Health Care for all in Bangladesh
SRHR in garment industry can be a win-win situation for both the factory owners and the employees.
Many factory owners realized that after Phulki started distributing sanitary napkins to the workers, sewage line blocking stopped. Earlier, the workers used rejected pieces of cloths as sanitary pads and threw them to the toilet. The practice was unhygienic and problematic for the factory sewage systems..
Phulki is an organization run by women only. The organization has been working in RMG (Ready Made Garment) sector in Bangladesh for 26 years.
Salma Parvin, project manager of Phulki tells that a present Phulki project is targeted to female garment workers. The project covers 10 issues:
# Reproductive Health
# Personal and Menstrual hygiene with Sanitary Napkin Use and Disposal
# Adolescence Health
# Safe Maternal Health
# Family Planning
# Menstrual Regulation
# Reproductive Transmitted Infections (RTI) and Sexually Transmitted Infections (STI)
# Violence against Women in Family/ Domestic Violence
# Early Marriage
# Client Chartered Rights
“It was really hard to get to the factories in the past, because the owners did not trust us with the workers. But we tried hard to make them believe that we were there to talk about health issues only, not the salary or other rights of the workers,” Parvin tells.
Phulki did not give up trying and worked in RMG factories in Gazipur, Pubail and Kaliganj. Today, it is now working with 173000 workers in 48 factories.
“The owners are now second generation, and many of them have studied abroad. Thus, they and are aware of the workers’ health and other issues. We could make them understand that if they provide proper health care for the workers, the workers are able to work more efficiently and the dropout rate will decrease” Parvin added.
Parvin said that they have a plan to collaborate with the government so that they can get rid of the obligations of donor agencies. They have already started working with the ministries concerned. Phulki plans to provide sanitary napkins to female RMG workers for 36 taka per package while the actual price in stores is 80-100 taka.
“SRHR is still a taboo in Bangladesh, especially during the month of Ramadan, and we cannot talk about these issues with the workers, let alone conduct training or workshops. Still, I think that the present situation is much better than earlier” said Parvin.
Sexual and Reproductive Health and Rights (SRHR)
Sexual and Reproductive Health and Rights (SRHR) is a comparatively new issue in Bangladesh but many NGOs and Development Organizations have been working on it for nearly a decade. Share-net Bangladesh visited Phulki which focus on SRHR and take policies into their projects.
Health care in Bangladesh
Bangladesh is an overpopulated country with – surprisingly enough – a relatively extensive health infrastructure. The country has eight administrative divisions, and the districts under the divisions are divided into upazilas.
Under the upazilas are unions that are under the local government. There are Union Health and Family Welfare Centers in each union. Each union health care center has staff including Medical Assistant and Family Welfare Visitor.
The health care system is controlled by the Ministry of Health and Family Welfare (MOHFW). MOHFW is divided into two wings, one works with population and family planning and the other with other health issues.
But the ministry is not able to provide family planning and reproductive health care. Several NGOs and private sector health service clinics have been working on these issues since the independence of Bangladesh.
Several studies and research papers state reasons for the government not being able to provide complete health care for all. Regardless of the area they live in, whether it is rural or urban, poor people are mostly deprived of accessibility of health care service.
The challenges of the health care sectors are
# Population Growth
# Changes in the Spectrum of Diseases
# Lack of Monitoring and Accountability
# Administrative Mismanagement
# Insufficient Budget Allocation
# Poor Health Knowledge
# Lack of Coordination