Comprehensive Report: TB Health Challenge Analysis in Bangladesh

This report provides a comprehensive analysis of the tuberculosis (TB) health challenge in Bangladesh, examining various determinants of health including social, economic, and cultural factors. It delves into the impact of policies and organizations like the WHO, and considers cultural practices. The report highlights core determinants such as exposure to Mycobacterium tuberculosis, risk factors like congestion and poor ventilation, and root causes including HIV, smoking, and poverty. Fiscal resources and social support networks are also evaluated, alongside health equity and social justice issues. The report emphasizes the vulnerability of garment workers, the role of the MOHFW, and the need for improved health equity through primary healthcare approaches. It also discusses the importance of social justice and underlying causes of TB, providing a detailed overview of the complexities surrounding TB in Bangladesh and potential solutions.

Running head: REPORT ON TUBERCULOSIS HEALTH CHALLENGE IN BANGLADESH 1
Report on Tb Health Challenge in Bangladesh
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Determinants of Health Analysis: Overview
Bangladesh is one of the most densely populated nation on the planet, with one of the
quickest developing global economies. A significant supporter of this financial boom has
been the ready-made clothing and material assembling enterprises. Bangladesh is the third
leader maker of clothing and material fares around the world, with 7000 assessed sending out
manufacturing plants utilizing 6 million specialists (Begum, 2019).
Garment laborers are vulnerable against discretionary stipulations set by their local
leaders, unchecked buyer requests of global economies, and provokes looked by the
administration to provide necessary rights to their residents. Most garment laborers have
restricted access to social insurance because of requesting work conditions, long working
hours, low wages, and difficult to reach resources. In 2010, 85% of the female clothing
production line workers were experiencing hunger, regenerative medical issues, and network
procured infections (Johansson, 2019)
Determinants of Health Analysis: Policies and Organizations
Embracing and executing universally perceived tuberculosis strategies and rules from
the World Health Organization (WHO) is principal to consummation tuberculosis by 2030.
Diagnosing tuberculosis rapidly and precisely, with the goal that individuals get proper
treatment is a necessary initial step. While numerous nations have embraced WHO rules and
approaches for analysis, the frosty pace of usage costs the two lives and employments (Maruf
et al., 2012).
In 2010, WHO supported Xpert MTB/RIF;14 in 2011, WHO gave a policy
proclamation prescribing it as the underlying demonstrative test for possible MDR-
tuberculosis or HIV-related tuberculosis in grown-ups. In 2013, WHO extended its
suggestion to incorporate youngsters, including that Xpert MTB/RIF might be utilized as an

underlying symptomatic test for adults and kids with signs and manifestations of tuberculosis
(rather than smear microscopy and culture) (Das, Hossain and Karim, 2016).
The Global Laboratory Initiative (GLI), a working group of the Stop tuberculosis
Partnership, has created policy direction for simple progress to Xpert UItra, and WHO
discharged strategy suggestions for Xpert Ultra in 2018.
Cepheid is building up another system, Xpert Omni, convenient, battery-powered
instrument that can be utilized in remote country settings. The Omni will have the option to
run Xpert MTB/RIF and Ultra cartridges, and other Xpert sickness explicit cartridges. The
expense of the one-module Omni model is required to be around US$ 2,89518 versus the
US$ 17,000 marked down the cost for the present four-module Gene Xpert model.
Global Health Analysis: Cultural Considerations
It had been a relatively belittling presumption of our own that individuals just utilized
one 'style' of treatment. Similarly, as somebody would look for help from an acupuncturist for
his back agony only as an orthopedic specialist, patients likewise counseled with and are
treated by more than one mode of health experts. One type of conventional medication that
has gotten progressively famous within the Bangladeshi people. Measuring is the strategy of
putting hot glass cups or containers on a person who has returned to draw out any polluting
effects in the body (Aedicula, 2017). A cut is made in the skin under the region where the cup
is set to draw out contaminations in the blood. A few more youthful Bangladeshi patients
have had the method applied, as portrayed by the imprints left by the cups on their bodies.
The training seems to have gotten increasingly well known in the course of the past decade
among more youthful individuals, not really for medical problems, yet as a type of refinement
or detoxification and uplift the feeling of spiritualization (Begum, 2019). Utilization of the
training and where to have it performed is spread by listening in on others' conversations; in

