[🇧🇩] Healthcare Industry in Bangladesh

[Saif]

Rural health clinics: promises, performances, and despair

Across Bangladesh’s countryside, a remarkable health-policy transformation has unfolded over the past two decades. Tens of thousands of low-level health posts—community clinics and union-level health and family welfare centres—now bring medical care within reach of rural populatio

thefinancialexpress.com.bd

Rural health clinics: promises, performances, and despair

Abdullah A Dewan and Dulary A Maher
Published :
Jan 08, 2026 00:58
Updated :
Jan 08, 2026 00:58
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A heath worker providing health tips to a group of young mothers at a community clinic in Bangladesh — WHO Photo

Across Bangladesh’s countryside, a remarkable health-policy transformation has unfolded over the past two decades. Tens of thousands of low-level health posts—community clinics and union-level health and family welfare centres—now bring medical care within reach of rural populations. The ambition is noble: to make healthcare a right at the doorstep of every village. Yet behind the success of expanded access lie persistent deficiencies in staffing, medicine supply, and service quality. The question is no longer whether these clinics exist, but whether they effectively and consistently deliver the care rural Bangladeshis need.

Structure of Rural Health Care: Bangladesh’s rural health system rests on two foundational tiers. The first and most localised is the community clinic, each designed to serve roughly 6,000 people in a cluster of villages. These clinics provide basic preventive and promotive care—immunisations, family planning, nutrition counselling, and treatment of minor ailments. Above them are the union health and family welfare centres, which cover about 25,000 people per union and offer maternal and child healthcare, deliveries, and limited curative services. Together, they form the lowest rungs of the national healthcare ladder, linking upward to upazila health complexes and district hospitals.

The Promise of Accessibility: The World Health Organization (WHO) and the World Bank have hailed Bangladesh’s community clinic model as a milestone in reaching rural and marginalised populations. Each clinic typically has one full-time Community Health Care Provider (CHCP), assisted by two part-time workers who visit households, maintain vaccination coverage, and promote hygiene. Built on the principle of local ownership—where villagers donate land and manage operations—the system was revolutionary in its simplicity. By placing care within walking distance, the government reduced physical and psychological barriers that once kept villagers away from formal healthcare.

For millions, especially women and children, the community clinic became the first point of contact with the state’s health system. Proximity increased the likelihood that mothers would seek antenatal care and children would receive timely immunisations. Maternal and child health indicators improved steadily, and the clinics became the backbone of Covid-19 outreach and vaccination campaigns. Accessibility, once a dream, became reality.

Where the System Falters: The story of progress, however, must be balanced against performance. Efficiency—delivering the right care with the right resources—remains the system’s weak link.

Staffing shortages are the first constraint. Each community clinic employs a CHCP and shares a health assistant and a family welfare assistant. Yet these are paraprofessionals, not degree-holding physicians or registered nurses. Union-level centres, meant to have at least one doctor, midwife, and several paramedics, often operate with half their sanctioned staff. In many unions, one worker shoulders the duties of ten. Without qualified personnel, many clinics are limited to dispensing paracetamol, saline, and advice.

Medicine availability and treatment capacity present the second bottleneck. Community clinics were designed primarily for prevention, not full-scale curative care. Consequently, many lack a reliable supply of antibiotics or diagnostic tools. Drug shortages are common, forcing patients to buy medicines from private pharmacies or travel to distant upazila hospitals. A 2025 reform commission even recommended authorising these clinics to sell essential over-the-counter medicines at subsidised prices—an implicit acknowledgment that rural demand for basic treatment remains unmet.

Workload pressure and weak supervision form the third constraint. Multiple staffing studies using the World Health Organization’s Workload Indicators of Staffing Need (WISN) method reveal that staffing norms are out dated and fail to reflect actual patient volumes. Community health workers face overwhelming workloads, leading to rushed consultations that often last less than four minutes. Weak referral systems, poor transportation, and inadequate communication with higher-tier facilities further erode efficiency.

