Changes in the readiness of healthcare systems to provide diabetes- and cardiovascular disease-related services: A comparison of indices using data from the 2014 and 2017 Bangladesh Health Facility Surveys

Abstract

Background: The increasing prevalence of non-communicable diseases (NCDs) in Bangladesh is a significant obstacle for the government's already under-resourced healthcare centers and healthcare management. This study aimed to determine whether healthcare services are prepared to handle cardiovascular disease (CVD) and diabetes in the future. Methods: This cross-sectional study used the Bangladesh Health Facilities Survey (BHFS) 2014 and 2017 data. The BHFS 2014 completed assessment of 317 facilities providing diabetes care and 407 facilities providing CVD care, while the 2017 BHFS included 305 and 368 facilities providing diabetes and CVD care, respectively. Results: A slight increase in facility readiness status was observed in 2017 compared with 2014, though it was not statistically significant. District hospitals (DHs) and Upazila health complexes (UHCs) showed improvement in staff and guidelines, basic equipment, diagnostic capabilities, and essential drugs, as their Readiness Index (RI) value increased in 2017 from 2014. The RI values of non-governmental organizations (NGOs) clinics were 48.65% in 2014, whereas the value was slightly increased to 55.28% in 2017. For private clinics, the RI value diminished in 2017 (56.11%), which was lower than the 2014 survey (60.62%). There was a slightly mixed trend for public and private facilities regarding managing CVDs. In DHs and UHCs, the RI value decreased to 58.5% and 53.06% in 2017 from 64.04% and 53.02% in 2014. NGO clinics were valued at 48.65% in 2014, which dropped to 44.53%. For private clinics, the value showed a decreasing trend as the value in 2017 was 61.58%, lower than the value of 2014 (64.15%). Conclusions: In Bangladesh, public and private healthcare facilities lack readiness for healthcare towards DM and CVD maintenance. It is noteworthy that this improvement has been insignificant over the years in this regard. Healthcare policy reform is urgently required to strengthen NCD healthcare, particularly in public healthcare facilities.