Over view of the Study Effective health policy is prime need of developing and developed countries to ensure peoples

access in health care system. This paper aims to explore the current status of health services & promotional activities comparing developed countries i.e. (Japan, Canada, England, Saudi ra!ia and ustralia". #ealthcare system in $angladesh has !een achieved a changed and improved continuous significant progress in many areas of maternal as %ell as child health status no%.

has !een o!tained during the last decade. &ne of the main goals of the 'ational #ealth (olicy of $angladesh is to improve the health of mothers and children and to ensure the provisions of facilities for the safe and clean delivery of children at local level. The )overnment of $angladesh envisages ensuring safe !irth and survival to all children through provision of appropriate and ade*uate family planning services, prenatal and postnatal health care as %ell as essential o!stetrical services and encouraging all mothers to !reastfeed their children . The )overnment of $angladesh ()o$" has formulated the National Reproductive Health Strategy (+,,-" on the !asis of the principles of .nternational Conference on (opulation and /evelopment (.C(/". .n that strategy, four !asic areas have !een outlined in the analysis of reproductive health %hich includes, safe motherhood, family planning, 01 and care for post a!ortion complications and management of Sexually Transmitted /iseases (ST."21eproductive Tract .nfections (1T." (3#&, 4556". $angladesh has some pro!lems in health policy service. (eople are more interested in ta7en service private medical than pu!lic medical. #ospitals are not providing 48 hours essential services due to lac7 of trained staff and related support facilities. #igh rate of mortality is one of the important pro!lems of $angladesh. 9o% *uality of services, poor status, insufficient expertise and experience of doctors, lac7 of advancement of health care technology, high *uality hospitals and nutrition etc. other pro!lems of health services are corruption, illiteracy rate, shortage of medical technology, poverty, insufficient of professional doctors, shortage of drugs etc. The main lac7ing of $angladesh health service is that health services are not sufficient for all citi:en of this country. .n $angladesh the total fertility rate (T;1" has declined from around < in the mid=seventies to 6.8 in +,,6=,8. ccording to the 3#& composite index for overall health system attainment of +,+ mem!er states, $angladesh is ran7ed +6+, %orse than Sri 9an7a, .ndia and the 0aldives !ut !etter than (a7istan, $hutan and 'epal (3#&, 4555". Similarly, out of +<4
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countries, $angladesh ran7s +64, according to the #uman /evelopment .ndex, 455+, !ehind the 0aldives, Sri 9an7a, .ndia, (a7istan, 'epal and $hutan (>'/(, 455+". The infant mortality and maternal mortality rates are still very high in $angladesh, -,.< per thousand live !irths and 8.6 per thousand live !irths respectively ($/#S (reliminary 1eport, 455+? $.1(E1#T, +,,<". The perinatal mortality rate is @-.8 per thousand pregnancies (of more than - months". The maAor causes of death are pneumonia, respiratory failure, inAuries? upper respiratory tract infection and diarrhoea, %hile the maAor causes of mor!idity appear to !e ulcer, diarrhoea, malaria, and asthma and rheumatism2rheumatic fever. There are only +B doctors and @ nurses for every +55,555 people in $angladesh. (#.' Syeda (45+4".This paper mainly contrast $angladesh health care system %ith developed countries, such as Japan, Canada, England, Saudi health care system. 3e try to identify gaps among them. Bangladesh health policy comparing with developed countries (Japan, Canada, Saudi !ra"ia and !ustralia# 1. Bangladesh $S Japan #ealthcare system in $angladesh has !een achieved a changed and improved status no%. continuous significant progress in many areas of maternal as %ell as child health has !een o!tained during the last decade. $angladesh is the most populated country in the %orld than her capacity, her population +<+,5B6,B58 (July 45+4 est.", (opulation gro%th rate +.@-,C (45+4 est.", $irth rate 44.@6 !irths2+,555 population (45+4 est.", /eath rate @.-+ deaths2+,555 population (July 45+4 est.", .nfant mortality rate male=@+.8B deaths2+,555 live !irths and female=8<.6, deaths2+,555 live !irths (45+4 est.", 9ife expectancy at !irth total population=-5.5< years %ithin male=<B.4+ years and female=-+.,B years (45+4 est."+.n the sphere of Japan have the highest life expectancy, the lo%est infant mortality, and the most aged population in the %orld today. #er (opulation=+4-,6<B,5BB (July 45+4 est." (opulation gro%th rate =5.5--C (45+4 est.", $irth rate=B.6, !irths2+,555 population (45+4 est.", /eath rate=,.+@ deaths2+,555 population (July 45+4 est." 9ife expectancy at !irth total population=B6.,+ years among them male=B5.@- years and female=B-.86 years (45+4 est." .t %ill age even further in the first half of this century. $y the year 45@@, life expectancy for men is expected to reach B6.- years, compared %ith -,.4 years in 455-, %hile %omens life expectancy is expected to reach ,5.6 years, compared %ith B< years in
1

ra!ia and

ustralia

ngland,

http://www.indexmundi.com/bangladesh/demographics_profile.html accessed on 22-06-13