Dual Practice and Referral Malpractice: Beyond shortages and inefficiencies lies an ethical fault line that quietly corrodes rural healthcare. Many government-employed doctors, officially posted at union or upazila health complexes, also maintain part-time private practices in nearby towns. This dual practice often turns into dual morality. In the government clinic, patients complain of being hurried, dismissed, or even scolded. Yet when the same doctor is visited in a private chamber—after paying consultation fees—the tone changes to courtesy, patience, and care.

Even more troubling is the referral-for-profit network that has emerged, as documented repeatedly in media reports and health-sector studies. Some doctors routinely direct patients to city-based diagnostic centres or specialists with whom they have personal or financial ties. In many cases, the referrals are unnecessary, driven not by medical need but by commission-based incentives. Such practices impose crushing financial burdens on poor families and erode faith in local health facilities.

This behaviour transforms what should be a public service into a marketplace of manipulation. The poor, who turn to government clinics precisely because they cannot afford private care, end up neglected or deceived into unnecessary expenditures. Without strict enforcement, dual practice has become the unspoken rule of the rural health economy—where duty ends at the clinic gate and profit begins at dusk.

Measuring Efficiency: Judged by four criteria—human resources, medicine availability, quality of care, and accessibility, the results are mixed. On access, Bangladesh has succeeded impressively; nearly every rural citizen now lives within a few kilometres of a health post. But the absence of qualified physicians and nurses leaves many facilities operating on the margins of competence. Quality and monitoring vary widely across districts: some clinics thrive under motivated leadership, while others stagnate due to absenteeism or neglect. The problem is not intent but implementation design that favours coverage over capability.

What Must Change: To fulfil the promise of universal health coverage, Bangladesh must move from access to efficiency. This requires recruiting more doctors, nurses, and midwives for rural postings, supported by financial incentives and credible pathways for career advancement. The current two-tier paraprofessional model is insufficient for a country facing a rising burden of chronic and non-communicable diseases.

Equally urgent is guaranteeing consistent stocks of essential drugs, including antibiotics, and equipping clinics with basic diagnostic tools for blood pressure, glucose, and common infections. Without medicines and diagnostics, proximity offers little more than false reassurance.

The system must also pilot enhanced community clinics staffed by at least one trained nurse or physician’s assistant capable of managing uncomplicated infections and chronic conditions. Such intermediate capacity would relieve pressure on hospitals while restoring confidence in local care.

Digital registers and connectivity should be leveraged to monitor attendance, medicine stocks, and referral patterns in real time, allowing district authorities to identify underperforming clinics and intervene early. Finally, citizen participation must be institutionalised through active management committees and regular public hearings, empowering villagers to demand transparency and quality from local providers.

The Road Ahead: Bangladesh’s network of rural clinics remains one of the boldest health outreach initiatives in the developing world. It has achieved what many nations still struggle with—universal access to a health facility within walking distance. Yet access alone is not enough. Without qualified staff, adequate drugs, reliable diagnostics, and effective supervision, accessibility risks becoming a hollow victory. The measure of success should not be how many clinics exist, but how many lives they improve.

These concerns are widely shared among observers of Bangladesh’s health system. Yet the deeper problem lies in the quiet despair gripping rural patients—mistreated by medical professionals, denied basic services, and driven toward private clinics run by the very doctors entrusted with public duty. Such hopelessness reflects a broader culture of dishonesty and corruption that has trickled down from the top to every tier of society. It exposes how numerical policy achievements can conceal lived disillusion when care is indifferent, supervision weak, and accountability absent.

Part of the remedy must begin with raising the salaries of medical professionals to restore dignity to their service, while making private practice for government-employed doctors strictly illegal—punishable by permanent removal from public employment and ineligibility for future government fellowships, including FCPS and foreign training programs. The call is for a renewal of purpose, so that access is matched by care, performance by compassion, and promise by integrity.

Dr Abdullah A. Dewan, Professor Emeritus of Economics at Eastern Michigan University, USA, formerly a Physicist and Nuclear Engineer, BAEC.

