Insights from a Global Health Manager

Long-time BHP collaborator Dr. Nazmul Huda was recently interviewed by Health Systems Matter, a Dhaka-based knowledge platform that offers evidence-based updates on key global health issues. In a wide-ranging discussion, Nazmul described his experience in leading international programs in obstetric fistula prevention, breast-feeding, TB control and vaccines. Key insights from this interview:

“I was the first to raise the alarm about the epidemic of unnecessary caesarean section in Bangladesh. We engaged with the Obstetrical and Gynecological Society of Bangladesh to develop a position paper on C-sections.... I also developed community-based fistula diagnosis events, a simple structured system for primary care workers to identify cases and bring women to treatment. We treated thousands of patients through this program.”

 “The achievements of Bangladesh in public health are laudable. Development partners have made tremendous contributions but over-dependence on these partners is a major challenge…. Bangladesh is gradually taking more financial responsibility for its health programs, but the government lacks capacity for technical management. [We need to] prepare a smooth transfer from a partner-induced system to the regular government systems for program management.”

“The most significant limitations of the current government health initiatives are the lack of transparency, discipline, accountability and effective leadership. The current system is largely doctor-centered; the contributions of nurses, midwives, therapists, managers and researchers are largely ignored.”