[🇧🇩] Healthcare Industry in Bangladesh

[Saif]

Well-meaning health-sector reforms that call for will

A SOUND referral and back-referral system in health care potentially has several merits. It can ensure equitable access to specialised health care. It can optimise the use of resources. It can improve patient outcomes. It can also enhance coordination between levels of health care. This is...

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Well-meaning health-sector reforms that call for will
03 April, 2025, 00:00

A SOUND referral and back-referral system in health care potentially has several merits. It can ensure equitable access to specialised health care. It can optimise the use of resources. It can improve patient outcomes. It can also enhance coordination between levels of health care. This is, therefore, a welcome move that the health-sector reforms commission is set to recommend ‘an effective referral and back-referral system’ to link tertiary to primary health services. The commission’s members say that it would not only facilitate the full recovery of critical patients at minimised costs but also unburden public and private hospitals in cities. In a society where out-of-the-pocket expenditure of patients is too high and quality medical treatment is too costly, the likely move certainly appears a glimmer of light at the end of the tunnel. If the referral system works effectively, insolvent patients from remote, rural areas would receive specialised medical care in tertiary hospitals, which the commission envisages to be upgraded from district general hospitals. In the back referral part of the system, patients could receive rehabilitation services in the initial health centres after they receive specialised treatment in tertiary hospitals.

A commission member says that there are plans to develop a network of general practitioners to initially respond to patients. No patient but in case of emergencies can visit a specialist or specialised hospitals without referral. The restriction would save patients unnecessary hospital visits and money on avoidable diagnostic tests and medical expenditure. The commission also envisages the availability of at least two people with MBBS degrees to work as family care physicians or one family care physicians per 15,000 people at union health centres in rural areas and at wards in urban areas. The Bureau of Statistics in a survey made public on March 20 shows that 91.3 per cent of respondents want primary health care to be recognised as a constitutional right. And, experts believe that the constitution should make citizens’ primary health care legally-binding for the government. The commission on constitutional reforms on January 15 recommended that the right to health should be implemented based on the ‘availability of resources’ with a commitment to ‘progressive realisation.’ The commission on health-sector reforms notes that it would propose that the government should be legally bound to ensure citizens’ primary health care. And, the basic emergency care should be free even if the patients receive the services in private hospitals.

Most of the propositions that have come to light appear well-meaning steps towards an effective reform of the health care system, but the government needs to show the will to carry out the reforms in the first place.​

 

[Saif]

Medical sector projected to reach $23b

Experts at a session on Thursday urged the investors to invest in Bangladesh’s medical sector as it is experiencing robust growth...

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Medical sector projected to reach $23b
Bangladesh Sangbad Sangstha . Dhaka 10 April, 2025, 22:23

Experts at a session on Thursday urged the investors to invest in Bangladesh’s medical sector as it is experiencing robust growth.

They also projected that the market volume will reach $23 billion by 2033, driven by increasing demand for medical consumables and advanced diagnostic tools.

They made the projection at a session on ‘Unlocking Healthcare Investment Potential in Bangladesh’ of the ‘Bangladesh Investment Summit 2025’ at a hotel in the city.

Md Saidur Rahman, secretary of the Health Services Division, was speaker of the session while Sylvana Quader Sinha, founder, chair and CEO of Praava Health delivered the keynote speech on ‘Unlocking Healthcare Investment Potential in Bangladesh’.

In his speech, Saidur Rahman described the remarkable growth of the country’s health sector and urged the investors to invest here.

‘It’s projected that the market volume of the country’s health sector will be $23 billion by 2033. It is clear that there are huge potentials for investors of the country’s health sector,’ he added.

Sylvana Quader Sinha said that the medical equipment and devices market was experiencing robust growth, driven by increasing demand for medical consumables and advanced diagnostic tools.

‘The sector is heavily reliant on imports, creating a significant opportunity for local manufacturing of medical devices, especially as the country works towards self-sufficiency in producing critical healthcare products. Investment potential exists in establishing manufacturing units for essential medical consumables, like in vitro diagnostic test kits, and low-risk health monitoring devices, and leveraging the B2C model to address the rising demand for consumables. As the health complexity increases, the demand for OT support and ICU equipment is also increasing, presenting the sector as a lucrative segment for investment with high returns,’ she added.

The founder of Praava Health said that healthcare had become one of the largest sectors of the Bangladeshi economy, in terms of revenue, it has been growing at a CAGR of 10.3 per cent since 2010, employing nearly 0.3 million people directly.