Dr Dulary A Maher, MBBS (DU), PGT, CCU, Urban Primary Care Delivery Project Suja Nagar, Comilla.

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[Saif]

Effective strategies for health care

BANGLADESH, with significantly high life expectancy and infant mortality rates, is confronted with a growing prevalence of non-communicable diseases alongside growing mental health issues. It also faces dual challenges from chronic infectious...

www.newagebd.net

Effective strategies for health care

BANGLADESH, with significantly high life expectancy and infant mortality rates, is confronted with a growing prevalence of non-communicable diseases alongside growing mental health issues. It also faces dual challenges from chronic infectious diseases such as tuberculosis, which are intensified by inadequate funding, uneven distribution of resources, especially between urban and rural areas, and administrative shortcomings. From a geographical perspective, Bangladesh benefits from improved access and a skilled work force, which contributes to the substantial economic growth.

The primary health care initiative focused on boosting immunisation to reduce child mortality, notably in achieving a ‘polio-free’ status and implementing oral dehydration therapy for diarrhoea treatment, has seen a considerable success. However, the rapid and uneven growth of urbanisation poses long-term challenges for health management, alongside pollution and environmental pressure which are a major barrier to health infrastructure. Consequently, the current health landscape is confronted with numerous challenges and adversities.


Infectious diseases such as bacterial pathogens such as Mycobacterium tuberculosis, are responsible for tuberculosis. Over time, the focus has shifted from tuberculosis to non-communicable diseases, including stroke, heart diseases, chronic obstructive pulmonary disease, cancer and diabetes, which now account for the majority of fatalities. Simultaneously, the population bears a dual burden of inadequate public health and personal financial strain in addressing these diseases.

Mental health is another critical area of concern as Bangladesh handles a significant and escalating burden of mental health issues, with approximately 19 per cent of the adult experiencing mental disorders. The issues are exacerbated by rapid urbanisation, poverty, familial conflicts and certain genetic pre-dispositions. The acute shortage of mental health professionals, coupled with widespread medical shortage exceeding 90 per cent in this sector, is apparent. Women are particularly vulnerable to these conditions and while urban/rural discrimination is not excessively pronounced, there remains a substantial lack of mental health resources in rural areas, where conditions such as depression and anxiety are dominant.

The rise in stress, depression, neurological disorders, strokes and epilepsy is alarming. Anxiety disorders represent one of the fastest-growing categories of mental illness globally, impacting the mental development of at least 4.1 per cent of children and the adolescent. Among the most diagnosed anxiety symptoms in children and young adults aged 11 to 19 are separation anxiety or dissociative disorder; specific phobia, characterised by an irrational fear of certain stimuli; social anxiety disorder; generalised anxiety disorder; and panic disorder.


These mental anxiety disorders typically begin in early childhood or adolescence and over time, the symptoms often interact with other anxiety disorders. Bangladesh ranks among the lowest in public health expenditure globally, frequently fluctuating between about 0.7 per cent and 1.1v of its gross domestic product. As a result of insufficient funding, around 63 per cent to 73 per cent of the total health expenditure is directly incurred by patients.

This financial burden drives millions into poverty each year. Health insurance for the general populace is nearly non-existent, leaving individuals without financial protection during emergency medical situations. The scarcity of resources within the healthcare system, coupled with a lack of personnel and poor governance, perpetuates a vicious circle of underdevelopment, where the absence of resources and accountability results in significant adverse effects, including corruption, economic instability and inadequate public service delivery.

The unequal distribution of healthcare professionals, particularly specialists, between urban and rural regions is recognised as a contributing factor to the emergence of risks and illnesses. The systematic shortcomings in disease prevention and health awareness stem from various interconnected challenges within the healthcare system. A significant barrier is an inadequate emphasis on preventive measures and health promotion initiatives. The current overly centralised decision-making structure of the health ministry is deemed inappropriate, which is often the case. Top-down or top-down strategies result in a disconnect with the actual conditions in rural areas. These systemic issues are exacerbated by insufficient public health communication, particularly during emergencies such as the Covid outbreak, when misinformation proliferates because of ineffective information dissemination and subpar public health messaging.


