6th TAG Meeting

TAG meeting

Prof. Dr. Nasima Sultana, ADG (Admin), DGHS chaired the TAG meeting. Dr. Iqbal Anwar, Scientist, and Principal Investigator, of SHARE project welcomed all the meeting participants.

Highlights of the discussion:

• The meeting minutes of the 5^th TAG meeting were read-out and after detailed discussions it was approved unanimously.
• Then Dr. Iqbal Anwar presented the overview of the project. He mainly focused on how SHARE project contributed for the capacity development of individual, organizational and institutional level.
• Sohana Shafique, Deputy Project Co-coordinator gave presentation on the progress of the activities made so far according to the work plan, 2018.

Human Resource for Health:

• There was a very huge and important discussion on improvement of health workforce (both public health and service delivery workforce)
• Focusing on creating a dedicated public health workforce is a vital issue and is a vital component to strengthen the health system. In the developed countries, there are good scopes for public health specialist than doctors of clinical specialists. But in Bangladesh, in the medical sector, Public health is a neglected area. Incentives like going abroad for training, promotion or private practice is also fewer in this area. If public health workforce is demarcated and incentivized from the very beginning of their professional life, doctors might be interested to come. New openings and opportunities should be created focusing on public health cadres to attract them instead of raising only salaries.
• Changing of the mindset of people to come to this field is mandatory and medical curriculum should focus on scopes of public health. So if from the beginning of medical education, if the curriculum is public health friendly, then doctors will understand its importance and mainstreaming of public health workforce will be possible which will ultimately help for Evidence informed policy making process.
• For making good health workforce, skilled teachers are needed especially in basic subjects and they need formal training in teaching. There should be separate cadre for producing good teachers in Government medical colleges as well as emphasize should be given on quality improvement of teachers of private medical colleges. There might be separate cadres for medical college lectures than medical service providers. Otherwise this teaching sector would always be neglected. Curriculum of public health should get more attention and should be changed according to time demand.
• Not only doctors, Scarcity of other support staff (technologist, MLSS) in this sector is very huge. Actions should be taken in this regard
• Moreover, in different sectors, job description s not well defined. So ensuring accountability is problematic. So, holistic approach is needed.

Multi-sectoral Approach:

• The quality improvement activities needs Multi-sectoral action plan. It is important to drop fragmented initiatives for quality improvement. Rather, depending on the strategy, action plans need to be prepared and from that prioritization of activities (short term, midterm and long term) should be done. Moreover, initiatives should be taken on the basis of what already exists and where the gap is.Moreover multi-sectoral action plan needs to be formed. For example, to prevent NCD, NCD department might collaborate with Ministry of industry about the salt and sugar policy.
• Research findings are not translated into action (policy making) most of the time. To make Evidence Informed Policy Making, some relevant personnel from Ministry of Health and Family Welfare (Hospital Wing, Public Health wing, Health economics unit) need to be involved in TAG meetings. Trainings like EIPM might be arranged for them which will contribute to evidence Informed Policy Making. (Additional secretary public Health wing should be the contact person to arrange it).
• Policy briefs and publication should be shared within the TAG members who can influence policy.

• Sustainability: The SHARE project has shown some good signs of sustainability after its completion.

• RPCC is established and incorporated in DG health.
• Systematic review centre is housed in BSMMU and one staff has been joined as permanent staff in Public health Department.
• An initiative for Cochrane Bangladesh has been taken from SHARE project (is in final stage) and it will be housed in Icddr,b.

• Achievements of SHARE projects: SHARE project has some remarkable achievements in 2018-
• Participation in International Conference in Liver pool and presented a panel session on engaging private sector in Health to achieve UHC.
• One international Conference on CHW (Funded by Health systems Global) is going to be organized in November, 2019 by SHARE project, icddrb, in collaboration with GoB, JPG, Save the children. Madam can be called as a key note speaker.
• “Think tank” is now being tried to be registered by social welfare Dept.
• One donor (CDC Atlanta) organization has shown interest to provide fund for mainstreaming of public health workforce
• It was also discussed that, to scale up the CJ model, one strategy and Standard operating procedure (SOP) is now being developed in collaboration with Co ordination Cell of DGHS under the leadership of Dr. Nasima Sultana, ADG (Admin) which might be regarded as a byproduct of SHARE project.

Think Tank Group

This meeting was chaired by Prof. TA Chowdhury.

Discussion:

• A health policy Dialogue should be arranged in February, 2019
• Health policy dialogues need to be focused on urban poor, NCD and Universal health coverage.
• The condition of urban poor particularly in slums is worst. The main problem is, urban PHC is the responsibility of CCs and municipalities which are not health oriented organizations. Moreover, PHC in some urban areas are covered by donor funded projects and in other areas mainly by private sectors which are expensive. So, the slum people cannot always access it.
• Now is the high time for focusing on urban PHC as NCD is increasing in urban slums. Some initiatives like Community Clinics should be done in urban areas especially in slums.
• MPs and Mayors should be invited for policy dialogues as they are the policy makers
• New member of Think tank-
• Makhduma Nargis,
• Sohel Reza Chowdhury

Priority areas for HPD

• Policy dialogue on NCD policy- a multi-sectoral approach- A presentation on the knowledge synthesis and then seek recommendation from the house on way forward;
• Urban PHC: Co-ordination and collaboration between  MoH and LGD
• Human resource for Health- How to improve quality of medical education/ medical graduates in the context of UHC/ Status and scope of improvement in the medical curriculum.(production quality).
• NCD (RTA/ Drowning/Mental Health)- To contact with CIPRB for data

Participants (Not according to seniority)