‘Several factors are driving the growth of the healthcare sector, including an aging population, a growing middle and affluent class, and the rising proportion of non-communicable diseases. The healthcare industry of Bangladesh comprises five prime subsectors: Healthcare Facilities, Pharmaceuticals, Medical Equipment and Devices, Digital Healthcare and Medical Biotechnology,’ she added.

Sylvana said that the country’s healthcare facilities are expanding with private hospitals, clinics, and diagnostic centres showing strong growth.

‘Public-private partnerships (PPP) and government incentives are encouraging investments. The sector benefits from policies like tax exemptions for private hospitals outside major cities, making it an attractive market for both local and foreign investors. The ongoing need for tertiary and specialized healthcare services in urban cities and the demand for primary healthcare in rural areas enhance the sector’s growth potential, positioning it as a key segment to invest in,’ she added.

She said that the pharmaceutical sector, recognised as a Pharmerging Market, is projected to reach $6 billion in 2025 at a 12 per cent compound annual growth rate (CAGR).

The industry is well known for branded generics-particularly in gastrointestinal, antibiotic and antipyretic therapies that quenches nearly all the domestic demand, she added.

Sylvana Quader said that digital transformation was further accelerating the growth in the healthcare sector. Since COVID-19, digital health has emerged as a key area of innovation, gaining momentum as the tech-savvy youth population increasingly turns to digital solutions for healthcare access.

The government’s Digital Healthcare Strategy 2023-2027 aims to integrate digital tools like cloud-based Electronic Health Records (EHRs) and telehealth platforms to enhance healthcare delivery and reduce costs, she continued.

She said that this transition presented investment opportunities in cloud-based services, interoperable health systems, and remote patient monitoring.

Additionally, partnerships with foreign tech companies for disease management solutions and healthcare technology innovations will be crucial in driving the sector’s growth, she added.​

 

[Saif]

Transforming Bangladesh into a healthcare hub

Bangladesh, one of South Asia’s fastest-growing economies, holds immense potential in the healthcare sector. However, the country’s health system currently faces several critical challenges — particularly the high cost of treatment, increasing patient outflow to foreign countries, the rising...

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Transforming Bangladesh into a healthcare hub
Syed Akram Hussain 11 April, 2025, 00:00

Bangladesh, one of South Asia’s fastest-growing economies, holds immense potential in the healthcare sector. However, the country’s health system currently faces several critical challenges — particularly the high cost of treatment, increasing patient outflow to foreign countries, the rising burden of cancer and chronic diseases, and heavy reliance on imported medical equipment and pharmaceuticals. According to the World Health Organization, government spending on health in Bangladesh was only 2.3 per cent of GDP in 2023, which is lower than the South Asian average of 3.4 per cent. On the other hand, an estimated $700 million in foreign currency is spent annually on treatment abroad. In this context, foreign and joint investments in Bangladesh’s healthcare sector are both timely and justified.

As a densely populated and rapidly growing country, Bangladesh offers significant potential for investment in healthcare. Each year, hundreds of thousands of patients seek treatment in countries such as India, Singapore, and Thailand, as well as the Middle East, Australia, and the United States. This leads to massive foreign currency outflow and places quality healthcare out of reach for many. Establishing world-class hospitals, cancer centres, transplant surgery facilities, and trauma rehabilitation centres in Bangladesh could drastically change this reality. The student and mass movement of August 2024, which resulted in numerous injuries, underscored the urgent need for dedicated trauma and injury rehabilitation facilities. This experience has made it clear — now is the time to invest in this critical sector.

Spotlight on visionary leadership

THE Investment SUMMIT 2025 was further elevated by the outstanding performance and strategic insights of Ashik Chowdhury, whose vision and coordination were instrumental in bringing together stakeholders across public and private sectors.

Special recognition also goes to Nobel Laureate Dr Muhammad Yunus, whose presence and commitment to social business innovation inspired all participants to reimagine healthcare as a human right and a scalable investment opportunity. Their contributions have set a high benchmark for future collaboration and innovation.

Priority areas for investment

Multi-super specialty hospitals: Establishment of international-standard facilities for complex care such as cancer, cardiology, neurology, and transplant surgery.

Cancer treatment centres: With approximately 150,000 new cancer cases diagnosed annually, each division in the country requires a modern, globally accredited cancer centre.

Transplant surgery centres: Kidney, liver, and bone marrow transplant facilities remain limited. Establishing full-scale transplant centres will reduce the need for overseas treatment.

Trauma and injury rehabilitation centres: Road accidents, political unrest, and natural disasters necessitate urgent and effective rehabilitation infrastructure.

Medical device manufacturing: Local production of technologically advanced equipment can reduce costs and create export potential.

Pharmaceutical research and export: Bangladeshi medicines are globally recognised. Increased investment in research and production will further boost exports.