Likewise, the recovery of the chronic infectious disease such as tuberculosis presents systemic obstacles, including inadequate patient support, exorbitant treatment costs and limited access to care, which contribute to incomplete treatment regimens and the emergence of resistant strains of Mycobacterium tuberculosis and its recovery. Despite ongoing efforts by government and non-governmental organisations through various initiatives, processes and local emergency care networks, there remains a significant deficiency in structural and institutional capacity to prioritise prevention and health education comprehensively, aiming for decentralisation and modernisation that benefits the most common and marginalised segments of the population.

The private health sector is often beyond control because of ineffective government systems, characterised by poor regulation, rampant commercialisation and high out-of-pocket expenses, leading to quality concerns and substantial financial strain for many. This unregulated landscape, marked by a focus on profit rather than quality, has driven many into debt. Conversely, key informal service providers in rural regions frequently lack adequate training, revealing significant administrative deficiencies. To transform Bangladesh into a healthy and developed nation, it is essential to establish a long-term strategic framework that addresses the issues, incorporating youth health and reproductive rights into the effective measures of the health planning structure.

At the core of this vision lies the commitment to ensuring an equitable access to health care, particularly for the adolescent and marginalised communities. It is advisable to execute the potential strategies that emphasise essential health systems, human capital, digital transformation and institutional reforms to establish a modern and stable Bangladesh, which can be viewed through the lens of current health practices, problem identification and actionable initiatives.

Universal health coverage can be broadened to encompass 75 per cent of the population by 2030, necessitating a service package that enhances health care, including lifestyle intervention and nutrition for women and children. The execution of a digital health strategy is crucial for the integration of telemedicine, electronic health records and data analysis among both public and private health service providers. The current primary health budget for the 2026 fiscal year stands at Tk 434.83 billion, reflecting a mere 5 per cent increase from the previous allocation of Tk 414.08 billion in the past financial year. This allocation constitutes 5.3 per cent of the national budget and 0.74 per cent of the gross domestic product, which is considerably lower than the 5 per cent of the gross domestic product recommended by the World Health Organisation.


Regrettably, public health allocations have consistently hovered around 5 per cent of the national budget for several years and even as the GDP share, it has marginally declined from 0.75 per cent in the 2024 financial year to 0.74 per cent in the 2025 financial year. This trend can be recognised as a clear contributor to administrative deficits and prudent management. To promote long-term health development, Bangladesh must enhance multilateral cooperation, which includes precise information sharing and investment strategies in health system infrastructure. Evidence-based decision-making, universal health coverage and community-based management will be crucial. Additionally, there will be sustainable coordination among government agencies, international donors and civic groups to align national health strategies with the Sustainable Development Goals, particularly in health.

By establishing social health protection systems and increasing government funding, while reducing out-of-pocket health expenditures for households, a blended financial system should integrates public and private capital, especially enhancing the capacity of the disease diagnostics sector, and extending medical care to health initiatives to ensure that they are more long-term, sustainable, and efficient. This can guarantee optimal resource use and social security levels.

Bangladesh has implemented several specialised training initiatives to strengthen its healthcare system, including the management sciences for health and good pharmacy practice training programme, supported by foreign funding and technology. This addresses fundamental topics including rational drug usage, patient consultation, antimicrobial resistance, pharmacovigilance and proper storage and labelling of medicines. Despite these advances, the challenges that remain include a significant shortage of healthcare workers, especially in rural areas, and a lack of investment in primary health care and community-based training. A recent survey reveals that 51 per cent of medical students are considering moving abroad, with 90 per cent expressing a preference for urban healthcare positions.

To tackle the challenges in the healthcare system, it is crucial to incorporate health workers into organised health frameworks, ensure ongoing training, and achieve a fair distribution of healthcare professionals. The progress of sustainable health systems relies on diversifying funding sources, boosting domestic investment and fortifying health systems through community-led initiatives, cross-border collaboration and integrated disease control. A modern, stable and resilient health system that promotes good health and well-being can be established through a combination of preventive services, health awareness and systemic approaches.

