Abstract
Poverty, Rurality and Disability are three major vulnerabilities to deliver quality healthcare services and ensure universal healthcare coverage (UHC). Disruptive technologies and a social business model can deliver healthcare services to non-UHC communities in a faster, affordable and sustainable manner. This chapter of the book investigates the status of UHC in Bangladesh, categorizing out of coverage communities. Kyushu University and Grameen Communications have developed an affordable, user-friendly, and sustainable digital healthcare delivery system, which we call Portable Health Clinic (PHC). A community-based micro healthcare entrepreneur can take the PHC to visit an elderly person, pregnant woman, or person with disability at their doorstep, and provide real-time primary health services connected to licensed healthcare professionals. Annual health checkups are a long-standing institutional practice in Japan, but not as prevalent in emerging countries including Bangladesh. Small organizations cannot afford a health center at their premises, thereby remaining out of coverage of healthcare services. Health insurance is not prevalent, which exposes not only well-being but savings or assets to risk in catastrophic situations. Regular health checkups are known to provide an early alert of any diseases, which can reduce health risks, save medical costs and increase productivity. We categorize five different rural and urban communities in which PHC pilot studies have been carried out over the last 12 years. We have designed five different delivery models and evaluated their financial sustainability, as well as social impact. This chapter describes this experience and identifies major challenges with the purpose of ensuring that UHC approaches can assimilate advanced technologies, mainstream them in national healthcare policy in the country, and train healthcare workers.
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References
Adnan, A. M. (2016). Universities in Bangladesh—A Fun Project. Retrieved April 28, 2022, from https://rstudio-pubs-static.s3.amazonaws.com/169329_95ad57e86a74439d8a2e18b0636ac2de.html
Ahmed, A., Inoue, S., Kai, E., Nakashima, N., & Nohara, Y. (2013). Portable Health Clinic: A Pervasive Way to Serve the Unreached Community for Preventive Healthcare. Springer. https://doi.org/10.1007/978-3-642-39351-8_29
Ahmed, A., Rebeiro-Hargrave, A., Nohara, Y., Maruf, R. I., Ghosh, P. P., Nakashima, N., & Yasuura, H. (2015). Portable health clinic: A telehealthcare system for unreached communities. In Smart Sensors and Systems (pp. 447–467). Springer International Publishing. https://doi.org/10.1007/978-3-319-14711-6_18
BANBEIS. (2018). Over 6 lakh slum dwellers in Dhaka. The Daily Star. Retrieved December 15, 2021, from https://www.thedailystar.net/city/6-lakh-slum-dwellers-in-dhaka-1757827
Bangladesh Bureau of Statistics (BBS). (2021). Bangladesh statistics-2018. Retrieved on December 20, 2021. https://bbs.portal.gov.bd/
Bangladesh Statistics of Bureau (BBS). (2014). Census of slum areas and floating population. Retrieved January 31, 2022. http://203.112.218.65:8008/WebTestApplication/userfiles/Image/Slum/Preli_Slum_Census.pdf
Begum, A., & Hamid, S. A. (2021). Impoverishment impact of out-of-pocket payments for healthcare in rural Bangladesh: Do the regions facing different climate change risks matter? PLoS ONE, 16(6), e0252706. https://doi.org/10.1371/journal.pone.0252706
Binagwaho, A., Hirschhorn, L. R., Frisch, M. (2019). Addressing barriers to achieving universal health coverage through implementation research: Uncovering and understanding context. Observer Research Foundation. Retrieved January 21, 2022. https://tinyurl.com/2b5xjm5a
Farole, T., Cho, Y., Bossavie, L., Aterido, R. (2017). Bangladesh jobs diagnostic. Open knowledge repository. Retrieved February 8, 2022. https://openknowledge.worldbank.org/handle/10986/28498
Hamid, S. A., Khanam, M., Azim, M. R., & Islam, M. S. (2021). Health insurance for university students in Bangladesh: A novel experiment. Health Science Reports, 4(4), e382. https://doi.org/10.1002/hsr2.382
Haque, D. A. K. E., Bari, E. (2020). RMG workers survey 2020: Asian Center for Development. Retrieved February 9, 2022. http://acdonline.org/rmg-workers-survey-2019/
Hossain, F., Ahmed, A. (2021). Visualization of healthcare data for busy doctors in develo** countries to make efficient clinical decisions. 10th social business academia conference, Nairobi, Kenya. https://www.researchgate.net/publication/355977949_Visualization_of_Healthcare_Data_for_Busy_Doctors_in_Develo**_Countries_to_make_Efficient_Clinical_Decisions