Call for global collaboration

WE INVITE globally ranked medical universities, academic health centres, teaching hospitals, and pharmaceutical corporations to explore joint collaborations with local institutions in Bangladesh. This includes:

Establishing branch campuses or twinning programmes with Bangladeshi medical schools.

Setting up clinical research partnerships in oncology, non-communicable diseases, and advanced therapeutics.

Launching technology transfer hubs in diagnostics, AI in health, and precision medicine.

Co-investing in centres of excellence for cancer care, trauma rehabilitation, and transplant services.

Creating incubators for health startups in collaboration with local entrepreneurs and investors.

Such collaborations will not only provide high returns but also ensure meaningful social impact by building capacity and reducing global health inequity.

Attracting international patients

MILLIONS across the globe are seeking affordable, high-quality medical care. India and Thailand have already capitalised on this through strong medical tourism markets. Bangladesh, too, can tap into this opportunity by ensuring international standards of care, skilled professionals, clean environments, advanced technology, and digital referral systems. Expatriate Bangladeshis from the Middle East, USA, Canada, and Australia are especially likely to return for treatment. Simplifying medical visa processes, introducing airport-to-hospital shuttles, and creating package-based medical tourism offers will further attract foreign patients.

Medical devices and equipment production

ACCORDING to data from the Directorate General of Health Services and the Ministry of Commerce, Bangladesh imports an estimated $1.5 to 2 billion worth of medical devices, radiotherapy machines, and diagnostic tools annually. Producing these locally would not only save massive foreign currency but also open export markets. Currently, most critical medical equipment, including cancer therapy and surgical tools, are imported. With the right technology and public-private partnerships, Bangladesh can develop its own manufacturing capacity. Countries like India, China, and Malaysia have already captured a significant share of this global market. With relatively low labour and production costs, Bangladesh is well-positioned to become a medical device exporter. According to Allied Market Research, the global medical device market was valued at $570 billion in 2023 and is projected to reach $800 billion by 2028.

Opportunity for foreign investment in pharmaceuticals


BANGLADESH’S pharmaceutical industry is thriving, with exports to more than 150 countries. However, greater research and international investment are needed for developing innovative drugs—particularly for cancer, diabetes, heart disease, and rare diseases. Collaborations between domestic and international pharmaceutical companies could accelerate this growth. Such partnerships would generate employment, facilitate technology transfer, and ensure high-quality local production. This would also reduce drug prices and enhance competition in the domestic market. According to Business Monitor International, Bangladesh’s pharmaceutical export market reached $2.1 billion in 2023, growing at a rate of 8–10 per cent annually. With TRIPS waiver benefits extended until 2033, Bangladesh can manufacture patented medicines without restriction, making it a highly attractive destination for pharmaceutical investment.

Potential benefits

Saving billions in foreign currency annually.

Ensuring access to world-class healthcare domestically.

Generating millions of new jobs in the health, pharma, and equipment sectors.

Establishing Bangladesh as the healthcare hub of South Asia.

Improving international investor confidence and economic ratings.

Conclusion

INVESTING in healthcare in Bangladesh is a strategic decision — one that can significantly impact public health, the national economy, and the country’s global standing. With defined policies, structured partnerships, and a long-term roadmap, Bangladesh has the potential to emerge as South Asia’s premier medical hub. For development partners and investors, this is a high-impact opportunity where humanitarian value, profitability, and social responsibility intersect.

Professor Dr Syed Akram Hussain is a member of Health Sector Reform Commission.​

 

[Saif]

icddr,b launches advanced genome sequencing-based cancer diagnostics in Bangladesh

icddr,b has launched its Next-Generation Sequencing (NGS)-based cancer diagnostic service, making a major step forward in making precision cancer care more accessible and affordable in Bangladesh. Offered by the icddr,b Genome Centre, this is the most comprehensive molecular testing service of its

thefinancialexpress.com.bd

icddr,b launches advanced genome sequencing-based cancer diagnostics in Bangladesh
FE Online Report
Published :
Apr 23, 2025 16:48
Updated :
Apr 23, 2025 16:48

icddr,b has launched its Next-Generation Sequencing (NGS)-based cancer diagnostic service, making a major step forward in making precision cancer care more accessible and affordable in Bangladesh.

Offered by the icddr,b Genome Centre, this is the most comprehensive molecular testing service of its kind in the country, developed to support cancer specialists with faster, more accurate, and locally available diagnostics to guide personalised treatment plans.

The initiative addresses a longstanding call from Bangladesh’s cancer specialist community to reduce dependence on overseas laboratories, according to icddr,b.