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455-. 1eflecting the improved longevity and lo% fertility, the percentage of the population at age <@ or older increased dramatically, from 8., percent in +,@@ to 45.+ percent in 455@. .t is expected to reach 85.@ percent in 45@@.4 $angladesh health indicators are= Sex ratio at !irth=+.58 male(s"2female, under +@ years=+.5+ male(s"2female and +@=<8 years=5.B, male(s"2female, <@ years and over=5.,6 male(s"2female, total populationD 5.,6 male(s"2female (45++ est." ,>#;3C E 66-@ 6+=@5 !ed >#C E 6,-,Farious types of district level hospitals E B5 ,)overnment medical college hospitals E +6,(ostgraduate hospitals E <,Specialised hospitals E 4@,/octor to population ratio E +D8,-+,,'urse to population ratio E +DB,44<,#ospital !eds E 85,--6 (over 4,,555 in )&$". 3hereas Japan .nfant mortality rate total=4.4+ deaths2+,555 live !irths, male=4.88 deaths2+,555 live !irths and female= +.,- deaths2+,555 live !irths (45+4 est." ,9ife expectancy at !irth total population=B6.,+ years male=B5.@- years and female=B-.86 years (45+4 est.", Total fertility rate +.6, children !orn2%oman (45+4 est." ,0aternal mortality rate @ deaths2+55,555 live !irths (45+5" #ealth expenditures ,.6C of )/( (455,", (hysicians density 4.5<6 physicians2+,555 population (455<", #ospital !ed density +6.-@ !eds2+,555 population (455B", &!esity = adult prevalence rate 6.+C (4555".6 Japan has a national health insurance system. The insurance covers the entire population either through employee programs, municipal programs, or special programs. ll programs offer the same !enefits. Employers pay @5 percent of the insurance premium. (atients currently contri!ute either +5 percent (age -5 or older" or 65 percent (all others and affluent elderly" to the cost of inpatient or outpatient care, or prescription drugs. Children also have a 45 percent co=payment, !ut many municipalities and cities are no% !earing some or all of these costs to attract and 7eep citi:ens. ;or people !et%een age -5 and -8, the co= payment rate %as scheduled to move up to 45 percent, !ut the move is temporarily suspended. There is a maximum su!sidy of G6@5,555 (a!out >SH6,455" to the cost of delivery for child!irth. 1outine chec7s during pregnancy are not covered !y health insurance. Japan ran7s slightly !elo% the average in terms of health spending per capita, !ut the contri!ution of its pu!lic sector to
2

!" #orld $actboo%:&nless otherwise noted' information in this page is accurate as of $ebruar( 21' 2013 ")ailable at http://www.econom(watch.com/economic-statistics/*angladesh/"ge_+tructure/