principle, as a strict practice, it ought to be offered for nothing with people making a blessing
to the expert as a by-product of the system, although as a general rule, some compensation
$150-$300 (Alitame, 2018).
Determinants of Health Analysis: Core Determinants of Health
The risk of exposure to Mycobacterium tuberculosis (MTB) is subject to social and risk
practices. Living or working in a high episode setting, congestion, and poor ventilation
increase the risk of exposure. Factors that defer conclusion comparably increment the length
of exposure to an irresistible tuberculosis persistent (Faysal, 2018).
Lack of healthy sustenance expands the vulnerability to ailment; salary limitations can
constrain the utilization of health services administrations. tuberculosis disgrace, perceived as
a social determinant of health and health disparities related to the absence of social help, can
prompt resistance and poor treatment results. The risk of exposure, the movement to active
tuberculosis (tuberculosis), and afterward to fix is a procedure influenced by a few risk
factors. Alongside surely understood risk factors, for example, human immunodeficiency
infection (HIV), the utilization of immunosuppressive medications, and being of young age,
developing risk factors, for example, financial and conduct perspectives, assume a critical job
in expanding the powerlessness to disease, and fruitless treatment results. This paper abridges
the impacts of these economic determinants and co-morbidities (counting HIV) on
tuberculosis contamination and sickness (Cassels, 2019).
Determinants of Health Analysis: Root Causes
As of late, the job of risk elements and social determinants of tuberculosis have been all
the more seriously contemplated, and the job of some exceptionally common determinants,
for example, human immunodeficiency infection (HIV), smoking, diabetes mellitus (DM),
liquor use and under-sustenance have been featured. Others incorporate congestion, lodging

conditions, or financial hardship. It has been indicated that the territories with the high
tuberculosis occurrence are additionally those with a high frequency of HIV disease,
imprisonment, congestion, joblessness, and outsiders (Ormerod et al., 2019).
Determinants of Health Analysis: Fiscal Resources
Resource requirement represents a significant issue to address these difficulties.
Bangladesh assigns deficient financial resources for health, given the generally expense base
and the resultant shortage of funds. In this manner, there is a need to grow the expense base
to produce more incomes and, simultaneously, investigate roads for creating extra resources
for health. In this regard, ample opportunity has already past to investigate and present
different kinds of medical coverage programs, including network health care coverage plans,
to create extra resources for health (Thorson and Diwan, 2001). Tobacco tax collection in the
financial spending plan is constantly contradicted by the business to keep tobacco items
generally moderate with the goal that the business benefits are not influenced.
Determinants of Health Analysis: Social Support Networks
The CSDH characterizes the underlying determinants of health as those conditions that
produce or fortify social stratification in the public arena. Social stratification, thus, offers to
ascend to an inconsistent dispersion of the social determinants of health, including material
living conditions and psychosocial conditions, just as conduct and organic risk factors. The
study of disease transmission incorporates global financial disparities, significant levels of
populace portability, and fast urbanization and populace development. These conditions offer
ascent to inconsistent dissemination of critical social determinants of tuberculosis, including
nourishment weakness and lack of healthy sustenance, poor lodging, and ecological
conditions, and money related, geographic, and social boundaries to health services access
(Ormerod et al., 2019). This way, the populace dissemination of tuberculosis mirrors the

dispersion of these social determinants, which impact the four phases of tuberculosis
pathogenesis: exposure to contamination, the movement to ailment, late or improper
determination and treatment, and poor treatment adherence and achievement.
These social determinants are among the principal risk factors for tuberculosis. For
instance, poor ventilation and congestion in homes, work environments, and networks
improve the probability of uninfected people being presented to tuberculosis contamination.
Neediness, lack of healthy sustenance, and appetite may expand vulnerability to pollution,
sickness, and seriousness of the clinical result. People with tuberculosis side effects, for
example, a constant hack frequently face substantial social and financial obstructions that
postpone their contact with health systems where a proper determination may be made,
remembering troubles for transport to health offices, the dread of trashing if they look for a
tuberculosis finding. Absence of social help to look for care when they fall debilitated
(Mohiuddin and Haqq, 2017).
Risk factors for various phases of tuberculosis pathogenesis and the study of
disease transmission
Although DOTS has spearheaded the utilization of a patient's informal community to
improve treatment adherence, a social determinant's structure additionally features how the
absence of trust, later on, driven by neediness, may likewise cultivate high paces of treatment
default that undermine tuberculosis control. At last, given the close connection among HIV

and tuberculosis in numerous settings, outstandingly sub-Saharan Africa, the fundamental
social determinants of HIV contamination likewise go about as roundabout determinants of
tuberculosis risk. Principal among these is a broad disparity in circumstances and desires for
people strengthened through social standards and financial systems (Al-Manini, 2007). These
changes and desires make conditions that offer ascent to systems of simultaneous gender
organizations described by power disparities among male and female accomplices.
Determinants of Health Analysis: Vulnerable
Laborers, in the article of the clothing industry, are vulnerable against tuberculosis. The
working environment setting expands its risk of getting tuberculosis because of word related
exposure and squeezed working conditions. Laborers additionally face the plausibility of
losing their employment and separation from businesses. For the laborer, the work
environment is a perfect spot to pick up attention to and get treatment for tuberculosis.
tuberculosis is a developing significant medical issue in the article of clothing
enterprises because of the nonattendance of DOTS in Workplace offices. Managers and
workers have a disgrace about tuberculosis. A large portion of the laborers hides tuberculosis
because of the dread of losing employment (Aedicula, 2017). Laborers experiencing
tuberculosis are treated sporadically by a private expert without appropriate records. MDR is
basic among such garment laborers.
Health Equity and Social Justice: Acted Upon
In Bangladesh, the MOHFW has made outstanding progress as of late through its part
comprehensive methodology, particularly as far as administration conveyance in country
zones. In any case, its stewardship is obliged by a feeble legal structure and institutional
deficiencies, especially around guideline and coordination. The administration's abilities to
control, plan, and provide health administrations have been additionally tested by fast

