[🇧🇩] Healthcare Industry in Bangladesh

[Saif]

SWAp’s effectiveness for Bangladesh’s health sector

Exploring alternatives to SWAp in Bangladesh’s health sector is a pressing discussion.

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SWAp’s effectiveness for Bangladesh’s health sector

There is an urgent need for a comprehensive overhaul of Bangladesh’s health system. PHOTO: ORCHID CHAKMA

UHC Forum is a coalition of health sector practitioners, advocates and academics dedicated to a strategic push on the universal health coverage (UHC) agenda. UHC Forum Health Debates is one of its flagship activities carried out in partnership with the Power and Participation Research Centre (PPRC). This op-ed is derived from the health debate on the Sector Wide Approach (SWAp) modality adopted for health sector planning and implementation since 1998.

The Sector-Wide Approach (SWAp), introduced in Bangladesh in the late 1990s, sought to improve the health sector by uniting the efforts of government, donors, and NGOs under a unified national plan. The strategy proved effective in several areas—enhancing coordination, reducing duplication and ensuring more efficient use of resources. It fostered a government-led approach, empowering the Ministry of Health and Family Welfare (MOHFW) to take ownership of health programmes and make decisions that align with national priorities. The pooling of funds from various donors simplified financial management and allowed for a more harmonised implementation of health services. Moreover, SWAp contributed to capacity building by strengthening institutional frameworks, enhancing local expertise, and promoting evidence-based policymaking. However, SWAp also faced substantial challenges. Key stakeholders, such as the private sector and the Ministry of Local Government, Rural Development and Co-operatives, were excluded from planning processes, limiting its scope and effectiveness. Centralised decision-making created bureaucratic delays, slowing programme implementation. Additionally, larger donors, such as the World Bank, exerted disproportionate influence, at times, prioritising global agendas over local needs. The risk of mismanagement also grew as pooled funding lacked adequate oversight and accountability mechanisms.

To address these shortcomings, I advocate transitioning to a new model, termed Sector-Wide Inclusive Planning and Evaluation (SWIPE) to integrate private sector actors, and decentralised planning and budgeting to the district level.-----Dr Abu Jamil Faisel is a public health expert.

There is an urgent need for a comprehensive overhaul of Bangladesh's health system. The existing dual-budget structure, which separates operating and development budgets, lacks coherence and prevents effective symbiosis between routine operational costs (staff salaries, fuel and utilities, repair and maintenance, travel, etc), and development costs for new infrastructure development and health service improvements.

The Health Population and Nutrition Sector Program (HPNSP) under SWAp brought advantages such as faster decision-making, delegation of authority to health managers, health workforce capacity building, improved coordination, monitoring and supervision. However, critical issues remain unresolved. Universal health coverage, elimination of healthcare discrimination, substantial improvements in healthcare quality, avoidance of verticalisation in healthcare delivery, and the reduction of out-of-pocket expenses continue to elude the system.

The fragmented and verticalised delivery of healthcare services limits integration and patient-centred care. Bangladesh's age-old health systems have many inherent defects. The HPNSP or any similar prescription will not remedy it. Bangladesh urgently needs a serious and massive overhaul of its health systems in overall structure and processes to enable it effectively meeting the population's health needs through integrated primary healthcare, sustainable universal health coverage, health sustainable development goals (SDGs), and client satisfaction.----Professor Dr Abul Kalam Azad is former director general of health services.

Exploring alternatives to SWAp in Bangladesh's health sector is a pressing discussion, given the challenges faced in achieving sustainable programme outcomes. One of the critical considerations is whether it is time to pivot back to the original revenue-based system or implement a hybrid model that leverages the strengths of both approaches. The revenue-based system, rooted in direct budget allocations, could potentially offer more flexibility and control for domestic health programme funding. Ensuring financial sustainability remains a key focus as stakeholders debate these alternatives. The path forward must address how Bangladesh can maintain or enhance programme effectiveness without depending heavily on SWAp, which, while comprehensive, often leads to dependency on external funding and complex coordination issues.