Currently, many patients wait four to five weeks for results, often at high cost and with questionable report quality. In contrast, icddr,b will deliver reports in less than two weeks, backed by internationally trained experts, cutting-edge equipment, and globally benchmarked standards, it added.

“We are taking a transformative step toward accessible and precise cancer care in Bangladesh,” said Dr Md Mustafizur Rahman, Senior Scientist and Acting Senior Director, Infectious Diseases Division at icddr,b, adding that “We are ensuring the highest quality through globally trained professionals, rigorous validation, and world-class infrastructure. Our commitment is to provide cancer specialists and patients with timely, trusted insights that can make all the difference in cancer care.”

The service was developed under the leadership of Dr Tahmeed Ahmed, Executive Director of icddr,b, who envisioned the Genome Centre as a strategic initiative to strengthen national cancer care.

“This was a gap we could not ignore,” said Dr Tahmeed. “Our goal is to ensure no patient has to wait weeks or travel abroad for critical test results. We invite cancer specialists to work with us to bring this service to more people who need it most. This is not just a service—it’s a promise to deliver hope, trust, and better outcomes for all parties in cancer treatment and management in Bangladesh.”

This announcement builds on the momentum of a high-level visit to the icddr,b Genome Centre on 12 December 2024 by the Oncology Club of Bangladesh, and joined by members of the Lancet Oncology Editorial Board, and SAARC cancer specialists attending the Bangladesh International Cancer Congress.

The delegation praised icddr,b’s efforts to build world-class diagnostic capacity and advance cancer care in Bangladesh.

A 2025 nationwide study by BSMMU found that cancer affects over 100 in every 100,000 people in Bangladesh, with breast, oral, stomach, throat, and cervical cancers being the most common. Many patients facing delays in diagnosis, early and reliable testing is essential.

The icddr,b Genome Centre is well positioned to play a vital role in improving outcomes and reducing the national cancer burden. It offers testing for breast, lung, colon, ovarian, and blood cancers, enabling doctors to intervene when treatment is most effective.

To facilitate patient access, samples will be collected from any of the icddr,b Diagnostics Centres and booths in Mohakhali, Mirpur, Motijheel, Dhanmondi, Uttara, Niketon, Gulshan, and Baridhara.​

 

[Saif]

Health commission gets it right but execution matters

The recommendations, as reported primarily in the print media, made by the Health Sector Reform Commission look radical and ambitious. But the sector needs such a reconstructive surgery rather than a cosmetic one to cure the system. One of the basic human rights is right to health but this is gross

thefinancialexpress.com.bd

Health commission gets it right but execution matters
FE
Published :
May 07, 2025 23:44
Updated :
May 07, 2025 23:44

The recommendations, as reported primarily in the print media, made by the Health Sector Reform Commission look radical and ambitious. But the sector needs such a reconstructive surgery rather than a cosmetic one to cure the system. One of the basic human rights is right to health but this is grossly undermined almost everywhere, only more so in countries like Bangladesh, because of the outrageous social disparities. So the health reform commission has done the right thing by recommending legal coverage for every citizen's primary healthcare irrespective of his/her social standing. Incorporation of such a legal provision will guarantee that no one is denied medical attention. But this cannot be implemented automatically unless the medical infrastructure and other allied paraphernalia are attuned to the proposed healthcare act. Happily, the commission has focused on such details meticulously in order to make the medical marvel happen in the country through gradual implementation of its suggestions.

The first bold step would be higher health allocation initially at 15 per cent of the national budget. On the infrastructure side, the union level health and family planning centres have to be transformed into primary healthcare centres. What about upazila health complexes? In urban areas, their counterparts would be established at the ward level. Clearly, the emphasis is to take healthcare to the doorsteps of people at the grassroots level. If the programme can be made effective, it will be decentralisation of healthcare at its very best. The referral system suggested by the commission will then screen the patients with various acute or complicated ailments to district-level hospitals which will have specialised healthcare arrangements. Will the upazila health complexes serve as referral points? But how the medical facilities at the district level will improve their healthcare system is critical. Medical colleges and universities have to be restructured, according to the suggestion, to make them aligned to the World Federation for Medical Education (WFME). For overall supervision a permanent body to be named as the Bangladesh Health Commission will be assigned the job.

In fact, the whole gamut of medical system has been brought under the scanner. Medicines will have to be prescribed under the generic names, 25 per cent of which immediately and the rest within next five years in order to end the anarchy in the pharmaceutical sector. Alongside, the hawkish promotional activities by medical representatives, as prevailing now, will be banned. Additionally, establishment of a separate facility to be named a National Institute of Women's Health has also been recommended.

