The Story of Bangladesh

  • The health system of Bangladesh has to cope with a huge case load of diseases along with low service coverage.
  • There are 3.05 physicians / 10,000 population and 1.07 nurses/10,000 population [estimates based on MoHFW HRD 2011]
  • 28% of treatment provided in government health facilities is throughalternative medicine (Ayurveda, Unani, and Homeopathy). [Source :Global Health Workforce Alliance]
  • Although 70% of the population lives in rural areas , Health workers are concentrated in urban secondary and tertiary hospitals
Major challenges include:
  • An overly- centralized health system
  • Weak governance structure and regulatory framework
  • Weak management and institutional capacity in the Ministry of Health and
    Family Welfare (MoHFW)
  • Fragmented public service delivery
  •  Inefficient allocation of public resources
  • Lack of regulation of the private sector – which employs 58% of all physicians
  • High turnover and absenteeism of health workers
  • Poor maintenance of health facilities and medical equipment.

Bangladesh has a pluralistic highly unregulated healthcare system.

Consists mainly of five key Factors

  • Government
  • For-profit private sector
  • Not-for-profit private sector (mainly the non governmental organizations , NGO)
  • International development organizations
  • Informal providers (village doctors and other vast array of different unqualified providers) 

[Source: S. M. Ahmed, B. B. Alam, I. Anwar, T. Begum, R. Huque, J. A. M. Khan et al., Bangladesh Health System Review, A. Naheed and K. Hort, Eds., World Health Organization, Dhaka, Bangladesh, 2015]

The Public ( Government ) healthcare services are organized along four levels:

Community level healthcare

Provided by domiciliary health providers and community clinics.

Primary level healthcare

Provided in Rural Health Centers, Union Subcenters,Union Family Welfare Centers, and Upazila Health Complexes.

Secondary level healthcare

Provided in District Hospitals, General Hospitals.

Tertiary level healthcare

Provided in Post Graduate Medical Institutes, Specialized
Centers, Medical College Hospitals.

Health financing is underfunded
Only 2.64 percent of GDP is spent on health, which is the lowest in the south Asia region [source: World Bank, Data Bank [Internet], 2015] Health financial coverage is so sparse that 9 % households face catastrophic health payment 5.6 % face impoverishment 7% face distress financing (borrowing or selling household assets to finance healthcare costs) [source : M. R. Islam et al , “Inequalities in financial risk protection in Bangladesh: an assessment of universal health coverage,” International Journal for Equity in Health, vol. 16, no. 59, 2017.]