A well-articulated roadmap is essential for transitioning from SWAp to a new or modified system that prioritises local ownership and resilience. The government must lead with robust policy frameworks, while development partners can assist with technical expertise, transitional funding and access to global best practices.
-----Dr Md Aminul Hasan is a health system expert.

SWAp has played a pivotal role in shaping Bangladesh's health sector, improving coordination, ownership, and resource management. However, its limitations, including rigidity, donor dependency, and exclusion of key stakeholders, necessitate a reimagined approach.

Hybrid models, public-private partnerships, national health insurance schemes, and decentralised planning offer pathways to address these challenges. As Bangladesh works toward achieving universal health coverage and the health-related Sustainable Development Goals by 2030, a collaborative, inclusive, and forward-looking strategy will be essential.

Health system reform requires technical solutions, strong political will, and a commitment to equity and sustainability. While reform is essential, political will and strategic intent are critical in driving meaningful health sector reform. Bangladesh's health system requires a clear focus on necessary and actionable reforms. The challenge lies in crafting precise recommendations and mobilising the political leadership needed to implement them effectively. Without sharp, actionable strategies, opportunities for impactful reform may be missed. It is essential to foster collaborative efforts across stakeholders to address systemic gaps and meet the health aspirations of the population.-----Hossain Zillur Rahman is executive chairman of Power and Participation Research Centre (PPRC) and convener of universal health coverage (UHC) Forum.​

 

[Saif]

Three examples of badly-run public hospitals

Prioritise recruitment and efficient management

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Three examples of badly-run public hospitals
Prioritise recruitment and efficient management

We are appalled by the findings of a report by The Daily Star on three hospitals run by the Dhaka South City Corporation (DSCC), highlighting an acute shortage of staff and underutilised facilities, which cause unnecessary suffering for patients. In a city where accessible healthcare is increasingly out of reach for ordinary citizens, it is unacceptable that these public hospitals offer substandard services. This is a direct result of neglect and apathy from the Directorate General of Health Services (DGHS) and the Ministry of Health, a situation that has worsened over decades.

These hospitals are vital for low-income and lower-middle-class communities, as they offer subsidised healthcare. However, patients are forced to wait for hours due to the severe shortage of doctors, nurses, and other essential staff. As patient numbers rise, one hospital operates with half the required manpower. For instance, Mohanagar General Hospital, which installed ICU units and high-flow oxygen equipment during the Covid pandemic, cannot use them because there are no trained personnel. The surgery department has been non-functional since 2015, and high-dependency unit (HDU) beds installed in 2021 remain unused. Many posts are vacant, further crippling the hospital's ability to function.

A similar manpower crisis exists at Dhaka Metropolitan Children's Hospital, where the paediatric surgery department has been inactive since 2012, and 40 of the 100 beds remain unused. Nazirabazar Matri Sadan is also grappling with a shortage of doctors and essential medicines.

In all three hospitals, staff are spread too thin, leaving patients without the necessary medical care. Despite repeated official letters sent to the health ministry and DGHS, no action has been taken. These hospitals reflect the dysfunction plaguing public healthcare across the country, with severe staff shortages making them nearly non-functional. The DGHS and health ministry have ignored the needs of these hospitals for years. Why has this been allowed to continue? What happened to the allocated budgets? If they were insufficient, why wasn't more funding provided?

The healthcare system, especially in public hospitals, continues to be marked by gross inadequacies. And the conditions at these hospitals are a perfect example of that. We urge the interim government to immediately investigate these issues and take corrective action. The recruitment of medical personnel should be a top priority, along with the training of staff to operate specialised equipment. Meanwhile, strict management oversight is necessary to ensure that no resources go underutilised. Access to healthcare is a basic right, and the government must restore functionality to these hospitals as soon as possible.​

 

[Saif]

A wake-up call for Bangladesh to reform its healthcare

India’s visa restrictions on Bangladeshi nationals, while initially perceived as a barrier, could serve as a wake-up call for Bangladesh to strengthen its healthcare system and regain the confidence of its patients.

