Healthcare Assignment: Healthcare Strategy in Bangladesh

This assignment discusses the healthcare system of Bangladesh, immunisation status of children, social determinants of health, epidemiological studies, nursing professionals' role, and cultural competence in primary healthcare nurses.

Running head: HEALTHCARE ASSIGNMENT
HEALTHCARE STRATEGY (BANGLADESH)
Name of the student
Name of the university
Author note

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Introduction
As per Ashraf et al. (2015), healthcare system is the social response to the healthcare
determinants of any society as every society believes and trusts upon grew social
determinants and through these helps the population of that society to overcome their
healthcare complications. This paper is going to deal with the healthcare system of a South
Asian developing country, Bangladesh and will assess the immunisation status of the children
living in this country. Further, in this context the social determinants of health and its
connection to this health complication would be discussed (Rifat et al., 2015). Furthermore,
through the help of epidemiological studies, the complication or healthcare complication and
their connection in developing health equity would be discussed. Finally, the role of the
nursing professional in dealing with such health complication and the importance of the
cultural competency would be discussed in this paper.
Social determinants of health, equity and social justice and their contribution to the
health issue
As per Naz et al. (2016), social determinants of health are aspects that helps to
develop effective healthcare strategies so that equity and equality could be included in the
healthcare process. Social determinants are the aspects depending upon which or surrounding
by which an individual born, grows ad eventually dies. In such condition, if these
determinants are present unequal amount then it could affect the healthcare system and could
also increase the health complications for the patients involved in the care process (Huda et
al., 2016). Such social determinants of health and associated inequalities are present in
society’s deepening upon their availability among the population. For example, if the
population of the community are unable to receive proper educational and employment
opportunities then their healthcare process would be affected and the population would suffer

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from critical healthcare processes (Huda, Hayes, El Arifeen & Dibley, 2016). Hence, in such
conditions it becomes important analyse the presence of social determinants associated health
inequalities. Bangladesh is considered to be a developing country and hence, this country has
its own issues associated with development, service availability, legislations and other
aspects that could make the healthcare system effective. As per the World Health
Organisation (2019), there are multiple aspects of social determinants of health associated
with Bangladesh and these are the primary concerns of the community. These are climate
change, gender inequality, human resources and healthcare system, presence of arsenic and
other complications due to which the population suffer from critical healthcare complications.
Immunisation is one of the primary healthcare need of children as it help them to
protect themselves from critical healthcare complications associated with viral and bacterial
infections. In such condition, it should be noted that people living in such societies should be
aware of the aspects associated with vaccinations (Huda, 2017). Further, it also requires the
population to be aware and educated about the immunisation process, period and timeline so
that they could provide their children with effective identity so that they could develop
immunity against critical health complications. Hence, if the population is not aware of
effective immunisation process and does not implements these immunisation strategies upon
the healthcare system then it could increase the risk of health population involved (Leslie,
Spiegelman, Zhou & Kruk, 2017). The literacy rate in Bangladesh could be identified as
72.76% and within employment, 40% of the population work in agricultural sector, whereas
20% works in industries. Hence, a large section of the society is present in Bangladesh that
are unable to avail sources to education as well as are unable to develop employment abilities
so that they could develop effective abilities and provide the children with effective
immunisation (Marella et al., 2015). Further, the rural areas of the communities also lack
connectivity, development and other infrastructural aspects which is important for the growth

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and development of abilities for effective vaccination of children. Therefore, these are the
complications due to which the population suffer from critical conditions and health
inequality lies in the country’s healthcare system.
Interpret epidemiological studies to identify this health issue
While discussing about the epidemiological factors that are associated with critical
healthcare complication and poor or decreasing rate of immunisation in the population of
Bangladesh, factors such as their socio- economic aspects, their availability of resources,
their lack of social support, negligence and lack of awareness and other aspects should be
discussed. These epidemiological factors are the primary reason due to which majority of the
community living in Bangladesh are unable to develop effective abilities so that they could
overcome their population’s complication associated with vaccinations. Rifat et al. (2015)
also mentioned in their research proposal as per which these are the complications that are
associated with the improper immunisation process and should be considered while
developing effective vaccination strategies for the population affected with this situation. As
per Ashraf et al. (2015) it has been observed that population that live in the rural areas, lack
their social determinants of health and hence, they do not have proper access to the
vaccination strategies of Bangladesh. Hence, these factors, with lack of social determinants of
health prevent the rural populations of Bangladesh to achieve accurate level of immunisation.
Further, through the paper of Huda et al. (2016) it was also identified that the local
governments or regional governments that are responsible for spreading awareness and
healthcare literacy to the population, are unable to develop or implement the local plan
developed and hence the governmental strategies developed for the immunisation and
vaccination processes are not being implemented properly (Naz et al., 2016). Therefore, lack
of coordination among the governments and resulting lack of awareness could be the primary
reason due to which the populations are unable to develop effective abilities to provide