Clearly, a comprehensive analysis of the problems facing the health sector has been made. But still a few things need to be clarified. There is no guideline of taming the vested interest quarters including the big pharmaceutical sharks and commercial private practice. Although higher remuneration and special financial benefits have been suggested, those are unlikely to match the income from private practice by senior medical consultants. Similarly, streamlining the operation of pharmaceutical industries may not be any easy job unless a political government has the motivation and determination to do so. Finally, underlying the health reform commission's exercise is a highly appreciable intent to transform the healthcare system by revolutionising the process of accessing at least primary medical treatment on an equal basis. But the next level of healthcare will still remain unreachable to the poor and low-income people. Yet if the system offers medical treatment on a par with that offered abroad where $4.0-5.0 billion is spent annually by Bangladesh patients, the money thus saved can be reinvested for free treatment of at least a certain percentage of the poor and vulnerable.​

 

[Saif]

The alarming state of private healthcare

Licence renewal failures are undermining healthcare integrity

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The alarming state of private healthcare
Licence renewal failures are undermining healthcare integrity

It is deeply concerning that thousands of private hospitals, clinics, and diagnostic centres across the country continue to operate without renewing their licences, largely due to inadequate monitoring by the Directorate General of Health Services (DGHS). Reportedly, out of 19,627 registered private hospitals and clinics, only 914, or just 4.66 percent, renewed their licences as of April 27. The previous year saw slightly better compliance, with 2,754 facilities renewing their licences. Likewise, only 1,790 of the 35,597 registered private diagnostic centres—around 5 percent—have completed their renewals this year, compared to 5,735 last fiscal year. This situation poses serious risks to patient well-being and safety, treatment quality and overall service standards, as well as hygiene in these facilities. A lack of oversight by the authorities could also lead to the use of substandard medical equipment or unsafe practices, as experts have warned.

According to the acting president of the Bangladesh Private Hospital, Clinic, and Diagnostic Owners Association, 90 percent of hospitals and diagnostic centres have applied for renewal this fiscal year. However, the process faces delays due to the limited inspection capacity of the DGHS. The requirement for environmental and narcotics clearance further slows down the renewal process. Previously, facilities could submit proof that they had applied for clearance, which was considered sufficient for licence renewal. However, a recent policy change now mandates the submission of an environmental clearance certificate, adding another obstacle to timely renewals.

The authorities' failure to conduct inspections efficiently has also allowed some healthcare providers to exploit the system, submitting renewal applications without necessary or up-to-date documents while continuing operations unchecked. This issue demands immediate attention. Over the past two decades, private healthcare facilities have proliferated across the country, mainly due to gaps in the public healthcare system. Unfortunately, many of these hospitals prioritise profits over patient care, treating healthcare as a secondary concern. Some even operate without the required credentials, a situation made worse by the inefficiency of the regulatory bodies. Without regular renewals, maintaining quality healthcare will become increasingly difficult.

A renewed licence ensures that a healthcare facility has the necessary manpower, equipment, and operational standards in place. Therefore, we urge the DGHS to expand its inspection team and improve resource allocation to ensure thorough evaluations of these institutions. While the renewal process should be simplified to avoid unnecessary hassles, private hospitals, clinics and diagnostic centres must still comply with standard procedures and submit proper up-to-date documents. Additionally, the DGHS must proactively scrutinise the thousands of private healthcare facilities that have mushroomed across the country over the years. And institutions failing to meet required standards should have their licences revoked to uphold healthcare integrity and protect patient welfare across the country.​

 

[Saif]

Health budget cut runs counter to reform ambition

The education and health sectors have historically been neglected in government budget allocations, resulting in excessive commercialisation and high out-of-pocket expenses for citizens. Many had high hopes that the interim government would break this trend by prioritising these two critical sector

thefinancialexpress.com.bd

Health budget cut runs counter to reform ambition
Atiqul Kabir Tuhin

Published :
May 22, 2025 00:05
Updated :
May 22, 2025 00:05

The education and health sectors have historically been neglected in government budget allocations, resulting in excessive commercialisation and high out-of-pocket expenses for citizens. Many had high hopes that the interim government would break this trend by prioritising these two critical sectors through increased funding and meaningful reforms. Unfortunately, that hope now appears to be fading as allocations for both education and health are set to decrease in the upcoming fiscal year. Compared to the current fiscal year's Annual Development Programme (ADP), funding for education will be reduced by approximately 30 billion taka, while the health sector will see a cut of around 25 billion taka.

The funding cut for the health sector comes at a time when the Health Sector Reform Commission is advocating for an increase in health spending to 15 per cent of the national budget and 5 per cent of GDP. This recommendation reflects the magnitude of systemic investment needed to revitalise the country's ailing health sector.