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A wake-up call for Bangladesh to reform its healthcare

India's visa restrictions on Bangladeshi nationals, while initially perceived as a barrier, could serve as a wake-up call for Bangladesh to strengthen its healthcare system and regain the confidence of its patients. With as many as 3.5 lakh Bangladeshis seeking medical treatment in India annually, the restrictions offer a unique chance for local providers to address systemic issues and retain patients who would otherwise travel abroad. Experts urge Bangladesh's health authorities to rise to the occasion and rebuild trust among its citizens.

This systemic overhaul is especially urgent given the personal struggles of individuals like Sanjida (not a real name), a Mirpur resident, who faced a critical health challenge in 2020. After undergoing surgery at Dhaka's Green Life Hospital to remove an ovarian cyst, her biopsy reports delivered devastating news: she had cancer. Advised to start chemotherapy, she followed her oncologist's recommendation for additional tests, only to realise that the tests she had completed earlier had been overlooked. It became apparent that her doctor's approach was perfunctory at best. Terrified and disillusioned, her family decided to seek treatment abroad.

Sanjida travelled to Mumbai's Tata Memorial Hospital, where doctors reviewed her medical history and conducted fresh diagnostics. They concluded that the surgery in Dhaka had been incorrect. With an appropriate operation, her cancer could have been addressed earlier. After another surgery and three rounds of chemotherapy in Mumbai, she returned to Dhaka. Today, she takes regular medication and visits India every six months for follow-ups. Reflecting on her ordeal, Sanjida laments the inattentiveness and unprofessionalism she experienced in Bangladesh's medical system, contrasting it with the care she received in India.

"Even with the high cost of living and transportation, Indian hospitals are more affordable and trustworthy than those in Dhaka," she said.

Sanjida's story is not unique. Retired government officer Shahidur Rahman, 69, sought cardiac care in 2019 after experiencing chest pain. Diagnosed with three heart blockages at two leading hospitals in Dhaka, he was advised to undergo stent placement. Sceptical, Shahidur travelled to Bengaluru to consult Dr Devi Shetty, a renowned cardiologist. Additional tests revealed no blockages, and he was prescribed medication instead. Since then, Shahidur has lived without chest pain and has lost faith in Bangladeshi healthcare providers.

A CRISIS OF CONFIDENCE

The healthcare industry in Bangladesh is dominated by the private sector, which has seen significant growth in tertiary hospitals and diagnostic centres.

The stories of Sanjida and Shahidur are emblematic of a deeper issue -- a healthcare system grappling with a crisis of trust. On the surface, Bangladesh's healthcare infrastructure appears robust. The country boasts 566 public hospitals, which include 37 state-run medical colleges providing hospital services, and around 5,000 private medical facilities. Private sector investment has led to the growth of tertiary hospitals and diagnostic centres, creating an illusion of progress. Yet, beneath the numbers lies a stark reality: many Bangladeshis still feel compelled to seek treatment abroad, believing that local facilities cannot meet their needs.

The reasons for this exodus are manifold. Experts point to rushed consultations, diagnostic errors, steep treatment costs, and a perceived indifference from medical professionals. Many patients complain of being treated like mere numbers -- hurried through appointments with little to no time for questions, clarification, or reassurance. This lack of a personal touch often proves just as alienating as the more tangible deficiencies. In contrast, some patients argue, India has built a reputation for offering not only medical expertise but also a level of care that feels holistic and humane.

Bangladeshi patients primarily travel to India for cardiology (14 percent), oncology (13 percent), gastroenterology (11 percent) and other complex issues, according to a 2023 study published by the National Library of Medicine. The same report found that India's healthcare infrastructure -- including skilled specialists and comprehensive follow-up care -- attracts an estimated 3 lakh to 3.5 lakh Bangladeshi patients annually. Kolkata, Chennai, Vellore, and Mumbai are the most frequented destinations.

"Bangladesh's healthcare system lacks sufficient skilled physicians and technologists, especially for complex diseases like cancer and organ transplants," said Rumana Huque, a health economist and professor at Dhaka University. "While we have capable doctors, they are overstretched and unable to provide the level of care patients expect."

