Risks not addressed well in Bangladesh

Bangladesh's performance is poor in reducing the risks of non-communicable diseases (NCDs) like stroke, diabetes, cancer, and cardiac and chronic lung complications, says a report.

The country is not doing well in reducing risk factors, conducting research and surveillance, and strengthening health systems in relation to the NCDs, according to the study titled NCD Scoreboard 2014.

However, it's faring better in governance to control and prevent the NCDs, responsible for half of the country's annual mortality. The NCDs account for 61 percent of Bangladesh's disease burden, says the report published yesterday by the renowned medical journal -- The Lancet.

Grand South, a global network of 11 research centres including the Dhaka-based icddr,b, developed the scorecard on 23 countries as a tool to monitor and help improve performance of the countries with high NCDs prevalence.

Level of smoking, intake of saturated fats, salt and sugar, unhealthy food, physical activity, use of fossil fuel, obesity and level of cholesterol among the adults have been considered as factors in determining Bangladesh's performance.

Policies and laws, their implementation levels, allocation of resources, number of health personnel, availability of essential drugs, early diagnosis and treatment of the NCDs and level of immunisation were also included as factors.

These factors were divided into 51 indicators to measure Bangladesh's performance in preventing and controlling the NCDs.

The country earned "highly adequate" only in one indicator -- the hepatitis B vaccination programme. It was put in the "adequate" category in 12 indicators, "inadequate" in 19 and "no activity" in as many indicators.

The scorecard was developed in line with a 2011 UN political declaration that committed countries to taking actions that would help them prevent and control the NCDs.

In South Asia, Bangladesh and India scored moderately well in the areas of planning and leadership, while Pakistan scored very low.

Bangladesh scored less than India in reducing the risk factors. However, all three countries fared poorly in research and surveillance.

Talking to The Daily Star, Dr Aliya Naheed, interim head of the chronic non-communicable disease unit at the International Centre For Diarrhoeal Disease Research, Bangladesh (icddr,b), said: "Bangladesh has done quite well in terms of combating communicable diseases, but now it is the non-communicable diseases that are emerging as great health challenges."

Prevention and early diagnosis and treatment are key to combating the NCDs, but Bangladesh is poorly equipped in this regard, she said.

Little physical activity and unhealthy diet are becoming very common among the urbanites, noted the physician. "Our laws and policies must address the emerging threats."

"In Bangladesh, over 60 percent of healthcare expenses come out of individuals' own pockets. If strategic policies are not implemented, things would get even worse in future.

"The number of trained personnel at the secondary and tertiary healthcare services is also not sufficient for systematic risk assessment, diagnosis, and treatment of NCD," Dr Aliya added.

The report suggested that Bangladesh introduce on a priority basis a system for NCD surveillance, ensure availability of key essential drugs for the NCDs in primary healthcare centres and formulate policies to reduce intake of salt, high content sugar beverages, trans-fats and check marketing of unhealthy foods meant for children.

Other countries covered by the report include Chile, England, USA, Uruguay, Argentina, Brazil, China, Mexico, Panama, Peru, South Africa, Tunisia, Honduras and Kenya.