accessed on 23-06-13

https://www.cia.go)/librar(/publications/the world fact boo% (age & of 19

health spending is E at B6 percent E %ell a!ove the &EC/ average of -6 percent. Japan has fe%er physicians per capita, a!out t%o thirds of the &EC/ average, %hich is at least partly due to government policies fixing limits on the num!er of ne% entrants to medical schools. Japan has the highest num!er of hospital !eds, more than t%ice the &EC/ average, and the highest num!er of magnetic resonance scanners, a!out four times the &EC/ level. (hysicians density=4.5<6 physicians2+,555 population (455<", #ospital !ed density=+6.-@ !eds2+,555 population (455B" and &!esity = adult prevalence rate=6.+C (4555"..n the field of $angladesh )overnment Service (roviders .n order to increase the access of the people to *uality health care services, @,555 posts of doctors should !e created in the next five years. There should !e proper manpo%er planning to a!sor! the medical graduates into the national medical service. There should !e a doctor availa!le in every >nion #ealth and ;amily 3elfare Centre (>#;3C" and in Community Clinics (CC" for a fixed num!er of days. The health centers2clinics can !e made more functional if female doctors are employed for %omen patients. .n addition, presence of health personnel should !e ensured in their %or7 places. Community participation is essential to ma7e the health centres2clinics functional. The communities are to !e empo%ered %ith resource management and decision=ma7ing. .n order to ensure commitment of the doctors, it should !e made mandatory for doctors to serve in rural areas !efore they are allo%ed to practice in the cities. The government should devise a mechanism for evaluating and monitoring the professional development of doctors. (hysicians density=5.4,@ physicians2+,555 population (455-", #ospital !ed density=5.8 !eds2+,555 population (455@". The infant mortality and maternal mortality rates are still very high in $angladesh, -,.< per thousand live !irths and 8.6 per thousand live !irths respectively ($/#S (reliminary 1eport, 455+? $.1(E1#T, +,,<". The perinatal mortality rate is @-.8 per thousand pregnancies (of more than - months". .t is very disappointing to note that almost t%o= thirds of the !irths do not receive any antenatal care. mong those %ho receive antenatal care, only +< per cent are informed of the signs of complications, and slightly more than one=third receive iron ta!lets. ;or delivery, only < per cent use health facilities. Trained health personnel assist deliveries of only 44 per cent of the !irths. 3earers Japan .nfant mortality rate total=4.4+ deaths2+,555 live !irths, male=4.88 deaths2+,555 live !irths and female= +.,- deaths2+,555 live !irths (45+4 est." ,9ife expectancy at !irth total population=B6.,+ years male=B5.@- years and female=B-.86 years (45+4 est.", Total fertility rate +.6, children !orn2%oman (45+4 est." ,0aternal mortality rate @ deaths2+55,555 live !irths (45+5" #ealth expenditures ,.6C of )/(
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(455,", (hysicians density 4.5<6 physicians2+,555 population (455<", #ospital !ed density +6.-@ !eds2+,555 population (455B", &!esity = adult prevalence rate=6.+C (4555". )ood diet, a healthy lifestyle and high=*uality healthcare are all factors contri!uting to Japanese longevity. The remar7a!le gains in life expectancy in Japan in recent decades have !een driven !y a dramatic reduction in heart diseases, %hich are no% at the lo%est level in the &EC/ for !oth men and %omen. Japan also !oasts one of the lo%est incidences of o!esity in the &EC/, at 6.8C of the population compared %ith 68.6C in the >S. &n a less positive note, 4<C of adults in Japan are smo7ers, compared %ith an &EC/ average of 48C. Japan has one of the highest male smo7ing rates in the &EC/, at 85C. There are also particularly high levels of chronic hepatitis C virus (#CF" infectionD according to a local pharmaceutical company, Chugai, there are more than +.@m cases of chronic #CF in Japan. The large num!er of cases partly reflects the reuse of needles in government immuni:ation campaigns and the dissemination of contaminated !lood products !y local pharmaceutical firms in the late +,-5s and +,B5s. #epatitis C is the most common cause of hepatocellular carcinoma, %hich alone is associated %ith over 65,555 deaths in Japan each year. The virus is also the main reason for the large num!er of liver transplants carried out in Japan. The 3orld #ealth &rgani:ation (3#&" reported the num!er of #.F cases in Japan at ,,<55 in 455-. This e*uates to less than 5.55+C of the population, one of the lo%est ratios of #.F infection in the %orld. #o%ever, independent research suggests that actual infection rates may !e much higher, especially among the young, and the num!er of cases has !een increasing steadily. .n $angladesh 0aAor Causes of /eath (+,,-" Stratified et al., 455+, (neumonia=+@.- percent, 1espiratory ;ailure=,.8 percent, .nAuries (unintentional"=B.- percent, >pper 1espiratory Tract=@., percent, /iarrhoea=8., percent, >lcer=-.5 percent ,/iarrhoea=@.+ percent, 0alaria=6.4 percent, sthma=4.< percent, 1heumatism21heumatic ;ever=+.B percent. Japan spends a modest amount on healthcare !y the standards of the industriali:ed %orld, at an estimated <.BC of )/( and >SH4,<44 per head in 455B. This compares %ith +<.+C of )/( and >SH-,8,5 per head in the >S, %hich spends more on healthcare than any country in the %orld. 'evertheless, Japan is the largest healthcare spender in the sia region. (u!lic expenditure accounted for B+.6C of total health spending in Japan in 455<, according to the latest availa!le data from the &EC/? private household expenditure accounted for +@C, and private insurance for only 6C. Social security funds are the main source of pu!lic expenditure, representing <<C of total healthcare spending, %ith general government accounting for +<C of total spending.
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#ealth expenditures=,.6C of )/( (455,"8. .n $angladesh #ealth expenditures=6.8C of )/( (455,", $angladesh only H 6- >S/. The per head cost annually H C / +<86 to +B5B, %hile $angladesh per head cost annually @,5 ta7a (+.<4 ta7a per day".@

, 0

#orld *an% -e)elopment !ndicators .2006/

3orld #ealth &rgani:ation(3#&"