Bangladeshis spend over $5 billion annually on medical treatment abroad, with India and Thailand as top destinations. Yet, Huque emphasised, many of these expenses could be curtailed if local healthcare providers improved their practices.

Tamzeed Ahmed, a clinical and interventional cardiology specialist at Evercare Hospitals Dhaka, observed that the past two to three months have seen an uptick in patients seeking consultations in India. This trend persists despite India's visa restrictions.

Meanwhile, Md Esam Ebne Yousuf Siddique, chief operating officer of Square Hospitals, highlighted the uncertainty surrounding the long-term impact of these restrictions. He noted that, over the last three years, Square Hospitals has not recorded any significant fluctuation in patient numbers, suggesting that the effects of visa restrictions on local healthcare utilisation may still be unfolding.

SYSTEMIC CHALLENGES AND PATIENT DISSATISFACTION

Patients often cite Bangladesh's under-resourced diagnostic facilities and dismissive medical culture as significant deterrents. Even private hospitals equipped with advanced technology struggle due to a lack of trained personnel to operate it effectively.

Syed Abdul Hamid, a professor at the Institute of Health Economics, Dhaka University, pointed out that poor diagnostic accuracy, inadequate consultation time, and indifferent behaviour from medical professionals erode trust. "Doctors in India excel in patient communication, providing detailed explanations and emotional support. This starkly contrasts with the rushed consultations typical in Bangladesh," he said.

During the Covid-19 pandemic, when international travel was restricted, Bangladeshi patients had no choice but to rely on local healthcare providers. Many received quality care, proving that the country's medical system can deliver when adequately supported. However, the lasting perception of neglect and inefficiency continues to push patients abroad.

CALLS FOR REFORM

Industry leaders acknowledge the gaps. AM Shamim, founder of Labaid Hospital, admitted that while Bangladeshi doctors are technically skilled, they must improve their bedside manner and spend more time with patients. "We have the capacity to treat complex illnesses, but patient trust is eroded by behaviour and insufficient consultation time," he said.

Similarly, Prof Md Moazzem Hossain of Aichi Medical Group called for systemic reform. "We need skilled technologists, uniform cost structures, and better regulation from the Directorate General of Health Services," he said. "Patients need to feel confident in their care, and hospitals must prioritise patient-centred service over immediate profits."

India's visa restrictions, while inconvenient, offer Bangladesh a rare opportunity to reflect and reform. It's a chance to rebuild confidence, invest in patient-centred care, and address the systemic flaws that push patients abroad. Without addressing these issues, experts warn, the country risks perpetuating a reliance on foreign medical services -- a dependency both costly and avoidable.​

 

[Saif]

Looking back 2024: Corruption, poor service keep hurting health sector

Quality healthcare for people remained elusive throughout 2024 while the sector saw massive allegations of corruption and maltreatment in the first half of the year.

www.newagebd.net

Looking back 2024: Corruption, poor service keep hurting health sector
Rashad Ahamad 05 January, 2025, 00:19

Quality healthcare for people remained elusive throughout 2024 while the sector saw massive allegations of corruption and maltreatment in the first half of the year.

The second half of the past year that ended Tuesday was marked by massive demonstrations by health sector employees to press home their demands after the fall of Awami League government on August 5.

Health rights activists and patients said that no significant improvement was noticed in the health sector in the past year as people suffered to get services.

They demanded health sector’s legal reform, a pragmatic master plan, transparency, accountability and adequate budgetary allocation for the improvement of the sector.

Dhaka University’s Institute of Health Economics professor Syed Abdul Hamid said that the student-led July movement in 2024 created a huge scope for improvement, but still there was no visible impact.

He emphasised the health sector reform commission’s recommendation, legal reform, patients’ safety and service providers’ security for the development of the sector.

At the beginning of the year, a number of patients, including children, had died in alleged maltreatment that compelled the health department to conduct nationwide drives.

The Directorate General of Health Services closed on various grounds at least 1,600 hospitals and clinics in a month-long drive.

Sector people said that the healthcare institutions which were shut for different unlawful activities during the drive were back to operation again.