urbanization. Provided that Bangladesh has resolved to offer health administrations to every
one of its residents and to guarantee their entitlement to health, leaders should know about the
numerous moral quandaries natural in the urban health space.
Health Equity and Social Justice: Health Equity
Health systems in Bangladesh can successfully improve health value by stressing an
essential human services approach, including supporting intersectoral activity across
government offices to advance health as a need of various strategy motivation; promoting and
guaranteeing network cooperation including populace groups and common society
associations in necessary leadership procedures to distinguish, deliver and assign resources to
health needs; taking measures to provide widespread health inclusion that elevate access to
compelling administrations to all out of luck and budgetary security, and concentrating on the
development of essential degree of care, guaranteeing that vulnerable groups ordinarily not
secured by health systems can utilize powerful health administrations of worthy quality
(Cassels, 2019). The highlights referenced before are implanted in the Primary Health Care
approach (PHC) that the section contends is a crucial policy activity to improve health value
and to address the social determinants of health imbalances.
Health Equity and Social Justice: Social Justice
To begin with, value is a worth that supports social equity and has a long history of
general health. Ongoing history gives plentiful instances of nations subscribing to cooperate
in the quest for more prominent health value. The World Health Organization repeated that
the goal of good health and health systems is two-fold: "the best achievable normal level
goodness and possible contrasts among people and groups decency" (Begum, 2019). In the
contemporary setting, social equity is regularly interpreted as meaning distributive equity.
The report of the International Forum for Social Development (Mohiuddin and Haqq, 2017)

recognizes three primary spaces of uniformity and value as the key to reasonable
dissemination: balance of rights, equity of risks, and cost in living conditions.
Health Equity and Social Justice: Underlying Causes
An enormous and developing assemblage of proof abridged in this paper, and other
source underlines that the way towards improving health for all individuals expects activity to
address the fundamental reasons for health disparities just as action by health systems. These
underlying causes are complex, regularly reflecting orderly social, political, authentic,
financial, and natural factors that collect over individuals' lifetimes and are moved across
ages. Health systems and general health additionally can improve value, for example, through
dynamic financing of health administrations or different methodologies towards all-inclusive
inclusion (Johansson, 2019). On the other hand, health approaches can likewise decrease
amount, for instance, through the lacking policy of care or unfair practices.
Intervention Recommendations: Leaders
Essential to health value action programs is how they ought to be created, with the
primary job of individuals encountering health disparities in each production, from building
up their needs to checking and reconsidering them. Such investment in health-related
essential leadership is their right. The procedure must guarantee an opportunity for
underestimated and distraught populations to make their voices heard and to be a part of
primary leadership forms, taking an interest as equivalents – and, for sure, to have their points
of view and needs advantaged, to be a part of the initiative of all structures related with the
action programs (Thorson and Diwan, 2001).
The health value action programs ought to have a significant level of civic duty and
authority, from national to local levels. Just with such responsibility will they effectively
control policymaking and resource assignment all through the legislature. Political obligation

could be founded on factors as differing as to the guarantees of the SDGs and commitments
of human rights, financial returns of health speculations, and how individuals' minimization
and impediment may put them at risk for some irresistible maladies, illnesses that represent a
health risk for the whole populace. This degree of political responsibility will require key
government on-screen characters and substances to be full members during the time spent
driving and creating health value action programs.
Intervention Recommendations: Interventions
The expanding collaborations among health, feasible advancement, condition, and
gender orientation have underscored the significance of the aggregate impact of interventions
across different parts of society to guarantee social equity. In Bangladesh, approach
producers additionally need to recognize that health is not the output of the health sector, but
a result of numerous different components and divisions past the bounds of health
administration’s policy. The administration of Bangladesh ought to organize a "Health in All
Policies" (HiAP) way to deal with open approaches across parts that deliberately consider the
more extensive social determinants of health. As speculated by Rawls, this methodology will
provide the establishment to more prominent fairness of risk for the urban poor and burdened
and, in this way, guarantee social equity in health and different privileges.
Intervention Recommendations: Theories
In his Theory of Justice, Rawls set forward the possibility that to guarantee social
equity, the supporting organizations of society need to work with consistency with the
standards of equity. Rawls, in this manner, put specific accentuation on the instrument
through which the standards of equity are detailed. His perspectives on "unique position" and
"shroud of numbness" propose methods for detailing the rule of equity to help the structure of
a fair society. Precisely, extraordinary consideration ought to be provided to tending to

profound disparities in access to human services and diminishing the lopsided exposure of the
urban poor to unfriendly social, financial, and ecological conditions that cause ill health.
Significant in this reaction is an acknowledgment of the heterogeneity of the urban poor and
the setting explicit difficulties they face. To improve ghetto conditions, coordinated urban
advancement endeavors are particularly required that address issues of lodging, residency
security, water and sanitation, green space, training, and health services.