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%. !nalysis on comparison of health policy "etween Canada and Bangladesh .n Canada the improved hygienic sanitation facilities is +55C. $ut .mproved sanitation in $angladeshD ur!an= @-C , 1ural = @@C of population, Total = @<C of population. >nimproved sanitation facilities in $angladeshD ur!an= 86C of population, rural E 8@C of population, total= 88C of population< ..n $angladesh, the percentage of supply of improved drin7ing %ater has increased at an annual average rate of 5.65C during the period of 4558 to 455,. (C. %orld fact !oo7, 45+4" The present percentage of improved %ater supply in $angladeshD ur!an E B@C of population, rural E B5C of population, total E B+C of population and unimproved %ater supply ur!an E +@C of population, rural= 45C of population, total E +,C of population. .mproved %ater supply in CanadaD ur!an E +55C of population, rural E ,,C of population, total= +55C of
6

httpsD22%%%.cia.gov2li!rary2pu!lications2the=%orld=fact!oo72
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population and unimproved %ater supply in CanadaD ur!an E 5C of population, rural= +C of population, total E 5C. The fertility rate of $angladesh is 4.@@C %hile Canada is +.@, C( C. 3orld fact !oo7".The present rate of maternal mortality in $angladesh 485 deaths2 +55555 live !irths and Canada +4 deaths 2 +55555 live !irths (glo!al health facts, C. fact !oo7,45+5".The rate of infant mortality has decreased impressively during the period 4555=455B in $angladesh. The average annual reduction rate of infant mortality during that time %as 4.+6C.(*angladesh
1conomic &pdate' 2010/. The present infant mortality rate in $angladesh total E 8-.6 deaths2

+555 live deaths, ;emale E 88.-+ deaths2 +555 live deaths, 0aleE8,.-, deaths 2 +555 live deaths and Canada infant mortality rate total E 8.-B deaths2 +555 live deaths, ;emale E 8.86 deaths2 +555 live deaths and 0ale E @.++ deaths2 +555 live deaths. the annual num!er of !irths per +555 people in $angladesh is 45.-, %hile Canada !irth rate is +5.4,.0ost of the child death of $angladesh happens !ecause of for serious infections (6+C" from 1. and diarrhea. The num!er of deaths of child fe%er than one year old in a year per +555 lives in $angladesh is @-.-B and fe%er than @ are @4C and in Canada the num!er of child death is 8.,,C. (C. %orld fact !oo7"The num!er of !irths living %ith #.F2 ./S in $angladesh +5C , %hile Canada 85C (C. 3orld ;act !oo7 report".The present life expectancy of Canada total E B+.8B years, ;emale = B8.4+ years and 0ale=-B.B, years (C. fact !oo7 4+ ;e!,45+4" on the other hand expectancy in %orld fact $angladeshD total= -+.<, years, ;emale = -4.6+ years and 0ale= <,.4@ years(C.

!oo7, 45+6". There are currently +6<@ hospitals in Canada %hile total num!er of hospitals in $angladesh is +<B6. &f these hospitals <-B are governmental and +55@ are non=governmental. 4@=85C !eds are reserved for maternity patients in every hospital in $angladesh. $angladeshD 5.6 !eds2 +555 population and CanadaD 6.4 !eds2 +555 population reserve for maternity patients. .n Canada, hospitals are largely pu!lic and non=profit, %ith financing !ased on an annual glo!al !udget and all maAor surgery and high=technology diagnostic tests are provided in hospitals %hile in $angladesh people are interested in private services !ecause pu!lic services are not enough and sufficient for peoples need. The num!er of *ualified physicians and nurses in $angladesh is *uite lo%. round 4<C of professional posts in rural areas remain vacant. ;or $angladesh 6.< (per +5555 populations" physicians other hand 45.- physicians for Canada. (glo!al health fact,45+4"The cost of Canadas health care system, approximately ,C of Canada )/(, !ut in $angladesh the cost of health care system +C of )/(. (er capita pu!lic and private health expenditure com!ined in H 6,<-6 >S/ and in $angladesh only H 6- >S/. The per head
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cost annually H C / +<86 to +B5B, %hile $angladesh per head cost annually @,5 ta7a(+.<4 ta7a per day" (%orld health organi:ation".Canada health care services divided into the federal and provincial levels. (eople of Canada received ,,C health care services. The federal is responsi!le for all health service !ut provincial government is responsi!le for the primary delivery of physicians and hospital services. $angladesh health care system divided into several parts, such as upo:ila, district, division thana level etc. ur!an health services have !een the responsi!ility of the ministry of local government, rural development and cooperatives implemented through the city corporations and the municipalities. $ut all services provided from central health ministry. &nly <5C people of $angladesh has got very little access to !asic health care !ecause of limited man po%er and resources (0&#;3, 4556". &. Comparisons of health policy "etween Bangladesh and ngland $angladesh is a developing country it has +< Crore population %ithin its +,8-,@-5 s*uare 7ilometer. 0ost of the people of $angladesh are illiterate they are ignorant and careless a!out their health and the government of $angladesh has no enough resources to provide health facilities all the population of the country. England is a developed country and health facilities of England are recogni:ed all over the %orld. .t has ade*uate resources to provide health facilities to its people. s a developing country $angladesh and as a developed England there do exist several clear difference of the health policy !et%een $angladesh and England. These are descri!ed !elo%. #ealth program !oth in $angladesh and England are !ased on ur!an and rural area. .n $angladesh ur!an program includes 0edical College #ospitals, Speciali:ed 0edical College and rural program includes >pa:ila #ealth Complex, Community Clinic. .n England ur!an program includes /epartment of #ealth, (rimary Care Trusts and rural program includes The Countryside gency, The .nstitute of 1ural #ealth. #ealth facilities in $angladesh !oth in rural and ur!an area are not e*ually provided. .n England health facilities in ur!an and rural !oth areas are e*ually provided. #ealth instruments in $angladesh are not sufficient particularly in rural area !ut England are enriched %ith health instruments. .n England private health organi:ations are not so strong !ut in $angladesh private health organi:ation plays vital role rendering health facilities. modeling future supply. s a developing country $angladesh health policy focus on $angladesh spends 6.8C of )/( in health sector 0illennium /evelopment )oals(0/)" %hile England health policy focused on around