Hossain, F., Islam-Maruf, R., Osugi, T., Nakashima, N., & Ahmed, A. (2022, March). A Study on personal medical history visualization tools for doctors. 2022 IEEE 4th global conference on life sciences and technologies (LifeTech). https://doi.org/10.1109/lifetech53646.2022.9754925
Hossain, M. (2021). SME sector in Bangladesh and policy priorities. The business standard, Dhaka. Retrieved April 28, 2022. https://www.tbsnews.net/economy/sme-sector-bangladeshand-policy-priorities-266821
Hossain, M. N., Okajima, H., Kitaoka, H., Yokota, F., & Ahmed, A. (2018). eHealth consumer behavior. Springer International Publishing. https://doi.org/10.1007/978-3-319-76430-6_6
Hossain, S. Z. (2022). Get ready for even higher unemployment in 2022. DhakaTribune, Dhaka. Retrieved May 7, 2022. https://www.dhakatribune.com/business/2022/01/18/get-ready-for-even-higher-unemployment-in-2022
IOM. (2022). IOM appeals for USD 128 million to support Rohingya refugees and local communities in Cox’s Bazar. International Organization for Migration. Retrieved April 28, 2022. https://www.iom.int/news/iom-appeals-usd-128-million-support-rohingya-refugees-and-local-communities-coxs-bazar
Islam, R., Kikuchi, K., Sato, Y., Izukura, R., Jahan, N., Sultana, N., Nessa, M., Yokota, F., Nishikitani, M., Ahmed, A., & Nakashima, N. (2021). Maternal and child healthcare service by portable health clinic system using a triage protocol. Studies in Health Technology and Informatics, 284, 130–134. https://doi.org/10.3233/SHTI210684
Khokhar, T. (2010). Chart: 100 million people pushed into poverty by health costs in 2010. World Bank Blogs. Retrieved February 25, 2022. https://blogs.worldbank.org/opendata/ chart-100-million-people-pushed-poverty-health-costs-2010
Knoema. (2022). Health—Bangladesh. Retrieved April 1, 2022. https://knoema.com/atlas/Bangladesh/topics/Health
Ministry of health and family welfare-Bangladesh (MOHFW). (2022). Annual report HSD. Annual Report HSD. Retrieved May 10, 2022. http://www.mohfw.gov.bd/index.php
Ministry of Social Welfare (MSW). (2022). Department of social services of ministry of social welfare of Bangladesh: Number of total disabilities. Retrieved February 7, 2022. https://dis.gov.bd/
Molla, A. A., & Chi, C. (2017). Who pays for healthcare in Bangladesh? An analysis of progressivity in health systems financing. International Journal for Equity in Health, 16(1), 1–10.
O’Neill, A. (2022). Bangladesh—employment by economic sector: Statista. Retrieved February 8, 2022. https://www.statista.com/statistics/438360/employment-by-economic-sector-in-bangladesh/
Osugi, T., Kamau, J., Rebeiro-Hargrave, A., Emran, A., & Ahmed, A. (2016). Healthcare service on wheels for unreached communities. International Journal of Social Science and Humanity, 6(8), 594–599. https://doi.org/10.7763/ijssh.2016.v6.716
Podder, K. K., Tabassum, S., Khan, L. E., Salam, K. M. A., Maruf, R. I., & Ahmed, A. (2021). Design of a sign language transformer to enable the participation of persons with disabilities in remote healthcare systems for ensuring universal healthcare coverage. IEEE. https://doi.org/10.1109/temscon-eur52034.2021.9488605
Rahman, S. (2019). Universal health coverage in Bangladesh: The challenges. The Financial Express. Retrieved December 10. 2021. https://tinyurl.com/2p8v73n3
Sampa, M. B., Hoque, M. R., Islam, R., Nishikitani, M., Nakashima, N., Yokota, F., Kikuchi, K., Rahman, M. M., Shah, F., & Ahmed, A. (2020). Redesigning portable health clinic platform as a remote healthcare system to tackle COVID-19 pandemic situation in unreached communities. International Journal of Environmental Research and Public Health, 17(13), 4709. https://doi.org/10.3390/ijerph17134709
Sanadgol, A., Doshmangir, L., Majdzadeh, R., & Gordeev, V. S. (2021). Engagement of non-governmental organisations in moving towards universal health coverage: A sco** review. Globalization and Health, 17(1), 129. https://doi.org/10.1186/s12992-021-00778-1
Tabassum, S., Sampa, M. B., Islam, R., Yokota, F., Nakashima, N., & Ahmed, A. (2020a). A data enhancement approach to improve machine learning performance for predicting health status using remote healthcare data. IEEE. https://doi.org/10.1109/icaict51780.2020.9333506
Tabassum, S., Sampa, M. B., Islam, R., Yokota, F., Nakashima, N., Sampa, M. B., Hossain, M. N., Hoque, M. R., Islam, R., Yokota, F., Nishikitani, M., & Ahmed, A. (2020b). Blood uric acid prediction with machine learning: Model development and performance comparison. JMIR Medical Informatics, 8(10), e18331. https://doi.org/10.2196/18331
Tabassum, S., Sampa, M., Maruf, R., Yokota, F., Nakashima, N., Ahmed, A. (2020c). An analysis on remote healthcare data for future health risk prediction to reduce health management cost. APAMI 2020c: 11th Biennial Conference of the Asia- Pacific Association for Medical Informatics, 115–119.
