare services. NGOs—there are about 105 national and 40 international ones—are also a key part of the private healthcare sector.

Here is a general plan on how this sector can be mobilised to help make the SDG 3 a reality.

Public-private partnership

Private sector entrepreneurship covers around 60 percent of the health sector in Bangladesh, having approximately 70,000 doctors and 100,000 hospital beds, providing employment to around 10 lakh people, and investment to the tune of USD 3,500 crore. With proper support and conducive conditions, this sector can be made more efficient and effective bringing in better quality and outcome for the citizens. The foreign currency of about USD 1,000 crore that is going abroad every year for the purpose of treatment, according to one estimate, can be saved by building people's trust in this sector.

EMR and use of National ID card

EMR, or electronic medical records, can be incorporated or interlinked with our National ID (NID) cards so that basic health-related information of the people can be recorded along with their sociodemographic information. The Emergency ID card will contain the medical records of an individual, and doctors can access them easily, allowing them to provide treatment swiftly and safely.

Separate Directorate for private sector

A separate Directorate General for private health sector will help the sector run smoothly by providing one-stop service for the purpose of licensing, etc. which at present is provided from 17 different offices.

Zonal health workers and national referral

In every zone of every district, there should be zonal health workers who will be responsible for the health and welfare of the local community, along with family physicians. There should be a proper referral system to the district hospital for specialist advice. In this way, the burden on specialist medical professionals will be minimised.

Health insurance

Everyone should be brought under the universal health coverage. There should be different packages of health insurance according to the socioeconomic quintiles of people.

Clear paths for health professionals

Healthcare professionals like doctors, nurses, and allied health workers should be categorised according to their type of work, such as academic, administrative and practicing. It should be done in both the government and private healthcare facilities.

Health education and promotion are key

A person's physical, mental, social and spiritual health and healthcare needs should be assessed and taken care of. NGOs, which are already covering many of these areas, can play a pivotal role in this regard. Some of their interventions that contribute to the concept of holistic health include literacy programmes, nutrition, social awareness, primary and preventive healthcare, essential and professional skills building, mass-scale counselling for the workforce in high-risk industries (such as ship breaking), etc. So this can be strengthened by more investment and infusion of private equity.

Environmental, social and corporate governance (ESG)

These should be the three central factors in measuring the feasibility and societal impact of healthcare facilities and interventions. These criteria help to better determine the future impact and sustainability of the healthcare industry.

Grading

All healthcare facilities should be graded like Grade I, Grade II and Grade III, according to the pricing, type and quality of services provided. However, the general quality of clinical services has to be similar across all the grades—the difference will lie only in hospitality and other non-essential perks that can vary from one facility to another.

Non-branded (generic) drugs

Hospitals categorised in grades 2 and 3 will get the opportunity to provide non-branded medicines (generic) to cut the cost of services while preserving quality, as it can be assumed that low-income people will generally frequent those facilities.

Focus on local community clinics

Existing community clinics can be strengthened by organising them under committees, which should be comprised of members from local authorities, public representatives, and led by doctors or medical professionals. Private sector players can support the clinics as part of a social enterprise model.

Accountability

First, Bangladesh Medical & Dental Council (BM&DC) should be strengthened and made the highest body responsible for overseeing activities related to the medical profession, and entrusted with the tasks of registration, recognition, maintenance and monitoring of all medical/healthcare facilities and professionals. Second, there should be a Health Service Ombudsman, answerable to parliament, who will be responsible for protecting the interests of patients as well as health service providers. Third, there should be an independent Health Commission free from the influence of the government and the private sector to oversee all accountability exercises.

Research and Development

Private-sector R&D is critical for future development of the health sector. The research findings can be helpful for the policymakers and should influence decisions related to costing, accountability, and governance. This will also have a critical role while responding to health emergencies like the Covid-19 pandemic—in treatment, vaccination, post-Covid-19 complications, etc.

Accreditation and quality of services

A national accreditation system for healthcare providing organisations, under Bangladesh Accreditation Body (BAB) or some other competent authority, is a must to ensure the quality of services provided and build trust in local health facilities among the general populace.

Finally, to achieve the SDG 3 targets, the public and private sectors should work hand in hand to improve the health and wellbeing of the population in Bangladesh.

Dr A M Shamim is Managing Director, Labaid Group.