Yet, it is perplexing that the government is moving in the opposite direction. . Although the reform proposals have yet to be formally approved, the government could have at least signaled that, starting this year, health and education would be treated as priority sectors. If the current government ignores the reform commissions' recommendations, chances are high that all the well-meaning proposals, no matter how promising, will be shelved and forgotten under future political administrations.

The Health Sector Reform Commission, headed by National Professor Dr. AK Azad Khan submitted a fairly comprehensive report to Chief Advisor Dr Muhammad Yunus just two weeks back. The commission has put forward a bold and ambitious set of measures aimed at transforming the country's healthcare system into a more inclusive, accessible, and pro-people framework. At the heart of the Commission's recommendations is a call to recognise primary healthcare as a legally enforceable fundamental constitutional right, to be provided free of cost. It is unfortunate that, even after 54 years of independence, the state has failed to ensure basic rights such as healthcare for all citizens.

Although Article 15 of the Constitution enshrines food, clothing, shelter, education, and medical care as fundamental rights, there is no legal mandate to enforce it, rendering the basic rights largely ornamental. Recognising primary healthcare as a legal right, therefore, would mark a significant step forward, especially at a time when social disparities have been increasingly undermining equal access to these basic services. However, legal recognition alone is not enough. Such a shift demands concurrent investments in healthcare infrastructure, staffing, training, and logistics to become meaningful in practice.

To support this transformation, the Commission recommends making union-level health and family planning centres into fully functional primary healthcare centres, attended by at least two MBBS doctors and other necessary staff. In urban areas, equivalent facilities are to be established at the ward level. Once implemented, the people will receive free primary treatment at these facilities at ward or union levels. Facilities at this tier will function as referral points in the proposed system. According to the Commission's plan, a structured referral mechanism would direct patients with more chronic or acute conditions to Upazila or district-level hospitals.

The commission also proposes providing initial essential medicines ree of cost, then at subsidised prices from pharmacies at public healthcare facilities to be established under a National Pharmacy Network. Equally important is the proposed exemption of VAT on medicines for life-threatening and chronic conditions such as cancer, diabetes, hypertension, and essential antibiotics, which would significantly benefit low-income populations.

However, without sufficient budgetary support, even the most well-intentioned policies will remain nothing more than words on paper. Over the past decade, health sector budgetary allocations have remained stagnant at around five per cent of the national budget. Compounding the issue, the Ministry of Health has consistently failed to fully utilise its allocated funds. This lack of budget implementation capacity has often been cited as a reason for slashing allocation for health. Without enhancing the government's ability to plan, execute, and monitor spending effectively, increased allocations alone will not yield improved health outcomes. Deep-seated issues like corruption, administrative inefficiency and political interference must also be addressed for any reform measure to succeed. At the same time, good governance and oversight are essential to ensure that increased spending translates into improved outcomes for citizens.

Meanwhile, concerns about the feasibility of the Commission's proposals were raised during a recent webinar hosted by the South Asian Network on Economic Modeling (SANEM), titled "Health Reform Commission Report: Quick Fixes or Transformation?" Leading health economists pointed out that the report lacks a phased, time-bound roadmap. It offers limited guidance for policymakers on sequencing reforms, estimating costs, or identifying financing strategies. While the recommendation to increase health spending to 5 per cent of GDP is laudable, it would remain ambitious without a clear mechanism to fund such an expansion. They said the report does not address crucial options such as national health insurance, public-private partnerships (PPPs), or diaspora contributions-recourses that could help close the funding gap without unduly burdening taxpayers.

Bangladesh's healthcare sector stands at a pivotal crossroads. The country has made notable progress in several development indicators, yet the health sector continues to lag-not due to a lack of potential, but because of a lack of sustained priority. This trend must be reversed. A healthy population is not only a matter of social justice but also a cornerstone of economic productivity and national development. A universal healthcare system cannot be built on a fragile fiscal foundation. The government must take the Health Sector Reform Commission's recommendations seriously and act with urgency and commitment. Health is not a luxury-it is a fundamental necessity that must be enshrined and upheld in the national development agenda.

​

 

[Saif]

How young citizens of Bangladesh can transform the future of its healthcare

Students are uniquely positioned to act as catalysts for transformation.