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(nationmaster.com"that is not enough to providing health facilities noted that )/( of $angladesh is more less than England in contrast England spends B.8C of )/( in health sector (nationmaster.com". The determinant of health facilities in $angladesh measured !y income !ut in England heath facilities determined !y %hether education, income, occupation. ;or improvement of health facilities $angladesh do not ta7e proper strategies if they ta7e cant implement properly %hile England ta7e proper strategies for achieving specific goals. There is a !ig difference of population and doctor !et%een $angladesh and England. The proportion of doctor and population in England is +D+555(%i7ipedia.org" on the other hand in $angladesh 5.4,@ physicians against +555 population(.!dne%s48.com". #ealth policy in $angladesh greatly emphasis on infant, child mortality, and maternity on the contrary in England health policy emphasis on the individual and changing !ehavior. Child mortality rate is also mentiona!le difference, child mortality rate in $angladesh is 6B of per +555 live !irths !ut in England child mortality rate is very lo%, child mortality rate in England is 8.4 of per +555 live !irths (trading economics". lmost +55C !irth attended !y s7illed health personnel in England %hile !irth s !irth attended attended !y s7illed health personnel in $angladesh is only 6+C (.indexmundi".

!y s7illed health personnel the life expectancy in England is B5.+-C at !irth !ut life expectancy in $angladesh is -5.5<C at !irth. .n England government emphasis on peoples choice, right and information though $angladesh health policy has such features visi!le !ut not practically implemented. There is exist individual choose and autonomy in England !ut this type of facilities not get properly individual in $angladesh. England #ealth Care System support for smo7ing cessation and reducing to!acco advertising and promotion, reducing availa!ility and supply of to!acco including illicit and smuggled to!acco. .n fine, !oth $angladesh and England health policy provide health care for people and service oriented though their found some common distinction of services of health in $angladesh and England.

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'. Comparisons "etween Bangladesh and Saudi !ra"ia-s .ealth System/

E=health vision is a safe, *uality, health system !ased on patient centric care, guided !y standards, ena!led !y e=#ealth ..n $angladesh, e=health is not a popular process though Saudi ra!ians have developed the strategy of e=health %ith their consultants and involving people from across the 0&# (ministry of health".The proAect is structured %ith three %are streams? Strategy, )overnance and Technology.

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$oth the health care systems of $angladesh and Saudi

ra!ia fall under the control of the

0inistry of #ealth. $ut the pictures of the systems are different and vivid. ;or example, in the late +,B5s in $angladesh a su!=district health center had only 65 hospital !eds and poorly administrated. &n the contrary, the 0&# supervised 45 regional directorates=general of health affairs in various parts of the country. Each regional health directorate has a num!er of hospitals and health sectors and every health sector supervised a num!er of (#C (primary health care" centers. .