Runa Khatun, a resident of Sadullapur in Gaibandha, said that getting physician in a district- or upazila-level government hospital was very rare in her district while the physician was available in private medical facilities.

Janaastha Sangram Parishad convener Faizul Hakim Lala said that the ousting of a regime was a remarkable achievement in 2024 that created hope among the people for a new journey.

He urged for removing discrimination among the villagers and the city dwellers.

He also urged to ensure the presence of physicians at work stations and regular posting denying any political or other influences.

He said that the authorities must evaluate merit and qualification in posting.

He suggested decentralising the healthcare and producing adequate number of healthcare givers like doctors, nurses and technicians.

Public health campaigner Lenin Choudhury said that the DGHS was the first department which was formed after the independence of the country, but the department failed to place a comprehensive plan for the people’s health.

‘The DGHS is doing everything on an ad hoc basis,’ he said, adding that they needed a comprehensive plan and its proper implementation.

He said that a healthcare system sustained on five pillars, including promotive, curative, rehabilitative and palliative.

The government should give emphasis on the healthcare system that includes all of them, he said.

He said that the government promised to set up a 10-bed ICU facility in every district, but the service was still not available.

Rights activists said that healthcare was still expensive that the common people could afford.

They demanded reducing out-of-pocket healthcare expenditure.

The out-of-pocket healthcare expenditure in the country rose to 73 per cent in 2021 while it was 68.5 per cent in 2020, according to the Bangladesh National Health account.

Of the total out-of-pocket spending, 54.40 per cent was spent for purchasing medicines, 27.52 per cent for diagnosis, 10.31 per cent for consultation and 7.77 per cent for transport.

About 64 lakh people in the country get poorer every year due to high medical costs, according to a 2010 research by the icddr,b.

The government failed to control the prices of lifesaving drugs as the manufacturers have been increasing the drug prices at will over the years, rights activists said.

They said that the government had also a little control on the prices of medical equipment.​

 

[Saif]

Campaigners seek free healthcare

The Health Sector Reform Commission in 50 days of its formation is still gathering information and opinions on several focal areas such as service improvement while public health campaigners and medical practitioners demand free healthcare at all public health facilities...

www.newagebd.net

Campaigners seek free healthcare
Sadiqur Rahman 09 January, 2025, 00:28

The Health Sector Reform Commission in 50 days of its formation is still gathering information and opinions on several focal areas such as service improvement while public health campaigners and medical practitioners demand free healthcare at all public health facilities.

The latters expect sharper surveillance of overall health facilities, effective corruption-control measures and rational distribution of logistics between urban and rural healthcare centres.

The interim government formed the 12-member Health Sector Reform commission on November 18, 2024 for submitting necessary reform proposals in 90 days to make the country’s healthcare services people-oriented, accessible and universal.

Commission member Muzaherul Huq, also a former senior adviser to the World Federation for Medical Education, recently told New Age that the commission identified several focal areas for reforms.

‘We are gathering information and opinions from related professionals at grassroots-level and urban healthcare centres where marginalised people often visit for medical treatment. Our mission is to propose necessary improvements of the facilities so that patients can access better healthcare,’ Muzaherul said.

The commission has been analysing the autonomy of upazila health complexes, at least for procuring crucial logistics, and strong monitoring over its expenditures, he said.

The commission has also been talking to teachers and students at institutions of public health, medical science and nursing training, and paramedics and technicians to gather suggestions on the improvement of the health and medical science education, he said.

‘Improving the facilities for continuing education or professional training would be another focal area,’ said the commission member, adding, ‘widening scopes for research on the related fields would be focused.’

About corruption in the health sector, Muzaherul said that the issue had already been identified by several local and international organisations.

He said, ‘We will definitely recommend necessary measures to check corruption. At the same time, we will recommend conflict management procedures to minimise patients’ grievances and safety for the health practitioners as well.’

Public health campaigners have, however, demanded that the commission must recommend completely free medical facilities, including diagnosis and supply of medicines, at all public hospitals.

Faizul Hakim, the convener of the Janaswastha Sangram Parishad, a platform for raising voices against irregularities in the public health sector, said, ‘The government must bear the people’s health expenditures. I won’t recommend health insurance to facilitate insurance businesses.’