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How young citizens of Bangladesh can transform the future of its healthcare

Beyond the classroom, students would engage in hands-on, community-oriented activities designed to translate knowledge into action. Photo: FREEPIK

In Bangladesh, seeking healthcare services is marked by profound challenges that stem from a complex interplay of demand- and supply-side barriers. On the demand side, pervasive low health literacy severely limits individuals' ability to make informed decisions about their well-being. Sociocultural norms, often deeply entrenched, discourage proactive engagement with healthcare systems. At the same time, misconceptions about medical care, such as equating medicine with treatment, or assuming that costly interventions guarantee superior outcomes, further complicate the issue. Affordability remains a significant hurdle as many families struggle to access even basic services. Additionally, the readiness of public health facilities is often inadequate, undermining trust and discouraging utilisation. On the supply side, the healthcare system is a fragmented, pluralistic mix of providers, ranging from trained allopathic practitioners to unregulated traditional healers. This diversity, coupled with weak regulatory oversight, results in inconsistent care quality and frequent instances of inappropriate treatment.

For decades, efforts to address these issues have centred on behaviour change communication (BCC) campaigns, which aim to educate communities and shift attitudes towards healthier practices. While these initiatives have achieved some success in raising awareness, their impact is often fleeting. Top-down messaging struggles to resonate with our diverse population, failing to account for regional, cultural, or socioeconomic variations. Moreover, these campaigns rarely address deeper systemic issues, such as widespread mistrust in public health services or the absence of robust regulatory frameworks. As a result, the gains from such interventions tend to dissipate quickly, leaving communities vulnerable to the same barriers. To break this cycle, Bangladesh requires a transformative, community-driven solution, one that harnesses the potential of its youngest citizens to lead a paradigm shift in health literacy and behaviour.

Imagine a classroom in a rural Bangladeshi village where third-graders are not only learning foundational subjects like mathematics and language but also absorbing critical lessons about hygiene, the importance of vaccinations, and the value of clean water. Picture high school students stepping into leadership roles, organising health fairs to dispel myths about generic medicines or teaching their parents how to recognise early symptoms of common illnesses. This vision forms the core of an innovative proposal to train students from classes 3-12 as health ambassadors, equipping them with the knowledge, skills, and confidence to drive meaningful change in their families, peer groups, and broader communities.

Students are uniquely positioned to act as catalysts for transformation. As trusted members of their households, especially in rural areas, school-going children have a remarkable ability to share knowledge in ways that resonate deeply, often bypassing the resistance that external campaigns encounter. A young girl explaining the importance of antenatal care to her mother might inspire timely visits to a clinic, improving maternal and child health outcomes. A teenage boy challenging myths about traditional healers in his village could shift community perceptions, encouraging reliance on qualified providers. Through their peer networks, students can amplify these messages, normalising behaviours such as seeking care from licensed practitioners or prioritising preventive measures like regular check-ups. In communities where scepticism towards public health services runs high, students can serve as bridges, rebuilding trust by sharing evidence-based information about the benefits of government-run clinics and programmes.

The proposed approach is both practical and adaptable to the developmental stages of students. Children in classes 1-5 would focus on foundational health concepts, such as the importance of handwashing, safe drinking water, and balanced nutrition. These lessons would be integrated into their existing curriculum, making them accessible and engaging through interactive activities like storytelling or games. Older students, in classes 6-12, would tackle more complex topics, including maternal and child health, the management of non-communicable diseases like diabetes, and the dangers of self-medication or reliance on informal providers. To deliver this education, schools would establish well-being clubs—student-led groups supported by trained teachers. These clubs would serve as platforms for peer learning, fostering a sense of ownership and responsibility among participants.

Beyond the classroom, students would engage in hands-on, community-oriented activities designed to translate knowledge into action. Peer health clubs would encourage students to share what they have learnt with friends, creating a ripple effect of awareness. Community outreach initiatives, such as health fairs or door-to-door campaigns, would allow students to directly engage with neighbours, promoting local health services and addressing common misconceptions.

This strategy offers a sustainable, cost-effective alternative to traditional campaigns. By leveraging existing school infrastructure, the programme minimises the need for additional resources while maximising reach. Teachers, already embedded in the education system, can be trained to deliver health lessons, ensuring consistency and scalability. Local health workers can complement these efforts by providing technical support, such as guest lectures or materials for student-led campaigns. The ripple effect of this approach is profound: a single child educating their family can spark generational change, while peer-to-peer sharing builds a network of informed advocates. Over time, these efforts can reshape community norms, fostering a culture of accountability where citizens demand quality care and providers are incentivised to deliver it.

Evidence from similar initiatives underscores the potential for success. In India, school-based health education programmes have significantly improved hygiene practices, leading to measurable reductions in waterborne diseases. In sub-Saharan Africa, youth-led campaigns have increased awareness of HIV/AIDS, driving higher rates of testing and treatment adherence. These examples demonstrate that young people, when equipped with the right tools, can affect meaningful change. In Bangladesh, implementation would begin with the development of a tailored curriculum, designed in collaboration with health and education experts to align with national priorities. Teachers and students would undergo training to ensure effective delivery, while partnerships with local health offices would provide logistical support. Successful pilots could be scaled up through integration into national education policies, with backing from government agencies and development partners.