The concept of public-private partnership is increasingly acknowledged as a fundamental strategy for promoting long-term health development. With a population exceeding 180 million, Bangladesh faces challenges in accessing health care, particularly in rural and marginalized communities. Therefore, a measurable and sustainable model is crucial for reinforcing the health system. The governments, the private sector, non-governmental organisations and international donors are working collaboratively to address life-threatening diseases such as tuberculosis, HIV/AIDS and malaria while also establishing resilient infrastructure to achieve universal health coverage.

Sarker M Shaheen is a researcher of neurogenetics and precision medicine at the University of Calgary, Canada.​

 

[Saif]

Affordable care must be next govt’s focus: Say health experts

As major political parties prepare to roll out their election manifestos, health experts say that ensuring quality primary healthcare for all and reducing high out-of-pocket expenditure should be their top priority.

www.thedailystar.net

Affordable care must be next govt’s focus: Say health experts

By Tuhin Shubhra Adhikary

With the national election less than a month away, political parties are finalising their manifestos. The Daily Star spoke to experts to identify the pressing issues that should top the agenda for parties.

As major political parties prepare to roll out their election manifestos, health experts say that ensuring quality primary healthcare for all and reducing high out-of-pocket expenditure should be their top priority.

They note that primary healthcare remains weak and underfunded, particularly in urban areas, despite its critical role in preventing diseases and protecting people from falling into poverty due to high medical costs.

Health should not be treated as the sole responsibility of a single ministry; rather, it should be integrated into all government policies and activities, they observe.

To achieve these goals, the experts have called for an overhaul of health management, including restructuring the system under three separate directorates -- clinical, academic, and public and primary healthcare -- along with higher budgetary allocations to improve coordination, efficiency, and accountability.

The country goes to the polls at a time when the health sector faces major challenges, including inadequate funding, shortages of health workers, high out-of-pocket expenses, unequal access to services and weak governance.

As thousands of people continue to be deprived of quality treatment, the rise in the total fertility rate for the first time in 50 years has fuelled fresh concerns.

Public health expert Prof MA Faiz said that primary healthcare has not received due importance, particularly in urban areas, where services remain very poor. It should be given priority regardless of whether the area is rural or urban.

He suggested that a doctor-led team should provide services to a defined population size, ensuring that no one is left behind.

In Bangladesh, the universal service package exists only in name. It should be gradually expanded -- both in terms of the number of services and the population covered -- to ensure universal health coverage. Individuals should bear costs according to their financial capacity, said Prof Faiz, also former director general of Directorate General of Health Services (DGHS).

“This needs to be done to reduce people’s out-of-pocket expenditure that remains very high in the country. Excessive healthcare costs are pushing many people into poverty while depriving many others of services.”

He also stressed the need for skill-driven medical education to produce the required manpower capable of providing quality primary healthcare.

“The health budget must be increased to achieve these goals,” he added.

Outlining the major tasks for the next government, Prof Liaquat Ali, a member of the Health Sector Reform Commission, said it will need to review the commission’s report and set priorities for implementing the recommendations.

The first priority should be to enact a law declaring primary healthcare a constitutional obligation and provide these services free of cost, said Prof Liaquat, also a former vice chancellor of Bangladesh University of Health Sciences.

At least 15 percent of the national budget, or five percent of the country’s gross annual income, should be allocated to the health sector in phases, he said, adding that the allocated budget must be fully utilised.

He also recommended reorganising the healthcare system under three directorates -- clinical, academic, and public and primary healthcare -- to ensure better coordination and service delivery, with adequate manpower assigned accordingly.

Stressing the need to reduce out-of-pocket healthcare expenditure, Mohib Ullah Khondoker, a member of the executive management committee at Gonoshasthaya Kendra, said the next government must properly regulate the medicine market.