Non-practicing allowance for the physicians at public hospitals, limiting fees at physicians’ private chambers, strict surveillance over the services and expenses at the private hospitals and diagnosis centres, and a functional and independent Bangladesh Medical and Dental Council are among Faizul’s recommendations.

‘Corruption has paralysed the health sector, cornering the patients and their distressed families. Recommendations should come to check corruption anyhow,’ Faizul demanded, adding that the commission must come up with a white paper investigating the alleged corruption during and after the Covid pandemic.

‘Irregularities in procuring corona vaccines must be investigated.’

Public health and preventive medicine specialist Lenin Chowdhury said that reform proposals must include a comprehensive healthcare plan combining public health and treatment, defining rights and responsibilities of private clinics and practitioners, monitoring the quality of medical colleges and training institutions, a short-mid-long-term road map for manpower recruitment in the health sector and experts-led health ministry.

‘The insolvent patients need a safety net. Moreover, there must be a guideline for bringing poverty-ridden patients under a universal healthcare system,’ Lenin said.

Commission chief Professor AK Azad Khan, also the president of Bangladesh Diabetic Society, said that the commission continued discussing with key stakeholders, including common citizens.

‘We would prepare a precise draft of reform proposals at the end of this month,’ Azad said.​

 

[Saif]

A public cancer hospital in crisis

Prolonged equipment failure at NICRH is unacceptable

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A public cancer hospital in crisis
Prolonged equipment failure at NICRH is unacceptable

VISUAL: STAR

It is deeply concerning that the National Institute of Cancer Research and Hospital (NICRH)—the country's premier public facility for cancer care—is failing to provide radiotherapy treatment due to prolonged equipment failure. For over 19 days, according to a report by The Daily Star, all six radiotherapy machines at the hospital have been out of service, forcing cancer patients to delay their treatment at the risk of their conditions worsening or spreading.

NICRH is not just another healthcare facility; it is a lifeline for many patients, especially those from poor backgrounds, who rely on its subsidised services. For such a vital institution to go even a single day without functioning radiotherapy machines is thus unacceptable. That the current paralysis has dragged on for nearly three weeks only shows the gravity of the situation. In fact, the equipment failure has been a persistent problem for NICRH: one of the machines has been out of order for two years, and another for over a year. How has such a critical problem been allowed to continue unchecked for so long?

For many cancer patients, seeking treatment at private clinics is not an option due to the exorbitant costs involved. They rely on NICRH for affordable care. When that care is delayed, they face harrowing choices—some borrow or exhaust their life savings to seek private treatment, while others are left with no option but to wait, risking their lives as cancer progresses.

Reports of similar incidents paint a grim picture of recurring dysfunction at NICRH. Last year, Prothom Alo reported that all of the hospital's radiotherapy machines had malfunctioned. At that time, even the X-ray machine was out of order for two weeks. These repeated breakdowns are symptomatic of a broader systemic failure in public healthcare, at the core of which lies a disturbing culture of indifference and irregularities. Instead of prioritising urgent repairs or replacing outdated equipment, hospital authorities have shown a complacent attitude, waiting for external interventions that rarely come in time.

For many cancer patients, seeking treatment at private clinics is not an option due to the exorbitant costs involved. They rely on NICRH for affordable care. When that care is delayed, they face harrowing choices—some borrow or exhaust their life savings to seek private treatment, while others are left with no option but to wait, risking their lives as cancer progresses.

We urge the health authorities to address this crisis immediately. The radiotherapy machines at NICRH must be repaired or replaced immediately, and measures must be taken to prevent such prolonged disruptions in the future. The possibility that certain vested quarters may be deliberately sabotaging these machines to drive patients towards private facilities must also be thoroughly investigated. The health directorate's long-standing failure to properly oversee public hospitals like NICRH also must be rectified.​

 

[Saif]