$angladesh has a surprisingly extensive health infrastructure throughout the country. #ealth care delivery system in $angladesh !ased on (#C concept has got various 9evel of service deliveryD . #ome and community level. >nion level, $. >nion su! centre (>SC" or #ealth and family %elfare centre? This is the first health facility level. C. Thana level, Thana #ealth Complex (T#C"D This is the first referral level. /. /istrict #ospitalD This is the secondary referral level. E. 'ational 9evelD This is the tertiary referral level. - Saudi health services have advanced greatly over recent years in all levels of health servicesD primary, secondary and tertiary.
2

s a

'ational #ealth policy in (ost 'atal Care in $angladesh, 45+4

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conse*uence, the health of the Saudi population has improved mar7edly. The 0&# has introduced many reforms to its services, %ith su!stantial emphasis on (#C. $oth Countries have strategic health services. .n Saudi ra!ia, it is 0&#s national strategy adopted in 455,, and in ra!ia as usual. #ealth care delivery $angladesh it is (#C (primary health care" concept %hich got various levels of service delivery. Comparatively, $angladesh is less developed than Saudi system in $angladesh !ased on (#C (primary health care" concept has got various 9evel of service delivery. &n the other hand, The 0&# (ministry of health" is considered the lead )overnment agency responsi!le for the management, planning, financing and regulating of the health care sector in Saudi ra!ia. .n $angladesh #ealth expenditure, pu!lic (C of government expenditure" in $angladesh %as B.,6 as of 45++. .ts highest value over the past +< years %as ,.<- in 455,, %hile its lo%est value %as -.6@ in 455B( 3orld #ealth &rgani:ation" on the contrary, llocations for health and social affairs in Saudi ra!ia spending gre% !y +< percent year=on=year to reach H4<.- !illion (S1+55 !illion" in the 45+6 !udget.( Jeddah Centre for ;orums and Events I Jeddah, Saudi ra!ia."

(. Comparison "etween Bangladesh and !ustralian health sector s of July 45+4, there %ere a!out +<+ million people living in $angladesh. 9ife expectancy in the country is -5 years? the average %oman lives to -4 years old, almost 8 years longer than the average man. The population gro%th rate is a!out +.<C per year, %ith a fertility rate of 4.@@ children !orn to every %oman. The !irth rate compared to mortality rate is 44.@ !irths to @.deaths per +555 population. The maternal mortality rate is 485 deaths per +55555 live !irths (45+5", and the infant mortality rate is 8, deaths per +555 live !irths? male infant mortality rate is +5C higher than that for female infants. under%eight (C. !out 8+C of children under five years of age are 3orld ;act $oo7". The age structure of the population isD 68.6C are !et%een 3orld ;act $oo7". &n the

5=+8 years old? <+.+C are !et%een +@=<8 years old? 8.-C are <@ years or older (45++". The estimated median age of the population is young, at 46.< years (C. other hands in ustralia the (opulationD 44,5+@,@-< (July 45+4 est." life expectancy of male is-B years life expectancy of female is B4 years .(opulation gro%th rateD +.+4<C (45+4 est."$irth rateD +4.4B !irths2+,555 population (45+4 est." /eath rateD <.,8 deaths2+,555 population (July 45+4 est. #ealth policy of $angladesh 45++ didnt descri!e male and female different health care system
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particularly. This policy not identified different stage of life of male and female for treatment. 3hereas, ustralian government prepared health policy for male and female particularly for ustralian, 0ale and ;emale health policy identify the different stage of life for ustralian government allottedBC of annual !udget for the !etter health of

men and %omen particularly for !etter treatment. The !udget of $angladesh allotted to the health sector !elo% +C. &n the other hand, health sector.@+.@C of households in $angladesh %ere using hygienic sanitation facility in 455,. The average increase of percentage among +,,5 to 455, %as +.<+ per year sanitation facilities are given !elo%, .mproved sanitation in $angladeshD ur!an= @-C of population, 1ural = @@C of population. Total = @<C of population. >nimproved sanitation facilities in $angladeshD ur!an= 86C of population 1ural E 8@C of population. &n the other hand .n ustralia people using +55C sanitation facilities !oth ur!an and local areas.B report pu!lished !y 3orld #ealth &rgani:ation (3#&" in 45++ revealed that %hile communica!le diseases, maternal, perinatal and nutritional conditions ma7e up 6,C of total mortality, 'C/s account for @4C of total mortality. Cardiovascular disease (CF/" is the leading cause of death, accounting for 4-C of all deaths in $angladesh (3#& 'C/". 0alaria, /iarrhea, #.F2 ./S (sourceD $angladesh Country 1eport &cto!er, 45+4". 3hereas, The proportions of over%eight and o!ese people have significantly increased over the last 45 years. &!esity is associated %ith poor health and among people aged B years and over, <C of men and -C of %omen are o!ese. Child and adolescent o!esity has also !ecome a significant health pro!lem over the past fe% decades, and a!out one in four ustralian children are no% o!ese or over%eight ( ustralian .nstitute of #ealth & 3elfare 455@!". This rising tide of o!esity threatens the positive trend in #ealthy life expectancy. Some common disease food=!orne diseases emergence of antimicro!ial resistant !acteria sexually transmitted diseases vector=!orne disease Faccine=preventa!le diseases., #ealth expenditure in $angladesh is 6.8C of its )/( in 455,, %hich is relatively lo% for the South sia region. The physician and hospital !ed density ratios are also lo%D there are 5.4,@ physicians and 5.8 hospital !eds for every +555 people. 0ean%hile, the health system is slo%ly shifting emphasis from the traditional and charge=free pu!lic.+5 ustralia spends ,.-C of )/( on health, and expenditure ustralia per capita in terms of purchasing po%er parity ((((" %as >SH 6<@4, %hich puts
3