It must ensure that all stakeholders adhere to the updated National Essential Drug List once the prices of the 295 medicines on the list are fixed, he noted.

“Priority should be given to ensuring quality education for health professionals and strengthening primary healthcare services, particularly in view of the growing burden of non-communicable diseases, which involve high treatment costs,” he added.

Emphasising the importance of preventive and promotive healthcare, Prof Syed Abdul Hamid from the Institute of Health Economics at Dhaka University said these areas should be prioritised so that fewer people fall sick.

All ministries must play a role by giving priority to health issues, which means health should be integrated into all government policies and activities, he said.

The country has a large network of government hospitals to provide curative care, but these facilities are not functioning properly mainly due to poor governance and shortages of funds and manpower, he said, calling for effective measures to make them functional.

Private facilities, which charge higher fees but often fall short of quality service, must be brought under an accreditation council to ensure standards, said Prof Hamid, also convener of Alliance for Health Reforms Bangladesh.

Steps must be taken to improve the quality of medical education and promote professional development for doctors so that they stay aligned with global advancements in healthcare, he added.​

 

[Saif]

Healthcare costs should top agenda

What pundits on social and economic issues say, celebrate the outlook of people on how to improve the health of politics, governance and so on. However, of late, attention is also turning to the more fundamental issue of public health or, in other words, health of the very members of society

thefinancialexpress.com.bd

Healthcare costs should top agenda

SYED FATTAHUL ALIM
Published :
Jan 19, 2026 23:32
Updated :
Jan 19, 2026 23:32

What pundits on social and economic issues say, celebrate the outlook of people on how to improve the health of politics, governance and so on. However, of late, attention is also turning to the more fundamental issue of public health or, in other words, health of the very members of society who constitute politics, economics, science and what have you. Especially, the issues of free primary healthcare, increasing health budget to 5 per cent of the Gross Domestic Product (GDP) as recommended by the Health Reform Commission formed by the interim government, (experts are of the view that health budget should be 15 per cent of the national budget), giving constitutional recognition of people's right to health, decentralizing services and so on and so forth are being hotly debated at the moment. No doubt these are big ideas about reaching health services at low cost right on the common people's doorstep.

But it is one thing to have an idea, it is quite another to implement it. Now that the interim administration is soon going to hand over power to an elected government after February 12's general election, all eyes will now be on the next government to assume power. Will that government be just a chip off the old block of politics, or mark a departure from the past? Talking of promises made in a party's election manifesto, say, on healthcare, it is better forgotten like the leaflets and posters distributed during the election campaign. So, it is time experts and public intellectuals made the issues of healthcare the main agenda of their discussion and prevail upon the next government accordingly. The focus should be on making primary healthcare accessible to the low-income people in the rural as well as urban areas.

Admittedly, the country has a vast network of government hospitals at districts and health complexes and clinics at upazilas to serve the population at the remote corners of the country. Unfortunately, most of those hospitals and health complexes are understaffed and lack the facilities to deliver the basic services to the local communities. Most importantly, for delivering the required services, these hospitals and health complexes need the necessary medical equipment, infrastructures and skilled personnel to operate those. It is also necessary to provide those hospitals/health complexes with the appropriate amenities so skilled health professionals including doctors have the incentive to stay and work there along with their family members. In fact, in modern career-oriented professions, which include medicine, the mere call of serving humanity or fear of administrative action is not enough to motivate and retain skilled health professionals for long in the countryside.

