Funding uncertainty stalls post-crash response plan

The health authorities seek to roll out a post-crash response plan for the first time to reduce preventable deaths and disabilities resulting from road accidents, but funding uncertainties are delaying its implementation.

Though the draft of the three-year plan involving Tk 678.61 crore was formulated about four years ago for 2023-2025, it was finally approved on July 24 this year, leaving only five months for implementation.

The authorities are unsure about when they can start implementing it, as they are yet to secure funding.

Officials said the implementation window may close before the plan is put into effect, and in that case, it has to be revised.

The plan sets five strategic goals that include improving pre-hospital care for road crash victims and ensuring standard treatment at primary healthcare facilities.

The Noncommunicable Disease Control (NCDC) Programme of the DGHS prepared the plan titled "Strengthening post-crash response for the victims of road traffic injuries in Bangladesh: strategy and costed action plan for 2023-2025" in collaboration with the Centre for Injury Prevention and Research, Bangladesh (CIPRB). The World Health Organisation provided technical support.

FIVE STRATEGIC GOALS

The strategic goals include improving pre-hospital care for road crash victims; ensuring standard treatment at primary healthcare facilities; optimising the functioning of all hospitals to reduce mortality and reintegrate crash survivors into productive life; and providing logistics, essential medicines to health facilities along major highways.

The other goals are strengthening management of road traffic injury data and developing monitoring and evaluation system for post-crash management; and enhancing multi-sectoral collaboration to strengthen post-crash response.

Achieving these goals will require the involvement of more than a dozen stakeholders, including various ministries, governmental and non-governmental organisations, and the WHO.

UNCERTAINTY OVER FUNDING

The funds for implementing the plan were supposed to come from the Fifth Health, Population, and Nutrition Sector Programme (HPNSP), but the interim government scrapped the programme, said an official of the Directorate General of Health Services (DGHS), seeking anonymity.

Instead, the government decided to take up two projects to complete the unfinished task of the Fourth HPNSP and continue supply of emergency products to public hospitals. No allocations were made in the projects to implement the three-year plan, added the official.

"Funding is now uncertain, and it is difficult to say when the implementation can begin," the official said.

When contacted on August 31, Prof Syed Zakir Hossain, line director of the NCDC Programme at DGHS, said they have drafted a project proposal that includes an allocation for the plan.

"But we have to wait until the project is approved. If the plan's implementation window closes in the meantime, we may have to revise the strategy."

Saidur Rahman, secretary at the Health Services Division, told this correspondent yesterday that they would expedite the process of the project's approval to implement the plan as soon as possible.

WHY IS IT IMPORTANT?

The implementation of a post-crash response plan has become more urgent than ever with the country witnessing a sharp rise in road crash fatalities.

According to official data, 13,827 people were killed and 18,077 injured in road crashes between January 2023 and July this year.

However, the actual number is much higher, as many incidents go unreported.

According to the WHO Global Status Report on Road Safety 2023, an estimated 31,578 people were killed in road crashes in Bangladesh in 2021-- six times the official count for that year.

A national survey conducted in 2016 revealed that nearly two-thirds of road crash victims died on the way to hospitals, while three-fourths didn't receive any form of pre-hospital care.

A 2019 World Bank report said that improvement in trauma care -- a key component of post-crash response -- could save over a million lives globally, potentially reducing deaths from road injuries by up to 30 percent.

Trauma care refers to the medical management of patients who have suffered severe injuries from accidents or violence, with the aim of treating and rehabilitating them from the moment of injury through to recovery.

"Though Bangladesh has made remarkable improvement in expanding healthcare facilities over the last 30 years, trauma care facilities did not expand in the same pace because of scarcity of logistics and skilled human resources at all levels," said the plan.

It noted that Bangladesh currently doesn't have any strategy, protocol, or guideline for pre-hospital care to ensure emergency medical services at crash sites or to protect those providing roadside assistance.

"The present situation demands strengthening the full spectrum of the post-crash response system," it added.