Tabassum, S., Takahashi, R., Rahman, M. M., Imamura, Y., Sixian, L., Rahman, M. M., & Ahmed, A. (2021). Recognition of doctors’ cursive handwritten medical words by using bidirectional LSTM and SRP data augmentation. IEEE. https://doi.org/10.1109/temscon-eur52034.2021.9488622
Thelwell, K. (2020). 7 facts about healthcare in Bangladesh. The Borgen Project. Retrieved May 25, 2022. https://borgenproject.org/healthcare-in-bangladesh/
Think Hazard. (2020). Bangladesh. Retrieved January 26, 2022. https://thinkhazard.org/en/report/23-bangladesh
Umeh, C. A. (2018). Challenges toward achieving universal health coverage in Ghana, Kenya, Nigeria, and Tanzania. The International Journal of Health Planning and Management, 33(4), 794–805. https://doi.org/10.1002/hpm.2610
United Nations (UN). (2019a). World population prospects. Retrieved April 22, 2022. https://www.macrotrends.net/cities/20119/dhaka/population
United Nations (UN). (2019b). World population prospects 2019b—Bangladesh probabilistic projection of population of age 60 and over. Department of Economic and Social Affairs Population Dynamics. Retrieved February 7, 2022. https://population.un.org/wpp/Graphs/Probabilistic/POP/60plus/50
United Nations. (2022). World population prospects—population division. Department of Economic and Social Affairs Population Dynamics. Retrieved February 7, 2022. https://population.un.org/wpp/Graphs/Probabilistic/POP/60plus/50
United Nations high commissioner for refugees (UNHCR). (2020). UNHCR global trends 2020. Retrieved January 26, 2022. https://www.unhcr.org/figures-at-a-glance.html
United Nations office for the coordination of humanitarian affairs (UN-OCHA). (2022). Site management and development Sector-Cox’s Bazar. Retrieved January 31, 2022. https://www.humanitarianresponse.info/en/operations/bangladesh/camp-coordination-and-camp-management/infographics/table
World Bank. (2018). The World Bank data: Population living in slums (% of urban population)—Bangladesh. Retrieved January 31, 2022. https://data.worldbank.org/indicator/EN.POP.SLUM.UR.ZS?locations=BD
World Bank. (2021). World Bank climate change knowledge portal: Bangladesh vulnerability. Retrieved January 26, 2022. https://climateknowledgeportal.worldbank.org/country/bangladesh/vulnerability
World Health Organization (WHO). (2017). Bangladesh national health accounts, an overview on the public and private expenditures in the health sector. Retrieved January 25, 2022. https://bit.ly/3Px33hf
World Population Review (WPR). (2022). Dhaka population 2021 (Demographics, Maps, Graphs). Retrieved January 31, 2022. https://worldpopulationreview.com/world-cities/dhaka-population
Yunus, M. (2009). Creating a world without poverty: Social business and the future of capitalism. Public Affairs. p. 320. ISBN 978-1-58648-667-9.
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Ahmed, A., Hossain, F., Abedin, N., Islam, R., Shah, F., Hoshino, H. (2023). Digital Healthcare and a Social Business Model to Ensure Universal Health Coverage (UHC): A Case Study of Bangladesh. In: Hayashi, T., Hoshino, H., Hori, Y. (eds) Base of the Pyramid and Business Process Outsourcing Strategies. Springer, Singapore. https://doi.org/10.1007/978-981-19-8171-5_3
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