So, the programme of overhauling the healthcare system should take all these issues into consideration. In hospitals in the bigger cities including the capital city, governance is the central issue and has to be freed from bureaucracy, so service delivery mechanism is speedy and efficient. Of course, the latest digital technology including AI can help healthcare system rid itself of old-style bureaucracy. But these are all about improving the health service delivery mechanism. Seeing that costs of healthcare and medicine have gone beyond the reach of the low-income people, who make the bulk of the recipients of the service, the issue should be brought to the centre of the discussions at all public forums. And the abstract and catchy idea of affordability of medical service has to be concretized by way of reducing out-of-pocket (OOP) medical expenses to the bare minimum for the low-income segment of society. Consider that in Bangladesh, OOP payments account for more than 70 per cent of national health spending, while health expenses eat up around 35 per cent of the total earnings of the low-income households. Evidently, it is one of the main drivers of pauperization in Bangladesh. So, reducing OOP health expenses should top the agenda of the next government.​

 

[Saif]

Developing advanced healthcare facilities at home

With fewer than one hospital bed available per 1,000 patients and still fewer doctors to attend them, the need for more hospital beds and healthcare professionals in the country has been a long-felt demand. Yet, progress in this important sector has been limited so far. That explains why before the

thefinancialexpress.com.bd

Developing advanced healthcare facilities at home

Published :
Jan 20, 2026 23:04
Updated :
Jan 20, 2026 23:04

With fewer than one hospital bed available per 1,000 patients and still fewer doctors to attend them, the need for more hospital beds and healthcare professionals in the country has been a long-felt demand. Yet, progress in this important sector has been limited so far. That explains why before the July 2024 uprising, a large number of people would visit only India every year and spend worth around half a billion US dollar for treatment purpose. In this way, huge sums of hard-earned foreign currencies would be spent outside the country. If hospitals with advanced treatment facilities could be made available within the country, then the number of outbound patients could be significantly reduced and, at the same time, a lot of foreign currency could be saved. So, Bangladesh cannot waste any opportunity to strengthen and expand its domestic capacity to serve the growing number of patients across the country. Against this backdrop, the report that the proposed 1000-bed Bangladesh-China Friendship Hospital to be set up in the northern district of Nilphamari, which is part of a series of China-funded healthcare projects to be built in the country, is now in an advanced stage of planning and approval is no doubt a welcome development.

A report carried in this newspaper recently informs that the proposed hospital project is being reviewed by the relevant government body for its finalisation. Fund worth Tk22.2 billion has been earmarked for the project as China grant. An additional amount from the government's own sources will also, as reported, go into implementation of the project. Once complete, the hospital would serve around 3,000 people, while its capacity will allow admission of 1,000 patients every day. What is further gratifying about the proposed hospital project is that, as planned, consulting fees for both outpatients and inpatients would be affordable for the common people. However, the cost of especialised services would be somewhat higher, but still within the affordable limit. Notably, the Nilphamari district and the greater Rangpur division of which it is a part, is a less developed region of the country. From that perspective, the implementation of such a large healthcare facility will be of immense service to the region with a population of over 1.7 million. Considering the range of the general and advanced specialised healthcare services the hospital would offer, it will obviously be able to draw medical service-seekers from other parts of the country as well as from abroad. Add to this the medical tourism and all the related activities the project is going to generate. So, it is not purely healthcare service as such, a large-scale project of this type can help initiate multiple economic activities that can create employment opportunities for the local population.

In that case, the general expectation is that sooner the paperwork for the project is completed and activities for the physical infrastructure started, the better for the public. More such collaborative healthcare facilities are required to be established in the country. The country has numerous privately-run hospitals fitted with advanced medical technologies, many of which boast highly paid specialist doctors working on contract from abroad. But only affluent section of society can afford their service. So, building more such expensive private hospitals won't be in the interest of the common people.

Hopefully, foreign-financed hospital projects like the China-backed one in Nilphamari would go a long way in meeting the demand gap for low-cost but advanced healthcare service in the country.​

 

[Saif]

Inefficiency, poor planning waste 80% of health budget

Bangladesh’s healthcare system has become capable of meeting the majority of domestic demand, but chronic mismanagement and poor planning are draining nearly four-fifths of the sector’s public spending, according to AM Shamim, general secretary of the Bangladesh Private Hospital, Clinic and...

www.thedailystar.net

Inefficiency, poor planning waste 80% of health budget
Says a leader of private hospital and clinic owners’ association

10 February 2026, 00:00 AM
Jagaran Chakma and Tuhin Shubhra Adhikary

Bangladesh’s healthcare system has become capable of meeting the majority of domestic demand, but chronic mismanagement and poor planning are draining nearly four-fifths of the sector’s public spending, according to AM Shamim, general secretary of the Bangladesh Private Hospital, Clinic and Diagnostic Owners Association.