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effective immunisation and vaccination process to the population living in the rural areas of
Bangladesh.
Analyse the primary healthcare nurse’s role in your chosen country, including
discussion on what they are doing to help solve the health issue identified?
Research studies mention that health-care delivery is a complex challenge within the
rural region of Bangladesh (Roy et al., 2016). Upon critical evaluation of the same, it was
found that factors such as corruption, shortage of nurses, inefficient healthcare administration
as well as poor healthcare infrastructure attribute to the case why the overall healthcare status
has remained poor in quality. In this regard, it should further be noted that the immunization
status and overall health outcome has remained poor within the context of Rural Bangladesh.
As stated by Ahmed et al. (2017), inclusion of improved clinical governance, along with the
inclusion of training or monitoring and improved education on healthcare services to primary
healthcare nurses can help to improve immunisation outcome for the rural children. It is
integral to note in this context that the existing responsibilities for the primary healthcare
nurses within the healthcare system of Bangladesh include, preparation of immunization
chart, assessing the patient, preparing for pre-immunization and post-immunization
requirement, preparation of the immunization dose and appropriate dose administration of the
immunization. Within the healthcare context of the mentioned developing nation, it should be
stated that the significance and importance of immunization within the rural context is not so
popular and requires to be disseminated within the common mass (Ahmed et al., 2017). On
account of poor health literacy about the importance and significance of immunizations, local
people often overlook the routine immunization and follow up booster dose that must be
administered to the new-born babies (Roy et al., 2016). This results in poor health outcome
and increased susceptibility to acquire a number of life-threatening pathogenic disorders

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which could be prevented through vaccination. These factors diminish the life expectancy
and quality of life of the children (Roy et al., 2016).
Recent healthcare studies and epidemiological surveys reveal that the holistic health
outcome and immunisation reach to the children have increased manifold. Patient data
suggests that the life expectancy at birth around 2010 was equivalent to 61.9 years which has
now enhanced up to 72.8 years in the year 2019 (Islam et al., 2015). This suggests that the
heath outcome for the children has comparatively improved which has solely been possible
on account of increased health education and awareness that has made it possible to increase
access and ensure immunisation reach to more than 75% of the rural population based at
Bangladesh (Islam et al., 2015). Increased efforts in terms of public health campaigns as well
as patient counselling has improved overall health outcome for the children and made it
possible to ensure improved life expectancy. In addition to this, increased skills and training
with respect to advanced immunization technique and improved medical infrastructure would
lead to provision of improved patient safety and improved patient outcome (Meyer et al.,
2019). Further, the provision of improved governmental healthcare policies and healthcare
promotional programs has helped to improve the healthcare expectancy and access to the
immunisation which has turned out to be positive consequence and in the years to follow
would help to foster improved healthcare status for the identified vulnerable set of rural
population (Ahmed et al., 2017). In addition to this, nursing professionals must also organise
health education programs to educate people about the allergic immunological response that
might be manifested on account of an adverse reaction post the administration of an
immunization dose or booster dose (Roy et al., 2016). This kind of patient education and
counselling is imparted to the immediate care givers of the minors on a mandatory basis so as
to reduce the incidence risk of adverse immunological reactions that might mark the onset of
a fatal outcome (Meyer et al., 2019). Therefore, adapting government measures to

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disseminate such education and counselling programs to the caregivers can help secure
increased patient safety and promote overall positive patient outcome.
Reflect on the use of cultural competence in the Primary Health Care nurse role in
supporting this health issue.
Cultural incompetence and discrimination on the ground of ethnicity, religion and cast
is a prevalent issue within the context of Bangladesh. Provision of a culturally safe care
service and complying with the principles of cultural safety to promote positive care outcome
is secondary within the healthcare context of Bangladesh (Holland, 2017). Research studies
mention that within the rural regions of Bangladesh, cast difference is extremely prominent
and pronounced which results in division of society and leads to social stigma (Meyer et al.,
2019). This predominantly serves as a major reason why access to primary healthcare
services is reduced within certain ethnic minority communities. On account of the fear and
negative implication of experiencing stigma, a major proportion of the minority population
remain deprived of appropriate care services which included regular immunization routine
and as a result experience reduced life expectancy and poor health outcome (Tareque et al.,
2015). Considering the background of the existing health inequality, I believe primary health
nurses must advocate for the rights of the patient irrespective of their social, economic,
religious or ethnic status and impart care that serves their best interest. Further, as per
Holland (2017), nursing care professionals must endeavour to devise care services that focus
upon addressing the holistic healthcare needs of the patient and reinforce a culturally safe
care service that is aligned to the specific cultural preferences of the service users. In context
of immunization, provision of a culturally safe care service and consideration of the cultural
preferences of the service users while planning care would not only improve access to care
but at the same time improve holistic care outcome and alleviate the quality of life of the
identified marginalised targeted population (Meyer et al., 2019).

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Conclusion
Therefore, in conclusion it can be mentioned that the healthcare status with respect to
provision of immunization and the role of care professionals strikingly vary between a
developed nation such as Australia as discussed in the previous assignment and Bangladesh
as discussed in this assignment. The primary reason responsible for the variation can be
explained as poor infrastructure and lack of proper education and skill development of the
nursing professionals within the healthcare context. It should further be noted in this context
that lack of cultural safety and cultural incompetence is another factor that has diminished the
quality of the care services and has also reduced the access to primary healthcare for certain
marginalised population communities. Provision of culturally safe care services and increased
public awareness can help to promote improved care outcome.

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