The challenges facing Bangladesh's healthcare system are formidable, but they are not insurmountable. By investing in students as health ambassadors, the country can cultivate a generation of informed, empowered leaders who redefine how communities engage with healthcare. This approach taps into the energy, creativity, and influence of young people, transforming them into agents of change. As students share knowledge, challenge misconceptions, and advocate for better care, they lay the foundation for a healthier, more equitable society. The voices of confident, knowledgeable young ambassadors could ignite a healthcare revolution, ensuring that every citizen has the tools to seek, demand, and access quality care. Through this innovative strategy, Bangladesh has the opportunity to not only address its immediate health challenges but also build a resilient, informed population capable of sustaining progress for generations to come.

Dr Syed Abdul Hamid is professor at the Institute of Health Economics of Dhaka University and convener at Alliance for Health Reforms Bangladesh (AHRB).​

 

[Saif]

Underfunding cripples public health sector

Health facilities are the places where the two most important events of life for a large number of humans - birth and death - take place. In today's world parents want their babies are born in a hospital, not at home, to avoid childbirth complications that might risk the life of baby or mother or b

thefinancialexpress.com.bd

Underfunding cripples public health sector

Shiabur Rahman
Published :
May 30, 2025 00:05
Updated :
May 30, 2025 00:05

Health facilities are the places where the two most important events of life for a large number of humans - birth and death - take place. In today's world parents want their babies are born in a hospital, not at home, to avoid childbirth complications that might risk the life of baby or mother or both. People prefer hospital care for themselves and their dear ones whenever they fall sick, particularly when they are terminally ill. Budgetary allocation and government's attitude to healthcare, however, do not reflect the priority the sector deserves.

There is no denying that the country's public healthcare system is grappling with chronic underfunding, misplaced priorities, inefficient management, and structural rigidity. Budgetary data in the last decade suggest that successive governments consistently allocated an average of just 5.0 per cent of the national budget for health. The allocation accounted for 2.0 per cent of the Gross Domestic Product (GDP). The figures are alarmingly low when compared with the recent Health Sector Reform Commission's recommendations, which suggest an allocation of at least 5.0 per cent of GDP and 15 per cent of the national budget to improve the country's healthcare system. More concerning is the fact that despite increasing public health demands the health ministry cannot fully utilise whatever allocation it receives. It is subjected to major cuts during mid-year revisions.

A critical yet often overlooked issue contributing to poor budget utilisation is the lack of administrative and financial skills among hospital managers. Most public health facilities in the country are headed by physicians. These doctors may be highly skilled in clinical care, but lack experience in financial management, project planning or administrative governance as most of them do not receive any formal training in these fields. Such skill mismatch leads to significant inefficiencies, resulting in a struggle for directors or chief executive officers with planning expenditures, preparing detailed project proposals, and executing development funds. As a result, significant portions of the development budget or Annual Development Programme for the ministry remain unused, prompting the finance ministry to downsize it towards the end of the fiscal year. Poor implementation performance affects infrastructural development, equipment procurement, and system upgrades, delays service delivery and deters international development partners from channelling aid through government systems.

Another administrative bottleneck lies in the highly centralised nature of health financing. Public health facilities are not allowed to retain or reinvest their earnings, no matter how significant they are. Government health facilities are legally bound to deposit almost all their revenues to the national exchequer within a limited time frame, leaving facility managers with no flexibility to address urgent local needs or improve service delivery. Such rigidity discourages initiative at the local level. A government hospital that earns revenue from different services cannot use that money to repair essential equipment, purchase emergency medicines or procure other emergency supplies.

The underfunding and low budget implementation in the health sector lead to overcrowded hospitals, overworked doctors, inadequate medical supplies and poor infrastructure. People often have to rely on out-of-pocket (OOP) expenditures for even basic health services, deepening inequalities. According to several surveys, Bangladesh consistently ranks among the countries with the highest OOP spending on health globally. In 2021, the World Bank reported that Bangladesh's OOP expenditure was 73 per cent while health economists estimate that the current real OOP expenditure has reached 83 per cent. Low government investment in health sector and a lack of health insurance result in so high OOP, causing financial burdens on families.

The Health Sector Reform Commission has put forward a roadmap to reverse the current state of public healthcare. It is now up to policymakers to demonstrate the will to follow through. Ensuring adequate funding, building administrative capacity of health facility managers, and decentralising financial authority are not merely technical reforms; they are essential steps towards securing the health and dignity of every Bangladesh citizen.​