Services for the special needs children with neurodevelopmental conditions at the government Shishu Bikash Kendras across the country are facing serious disruption as its fourth phase ended in June and when the next phase would begin remains uncertain.
A section of the staff at these centres has stopped coming amid non-payment of salaries since July although other employees continue giving services to the patients.
Shishu Bikah Kedras are centres for providing high quality diagnostic, treatment and rehabilitation-related training services for the children suffering from neurodevelopmental issues at a low cost, according to documents from the Directorate General of Health Services.
The number of these special needs children is increasing in the country, while treatment and rehabilitation facilities for them remain severely limited.
According to the Bangladesh Sample Vital Statistics 2023 report of the Bangladesh Bureau of Statistics, people with autism or autism spectrum disorders comprise 0.07 per cent of the country鈥檚 total population, people with down syndrome comprise 0.07 per cent, people with cerebral palsy are 0.08 per cent and people with intellectual disability are 0.10 per cent.
As per the BBS Report on the National Survey on Persons with Disabilities 2021, people with autism or autism spectrum disorders comprised 0.05 per cent of the country鈥檚 population, people with down syndrome comprised 0.04 per cent, people with cerebral palsy were 0.08 per cent and people with intellectual disability were 0.21 per cent.
Initiated in 2008 by the then caretaker government and continued by the successive governments through establishing more centres, Shishu Bikah Kedras have seen little development in the past one and a half decade, said health directorate officials and the project staff.
Saying that the Shishu Bikash Kendra project is facing 鈥榥eglect鈥�, Health Services Division senior secretary MA Akmall Hossain Azad mentioned that he was not sure when the fifth phase of the project would start.聽
Officials of the Directorate General of Health Services and the staff of these centres said that the government should bring the project under the revenue budget, granting them the facilities, including maternity and sick leaves and promotions, under the government service rules.
No plans are there right now for these demands, said health ministry officials.聽聽
According to officials, so far 35 Shishu Bikash Kendras have been established under the 鈥楨stablishment of Shishu Bikash Kendra in Secondary and Tertiary Level Hospitals鈥� project, an initiative included in the Hospital Service Management operation plan of the Heath Services Division.
Of these centres, 24 are in the government medical college hospitals and 11 in district sadar hospitals.聽
Children aged up to 16 years from families of all income groups, in particular low-income families, are getting multidimensional services from a multidisciplinary team of healthcare providers at these centres for tickets worth Tk 10.聽聽
Tahmina Sultana, a child psychologist at the Shishu Bikash Kendra operating in Sir Salimullah Medical College Hospital, said that they continued providing services though they did not get salaries.
鈥楬ow can we stop our services to the children who are very poor and have no other places to go?鈥� she asked, adding children at her centre were coming from Doahr, Narayanganj, Bikrampur, Cumilla and even Barishal.
Project documents show that daily five to 60 children visit these centres across the country, while 2,37,934 children received services at the Shishu Bikash Kendras between August 2009 and June this year.
Services at these centres remained closed now, Directorate General of Health Services director general professor Md Abu Jafor told 抖阴精品 on Sunday, confirming that the staff at the centres were not getting salaries since July.
鈥榃e are confused as we are yet to get any decision from the ministry on the fifth phase of the project,鈥� he added.
The total sanctioned posts in the 35 Shishu Bikash Kendras are 186 against which 149 are now filled up with the rest 37 posts remaining vacant.
The multidisciplinary expert team engaged at each centre comprises one paediatrician, one child psychiatrist and one developmental therapist with some supporting staff.
When one key member of the team remains absent it affects the whole services of counselling and training, observes Hospital Services Management programme manager Supriya Sarkar.
He said that according to their observations more people with neurodevelopmental issues were identified in the country.
鈥楨arlier the parents used to hide these children,鈥� he said, adding, 鈥榥ow these children are coming under screening and are being identified which might be a reason for increase in their number.鈥�
Mostary Jannat, a developmental therapist at the Shishu Bikash Kendra in the Shaheed Ziaur Rahman Medical College Hospital, Bogura, said that they continued their services although they were living in an inhuman situation without salaries.聽
The staff of the centres alleged that since the inauguration of the project, no promise was made for its inclusion in the revenue budget.聽
They also alleged that they did not have any salary scales or time schedule scales, special incentive allowances, promotions, paid maternity leave and sick leave, while some staff claimed that bosses threatened to fire them if they could not come to office due to illness.聽聽聽
Hospital Services Management line director Md Zainal Abedin said that these centres provided services to the children with autism spectrum, neurological disorders and epilepsy and mental disabilities.
He also observed that given the vitally important services provided under the project to one of the most vulnerable section of the community, the Shishu Bikash Kendra project should be shifted under the revenue sector.聽
Through its diagnostic and rehabilitative counselling and training services the centres enable the children with these conditions to participate in family, social and state lives, reducing the level of their problems and increasing their everyday living capacity, officials said.
Senior secretary MA Akmall Hossain Azad told 抖阴精品 on Monday that they were trying to start the fifth phase as soon as possible, but it could take about five more months to follow the procedures at the Planning Commission and the ministries of finance and public administration.
About the demand for bringing the project under the revenue budget, he said that right now the government had no such plan.聽
The project needed Tk 5 crore annually to pay the staff salaries and benefits, officials said.
