Bangladesh has been ranked as the second worst country in an 80-country “quality of death” study released Tuesday, which warned that ageing and booming populations would make palliative care a growing worldwide issue.
The 2015 Quality of Death Index, compiled by the London-based Economist Intelligence Unit, found Bangladesh to be the second worst in terms of “end-of-life care.”
With a score of 14.1 out of 100, the country stands only above war-torn Iraq which got the worst ranking with 12.5 score.
Palliative care provision was also found to be worst in Philippines, Nigeria and Myanmar rounding out the bottom five.
The EIU said: “Palliative care remains an unresolved hurdle in Bangladesh’s path to provision of quality public health services. Policy obstacles and underinvestment plague the health sector but domestic and international organisations are tackling the challenge.”
“Only a fraction of people in Bangladesh have access to basic palliative care. Patient choices are severely limited. For a population of 160m, there are just a handful of foreign-trained specialists in Dhaka,” added the report.
It further reads: “Public hospitals only cover 30% of costs with the remainder borne by the patient. Access to painkillers is limited by bureaucratic red tape resulting in very low per capita consumption of opioids, and expensive opioids require contributions from patients.”
The report praised progress made by less wealthy states.
“Many developing countries are still unable to provide basic pain management due to limitations in staff and basic infrastructure,” it said.
“Yet some countries with lower income levels demonstrate the power of innovation and individual initiative.”
It said Panama (31st) was building palliative care into its primary care services, Mongolia (28th) had seen rapid growth in hospice facilities, while Uganda (35th) had made impressive advances in the availability of opioid painkillers.
China (71st) was found to be among the most vulnerable from population ageing and rising incidences of conditions such as cardiovascular disease.
“The adoption of palliative care in China has been slow, with a curative approach dominating healthcare strategies,” the study found.
“Many other developing countries will also need to work hard to meet rising future need as the incidence of non-communicable disease increases and their populations grow older,” the report said.
The study found that income levels correlated strongly with success in delivering palliative care, though some, such as Singapore (12th), Hong Kong (22nd) and Saudi Arabia (60th), were lagging.
The study said that, overall, palliative care was rising up the agenda as “seismic demographic shifts” force governments to confront the reality of providing for ageing populations.
Wealthy nations will have to shift from curative care to managing long-term conditions.
Meanwhile developing countries would have to deal with booming populations and increasingly unhealthy lifestyles that will force healthcare systems to adapt to chronic condition like diabetes.
Source: Dhaka Tribune