Healthcare system needs a thorough shakeup

That the country's healthcare system is plagued by a lot of discrepancies and inadequacies does not require any elaboration. Volumes have been said and written on this particular issue over the years but to no avail. Speakers at a debate programme organised in the city late last week came up

thefinancialexpress.com.bd

Healthcare system needs a thorough shakeup
Published :
Feb 08, 2025 22:34
Updated :
Feb 08, 2025 22:34

That the country's healthcare system is plagued by a lot of discrepancies and inadequacies does not require any elaboration. Volumes have been said and written on this particular issue over the years but to no avail. Speakers at a debate programme organised in the city late last week came up with a wide range of suggestions and recommendations including establishment of a regulatory body for streamlining the healthcare sector. The debate programme coincided with the government initiative to reform the sector. It may be mentioned that the interim government last November formed a Health Affairs Reform Commission to recommend reforms with the objective of making health services more accessible and universal. The core recommendation of the programme was the establishment of a regulatory body to standardise pricing, enforce quality accreditation and form a grievance mechanism for the patients.

Though there are several health-related agencies under the Ministry of Health and Family Welfare, those have hardly any control over cost of treatment, especially in private hospitals and clinics. These private healthcare outlets fix treatment charges whimsically. They do not bother to take into consideration the paying capacity of the poor and low-income people. In view of this, the speakers at the debate programme underscored the need for enacting a comprehensive health law and creating a central regulatory authority to oversee private sector engagement in health services. Patients usually do not have the scope to know beforehand how much they will have to spend for a specific treatment. For lack of effective control, pharmaceutical companies arbitrarily fix prices of medicines and increase them quite frequently. These are some of the reasons why expense for treatment is so high in Bangladesh. It is because the treatment cost remains much beyond commoners' affordability. The speakers at the programme raised concern over the high financial burden on the patients. The proposed regulatory body may devise mechanism for price control by distinguishing between actual medical cost and that charged by many healthcare outlets out of unethical commercial motive.

Healthcare services in Bangladesh are much below international standard. People do not have that much faith in the country's healthcare system. This loss of confidence prompts thousands of patients to opt for treatment outside the country at the expense of hard-earned foreign currencies from the state exchequer. Enforcement of quality accreditation is also vitally important for ensuring service quality of hospitals, laboratories and doctors. Establishment of a grievance mechanism for patients until now was an alien idea in the country. Very often patients are subjected to various forms of harassment but the victims have nowhere to go to lodge complaints for redress. The proposed grievance mechanism is expected to be a relief for the health service seekers. Similarly, public-private partnership in healthcare service is a unique idea in Bangladesh. So, serious efforts should be made to translate that idea into reality.

The Health Affairs Reform Commission has its own recommendations for streamlining the country's healthcare system. The authorities concerned are also expected to incorporate experts' suggestions if those are not already covered by the Reform Commission. Such an integration of suggestions and recommendations will hopefully free the archaic medical service system and make it accessible to common people.​

 

[Bilal9]

Bangladeshis spend $4b annually for healthcare abroad

DCCI Senior Vice President Malik Talha Ismail Bari says in a seminar on outbound healthcare tourism

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Bangladeshis spend $4b annually for healthcare abroad
DCCI Senior Vice President Malik Talha Ismail Bari says in a seminar on outbound healthcare tourism

View attachment 10882

Bangladeshis spend around $4 billion abroad every year for healthcare, according to Malik Talha Ismail Bari, senior vice president of the Dhaka Chamber of Commerce and Industry (DCCI).

This is due to a lack of specialised treatment, trust on doctors and advanced technology within the country alongside costs being comparatively lower abroad, he said.

Bari, also a director of United Hospital, was delivering a keynote paper through a presentation at a seminar, styled "Reversing the Outbound Healthcare Tourism", at the DCCI today.

There are 5,461 private hospitals and clinics in Bangladesh, of which 1,810 are within Dhaka division, he said.

People in rural areas are deprived of quality and adequate healthcare services while pressure is created for an influx of patients at healthcare facilities in Dhaka.

Limited infrastructure, a lack of skilled workforce, quality and safety concerns, low doctor-patient ratio and long waiting periods are some of the bottlenecks to access advanced healthcare in Bangladesh, he added.