C. 3orld ;act !oo7s Fol. B 'o. @ 455<, #ealth Systems in Transition ustraliaD #ealth system revie% $angladesh Country 1eport &cto!er, 45+4
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10

slightly a!ove the &EC/ average. Expenditure is expected to rise further %ith gro%ing demand !y the pu!lic, %ho have high expectations of health care goods and services, %ith increasing costs of high=technology medicine, and %ith the increasing need for health care for a rapidly ageing population. $angladeshJs economy has gro%n @.BC per year since +,,< despite political insta!ility, poor infrastructure, corruption, insufficient po%er supplies, and slo% implementation of economic reforms. $angladesh remains a poor, overpopulated, and inefficiently=governed nation. lthough more than half of )/( is generated through the service sector, 8@C of $angladeshis are employed in the agriculture sector %ith rice as the single=most=important product. $angladeshJs gro%th %as resilient during the 455B=5, glo!al financial crisis and recession. )arment exports, totaling H+4.6 !illion in ;K5, and remittances from overseas $angladeshis, totaling H++ !illion in ;K+5, accounted for almost +4C of )/(. (SourceD $angladesh Country 1eport &cto!er, 45+4". &n the other hand ustraliaJs a!undant and diverse series of maAor natural resources attract high levels of foreign investment and include extensive reserves of coal, iron ore, copper, gold, natural gas, uranium, and rene%a!le energy sources. expand the resources sector. investments, such as the >SH85 !illion )orgon 9i*uid 'atural )as proAect, %ill significantly ustralia also has a large services sector and is a significant ustraliaJs trade policy include exporter of natural resources, energy, and food. Ley tenets of

support for open trade and the successful culmination of the /oha 1ound of multilateral trade negotiations, )/( = real gro%th rateD 6.6C (45+4 EST."(opulation !elo% poverty lineD ' C, >nemployment rateD @.4C (45+4 EST.

Conclusion ;rom the a!ove differences !et%een $angladesh and developed countries(Japan, Canada, England, ustralia, Saudi ra!ia" it is simply can say that there are some clear differences as
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population, nutrition,

./S, child death, life expectancy etc. There is also a !ig !et%een health

policy and reality in $angladesh. .n spite of the fact that $angladesh did not have a proper #ealth (olicy until +,,B, more than a *uarter century after independence, the country made impressive strides in improving the health status of its people during the +,B5s and +,,5s. This is especially true for child mortality and mor!idity and %omens reproductive health Mleading to a sharp fall in fertility. The achievements of $angladesh %ith respect to mortality and fertility have !een %idely hailed !y the international community as !eing exceptional for its level of economic and technological development. So, it can !e said that in a!sence of national health policy untilln4555, health sector planning %as done through the frame %or7 of five years plan. .n national health policy of $angladesh, there have some salient features, goals and have some strategies to fulfill the goals and principles. $ut in 'ational health policy is properly implemented in our country !ecause of some restriction. So for solving this pro!lem the government must have ta7en some effective measures. $y implementing an effective 'ational #ealth (olicy %e can !e a healthy and prosperous nation. So it can !e said that the health facilities in $angladesh no% improving day !y day %ith the economic progress.

0eferences $angladesh /emographics (rofile 45+6 availa!le at httpD22%%%.indexmundi.com2!angladesh2demographicsNprofile.html accessed on 44=5<=+6