In a recent interview with The Daily Star, he argued that the country has reached a point of functional self-reliance in healthcare delivery, even as deep structural flaws continue to threaten efficiency, accountability and public trust.

Shamim, also the managing director of Labaid Group, one of the country’s largest private healthcare providers, said that over the past two decades, the health sector in Bangladesh has expanded in terms of both infrastructure and workforce, with the private sector now providing close to two-thirds of all health services.

The gains, however, he said, are being blunted by wastage, regulatory dysfunction and weak governance.

The Labaid MD pointed to the sharp fall in outbound medical travel as one of the indicators of the system’s growing capacity.

Caption AM Shamim

He claimed that medical visas to India, once routine for Bangladeshi patients seeking treatment, have fallen to a tenth of their previous levels over the past 18 months.

Despite this drop, he said, the local healthcare system has faced no major disruption, reflecting its growing capacity to meet domestic demand.


Where Dhaka Medical College Hospital once served as the default option for emergencies, private hospitals such as Square and Labaid are increasingly becoming the first choice for patients seeking timely and specialised care, he said.

Shamim noted that this progress masks a disturbing reality.

“Our national health budget stands at around Tk 42,000 crore. But nearly 80 percent of that is wasted. Equipment that isn’t needed is purchased, while the ones we do need often sit idle and unused,” he said.

The problem is not a lack of resources but their deployment. For instance, he said at Labaid Cancer Hospital, two linear accelerator (LINAC) machines deliver radiotherapy to between 160 and 220 patients a day.

In contrast, he emphasised, “government cancer hospitals have 8-12 LINAC machines, yet they treat fewer patients. That’s not a technical issue -- it’s purely a matter of management.”

Red tape compounds the dysfunction. Noting that there were once around 17,500 licensed hospitals and diagnostic centres, he said that number has now dropped to just 3,000 hospitals and 7,000 diagnostic centres.

“To set up a hospital, you need approvals from at least 18 different agencies, ranging from fire services, the Department of Environment, narcotics control, boiler inspection, generator compliance, and more,” he said.

“The main issue is that licenses remain valid for just one year. By the time one agency completes its inspection, the year is already over. This opens the door for delays, bribes, and inefficiencies,” he added.

The government extended the licence validity to two years last month. But Shamim warned that the underlying problems remain.

He proposed several fixes, including a unified licensing system that would consolidate approvals under a single authority.

Besides, he called for a national accreditation programme, modelled on India’s NABH and NABL systems, which would grade hospitals from A to C based on beds, staff, equipment and services, weeding out substandard establishments.

Public-private partnerships could revive nearly 80 idle public healthcare facilities, leveraging the private sector’s proven ability to attract talent, he added, noting that two-thirds of Bangladesh’s 70,000 physicians and three-quarters of its 26,000 nurses work privately.

“This proves that public and private healthcare are complementary, not competitors,” said the general secretary of the owners’ association.

Shamim acknowledged that the private sector has its own failings. “Many doctors do not spend enough time with patients and often fail to provide adequate counselling.”

He suggested regulations on consultation lengths and daily patient loads.

He also urged the media to play a more balanced role. “Take the example of primary angioplasty after a heart attack. Worldwide, 9 out of 10 patients survive. But when that one patient dies, it makes headlines, overshadowing the success of the other nine.”

But at the end of the day, the fundamental challenge remains governance.

“People may survive skipping a meal, but they cannot function without proper treatment,” Shamim said. “It’s time we nurture and invest in this sector with the seriousness it deserves.”

Restoring public confidence in healthcare requires coordinated effort among the government, private sector, and media, he said.

“We (the private healthcare sector) are not an opposition of the government, or the people. We are part of the same system. If we work together, we can build a truly healthy Bangladesh.”​