The High Court on Sunday directed the government to form a committee with stakeholders in a month and formulate guidelines in next six months to prevent performing unnecessary caesarean section surgery at government and private hospitals and clinics.
The bench of Justice Moyeenul Islam Chowdhury and Justice Md Ashraful Kamal also directed the health secretary and the director general of health services to submit compliance report at the next hearing on December 5.
The bench also issued a rule asking the health secretary, the director general of health services and the president of Bangladesh Medical and Dental Council to explain in four weeks why their failures to prevent unnecessary c-section delivery would not be declared illegal.
The bench passed the directives and rule after hearing a public interest litigation filed by Bangladesh Legal Aid and Services Trust.
During the hearing, the court said that it had never heard that doctors were punished and their private practices were stopped after frequent deaths of patients caused by wrong treatment.
BLAST lawyer Rashna Imam submitted though Bangladesh Medical and Dental Council authorised to regulate and inspect all the hospitals and clinics for their wrongdoings but they did not perform their duties.
She submitted that China, Brazil and Bulgaria prevented unnecessary C-section delivery by formulating guidelines.
Doctors and hospitals were fined in case of the unnecessary caesarean delivery in China while Bulgaria rewarded doctors and hospitals for arranging delivery of babies in normal way.
Rashna Imam, referring to World Health Organisation and UNICEF reports, submitted that about 77 per cent of the caesarean sections that took place in Bangladesh in 2018 were unnecessary.
Besides, caesarean sections increased by 51 per cent between 2016 and 2018, she submitted quoting the report.
She said that about 95 per cent of the income at private clinics came from caesarean sections which were being done without any proper consultation.
If the current trend continues, it might lead the country to a serious health hazard, she stated.
She said that no step had yet been taken by the government to monitor such practices of the doctors, private clinics and hospitals.
Then health minister told parliament on March 4, 2017 quoting Bangladesh Demographic and Health Survey 2014 that six in every 10 births were being delivered by caesarean section in Bangladesh.
The rate of caesarean section increased to the level of 23 in 2014 per cent from 17 per cent in 2011, which was 9 per cent in 2007 and only 4 per cent in 2004, marking a gradual increase to an alarming level. The World Health Organisation, keeping to its April 2015 statement, considers the ideal rate to range between 10 and 15 per cent.
This increase mostly reflected the profit-making motive of healthcare providers, the petitioner mentioned.
Urban women were twice likely than rural women to have delivery by caesarean section, 38 per cent in urban areas and 18 per cent in rural areas, which points to people increasingly going to private health facilities for child delivery, the petitioner stated referring to the reports.
Caesarean section, the safest and only option in cases of complications, could cause significant complications in both the mother and the child, the reports said.
Photo Source: Save the Children
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