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O#ealth (olicy 45++O. Ministry of Health & Family Welfare, Government of the People s Repu!lic of "angladesh (in $engali". 0inistry of #ealth & ;amily 3elfare, )overnment of the (eopleJs 1epu!lic of $angladesh. 1etrieved - June 45+4. #.' Syeda (45+4", 'ational #ealth (olicy in (ost 'atal Care in $angladeshD )ap !et%een (olicy and (ractice availa!le at %%%.mppg#nsu$org%attachments%&'()*+$,-+Nahida$pdf 'ational #ealth (olicy 45++D Challenges and prospects availa!le at ...$mohf.$gov$!d / 0!out M1H&FW The /aily Sun ne%spaper 56 0arch 45+4 availa!le at ...$daily#sun$com%details)yes)*2#+&# -+*-)National#Health#Policy#20 accessed on 5-=5<=45+6 JapanD >niversal #ealth Care at @5 Kears <, ;uture of Japans system of good health at lo% cost %ith e*uityD !eyond universal coverage. vaila!le at ...$hsph$harvard$edu%michael# reich%files%$$$%paper(#lancet#japan$pdf ccessed on 58=5<=+6 Japans )lo!al #ealth (olicy 45++=45+@D 0inistry of ;oreign ffairs of Japan .nternational Cooperation $ureau 4=4=+ Lasumigase7i, Chiyoda, To7yo, +55=B,+,, Japan, Septem!er 45+5 availa!le at ...$mofa$go$3p%policy%oda%mdg%pdfs%hea)pol)ful)en$pdf ccessed on 5-=5<=+6 C. 3orld ;act!oo7D>nless other%ise noted, information in this page is accurate as of ;e!ruary 4+, 45+6 vaila!le at httpD22%%%.economy%atch.com2economic= statistics2$angladesh2 geNStructure2 acessed on 46=5<=+6 4apaness!urg Summit -++-540P0N 617N8R9 PR1F:;< 7nited Nation availa!le at http5%%...$healthofnations$com% accessed on -&#+(#*& Election 455+ D 'ational (olicy ;orum, (&9.CK $1.E; &' P#E 9T# '/ (&(>9 T.&' SECT&1 (&9.CKQ 6P= 80S> F1R6< R<P1R8 availa!le at ...$cpd$org$!d%html%policy,-+brief%$$$%task)force)reports%Health$pdf ccessed on 4+=5<=+6

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#ealy,Judith.Sharman,Evelyn.9o7uge,$uddhima,#ealth Systems in Transition ustraliaD #ealth system revie%,Fol. B, 'o. @, 455<". httpsD22%%%.cia.gov2li!rary2pu!lications2the=%orld=fact!oo72. $angladesh Country 1eport &cto!er, 45+4". O;re*uently as7ed *uestionsO (3e! page". http5%%...$.ho$int%. 3orld #ealth &rgani:ation. 45+4. 1etrieved 4+ 0arch 45+4. Staff (45++". O#ealth (olicy 45++O ((/;". Ministry of Health & Family Welfare, Government of the People s Repu!lic of "angladesh (in $engali". 0inistry of #ealth & ;amily 3elfare, )overnment of the (eopleJs 1epu!lic of $angladesh. 1etrieved - June 45+4. Staff (455-=455B". O#omeO. Ministry of Health & Family Welfare, Government of the People s Repu!lic of "angladesh (in $engali and English". 0inistry of #ealth & ;amily 3elfare, )overnment of the (eopleJs 1epu!lic of $angladesh. 1etrieved - June 45+4 Josh Chang, ;elix (eysa7hovich, 3eimin 3ang, Jin Rhu (455@" The >L #ealth Care System. &mar #aider Cho%dhuhy and S. 1. &smani (45+5" To%ards chieving the 1ight to #ealthD The Case of $angladesh. Candace .mison, James $uchan and Su Savier (455," '#S 3or7force (lanningD 9imitations and (ossi!ilities. !ul $ar7at & L0 0a7sud (4556" #uman /evelopment 1esearch Centre (#/1C" httpD22%%%.itu.int2.T>/2cy!2events245+42ehealth2'atNe#N/ev2Session C4562$angladesh23#&.T>C45(resentation=1evC454.5C45(+".pdf. httpD22%%%.healthmetricsandevaluation.org2research2proAect27ingdom=saudi=ara!ia=health= trac7ing. 3orld #ealth &rgani:ation 'ational #ealth ccount data!ase (see httpD22apps.% ho.int2nha2data!ase2/ataExplorer1egime.aspx for the most recent updates". Jeddah Centre for ;orums and Events I Jeddah, Saudi ra!ia.
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httpsD22%%%.cia.gov2li!rary2pu!lications2the=%orld=fact!oo72. r?d$dfid$gov$u@%P=F%1utputs%HealthSys=ev)>P%+-#+&)bangladesh$pdf 56=o-=+6 ...$!angladesh$gov$!d / 6itiAen Services 5+=5- -D8- pm $ol. + 1o. +D+ doi/ +5.6B462++55 data$.orld!an@$org%indicator%SH$S80$06SN$7R 5+=5- +D88 pm ...$unnayan$org%reports%meu)Dec)2010$pdf +-=5<=+6, ++D@5 pm

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