Bari informed that Bangladesh allocated Tk 30,125 crore, or 3.78 percent of its national budget, for public healthcare in fiscal year 2024-25.

Pre-capita health expenditure, or annual government spending for healthcare per person, is $110 in Bangladesh whereas $401 in South Asia, he said.

Patients sometimes go abroad for healthcare services due to a lack of facilities, trust and comfort and reversing this trend requires formulation of a proper plan and identifying the bottlenecks, said National Professor AK Azad Khan.

"Since medical science is an ever-changing process, we need to have a proper curriculum to adopt the best technological advancements," said Khan, also president of the Diabetic Association of Bangladesh.

He also stressed on the standardisation of laboratories, adequate budgetary allocation, facilitating more research and strengthening the Bangladesh Medical and Dental Council (BM&DC), which is the regulatory authority for medical and dental education in Bangladesh.

Trust is a crucial factor when considering this sector's development, said Rezaul Karim Kazal, professor of the obstetrics and gynaecology department at Bangabandhu Sheikh Mujib Medical University.

Quality hospitals should be established in rural areas for wider coverage alongside customised services for all types of patients, he added.

Only doctors should be appointed through Bangladesh Civil Service for the public health administration to be run efficiently, said Syed Abdul Hamid, professor at the Institute of Health Economics of the University of Dhaka.

Moreover, a "health service commission" should be formed similar to the Bangladesh Judicial Service Commission, which assess the suitability of persons for entry-level appointments as assistant judges or judicial magistrates, he added.

Liaquat Hossain, registrar of the BM&DC, suggested that the national policy for registering foreign doctors to practice in Bangladesh could be simplified.

Of the 1,34,000 doctors in Bangladesh, only 33,000 are in public service, said Abul Bashar Md Jamal, a former professor of surgery at Dhaka Medical College Hospital.

However, over 10,000 foreign students are studying in different public and private medical colleges here, he added.

Members of middle-income households are increasingly seeking healthcare services abroad, mainly for a lack of confidence and satisfaction, said DCCI President Ashraf Ahmed.

Only a few types of advanced treatments, such as robotic surgery, are available locally, he said.

The trend can be reversed by outperforming regional competition, ensuring customer satisfaction and enhancing quality of medical services, reliability and branding initiatives, he added.

"We need to be more open to foreign doctors, nurses, medical technologists and other specialists," opined Ahmed.​

What needs to happen is for these talking heads stopping to "talk shop" and actually put in a "prescription" for concrete steps ( pun intended).

With mandatory temporary subsidies to set up specialized hospitals if necessary.

BS has gone on long enough while incompetent govt. idiots twiddle their thumbs with all these medical dollars go outside of the country.

If India can set up these substandard hospitals in Kolkata and Chennai area, there is no reason we cannot.

Also - we should set up some kind of necessary re-certification every year to train and certify doctors.

We need guarantees that our doctors are trained beyond a certain standard and fake doctors are weeded out.

 

[Saif]

What needs to happen is for these talking heads stopping to "talk shop" and actually put in a "prescription" for concrete steps ( pun intended).

With mandatory temporary subsidies to set up specialized hospitals if necessary.

BS has gone on long enough while incompetent govt. idiots twiddle their thumbs with all these medical dollars go outside of the country.

If India can set up these substandard hospitals in Kolkata and Chennai area, there is no reason we cannot.

Also - we should set up some kind of necessary re-certification every year to train and certify doctors.

We need guarantees that our doctors are trained beyond a certain standard and fake doctors are weeded out.

Our doctors are busy with their private practice and hardly have enough time to take care of their patients. The picture of all the public hospitals are the same.

 

[Bilal9]

Our doctors are busy with their private practice and hardly have enough time to take care of their patients. The picture of all the public hospitals are the same.

Agreed. Doctors are licensed. Govt. has the power to revoke those licenses.

So - if doctors do not abide by the rules (like take care of their patients in public hospitals per agreed rules), govt. has to revoke their licenses. This is exactly what they do in India. Why can't we?

Govt. has to realize that the money they spent to train doctors must have a proper return.

Becoming a doctor should not be a guarantee to print money - like it is now.