Current situation of nurses and paramedics in Bangladesh

It is evident that most healthcare-services clients in Bangladesh visit nurses or paramedics, who play a critical role in the provision and delivery of effective healthcare services. Government health infrastructure in rural and urban areas of Bangladesh is generally adequate. However, most public-health facilities in rural areas are under-utilized due to a lack of service providers including doctors, paramedics, and nurses at the respective health facilities. The current study sought to examine the skills of service providers, how they cope with the present situation, and how they manage healthcare services for clients. In addition, the study explored key policies and capacities of nurse training institutes, to produce new paramedics required to take up currently required positions. A total 132 in-depth interviews were conducted with service providers and 48 were conducted with program managers, to gain an understanding of their perceived barriers to providing quality services. The findings showed that a large number of clients received healthcare from services providers each day, but the service quality was poorly assured due to lack of skills or time. Similar evidence was adduced from the in-depth interviews with program managers, who mainly emphasized the scarcity of manpower at healthcare facilities as being responsible for the poor quality of the services provided. In addition, there was little on-the-job skills development, to assist improve the capacity of service providers. Likewise, the nursing institutes revealed that there was inadequate space to support production of the required number of nurses and paramedics to address the current emergency situation.