Volume 2, Issue 6, November 2014, Page: 366-374
Health System in Bangladesh: Challenges and Opportunities
Anwar Islam, Adjunct Scientist and Consultant, Centre for Control of Chronic Diseases (CCCD), International Centre for Diarrheal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh; and Adjunct Professor, School of Health Policy and Management, York University, Toronto, Canada
Tuhin Biswas, Research Officer, Centre for Control of Chronic Diseases (CCCD), International Centre for Diarrheal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
Received: Oct. 29, 2014;       Accepted: Nov. 10, 2014;       Published: Nov. 20, 2014
DOI: 10.11648/j.ajhr.20140206.18      View  3612      Downloads  1205
The health system of Bangladesh relies heavily on the government or the public sector for financing and setting overall policies and service delivery mechanisms. Although the health system is faced with many intractable challenges, it seems to receive little priority in terms of national resource allocation. According to the World Health Organization (WHO 2010) only about 3% of the Gross Domestic Product (GDP) is spent on health services. However, government expenditure on health is only about 34% of the total health expenditure (THE), the rest (66%) being out-of-pocket (OOP) expenses. Inequity, therefore, is a serious problem affecting the health care system. Based on a review of secondary data, the paper assesses the current challenges and opportunities of the health system in Bangladesh. The findings suggest that although the health system faces multifaceted challenges such as lack of public health facilities, scarcity of skilled workforce, inadequate financial resource allocation and political instability; Bangladesh has demonstrated much progress in achieving the health-related Millennium Development Goals (MDGs) especially MDG 4 and MDG 5. Although the country has a growing private sector primarily providing tertiary level health care services, Bangladesh still does not have a comprehensive health policy to strengthen the entire health system. Clearly, the most crucial challenge is the absence of a dynamic and proactive stewardship able to design and enforce policies to further strengthen and enhance the overall health system. Such strong leadership could bring about meaningful and effective health system reform, which will work more efficiently for the betterment of the health of the people of Bangladesh, and would be built upon the values of equity and accountability.
Health System, Determinants of Health, Societal Response
To cite this article
Anwar Islam, Tuhin Biswas, Health System in Bangladesh: Challenges and Opportunities, American Journal of Health Research. Vol. 2, No. 6, 2014, pp. 366-374. doi: 10.11648/j.ajhr.20140206.18
International Relations and Security Network, Primary Resources in International Affairs (1972). Constitution of the People’s Republic of Bangladesh.
Coker, R.J., Atun, R.A. & McKee, M. (2004). Health care system frailties and public health control of communicable disease on the European Union’s new eastern border. The Lancet 2004; 363: 1389-92
Barker, P.M., McCannon, C.J., Mehta, N., Green, C., Youngleson, M.S., Yarrow, J., Bennett, B. & Berwick, D.M. (2007). Strategies for the Scale-up of Antiretroviral Therapy in South Africa through Health System Optimization. The journal of Infectious Diseases 2007; 196:S457-63
Mahmood, S.A.I (2012). Health Systems in Bangladesh. The iMedPub Journal 2012; Vol 1, No. 1:1. Doi: 10.3823/1100.
G., Lansung, M.A., Mitta, V., Bornemisza, O., Blakley, M., Kley, N., Burgess, C. & Atun, R. (2010). Health systems strengthening: A common classification and framework for investment analysis. Health Policy and Planning 2010; 1-11. Doi: 10.1093/heapol/czq053.
Islam, A., Bangladesh health system in transition: selected articles. 2009: James P. Grant School of Public Health, BRAC University.
Official website of The World Bank. Retrieved from 29 September 2014. http://www.worldbank.org/en/country/bangladesh
World Bank. 2007. Improving living conditions for the urban poor. Bangladesh Development Series, paper no. 17. Dhaka
Bangladesh Bureau of Statistics (BBS). 2011. Statistical pocketbook of Bangladesh 2010. Dhaka: BBS.
The World Bank (2011). World Development Report 2011.
Vaughan, J.P., E. Karim and K. Buse. 2000. Health care systems in transition III. Bangladesh, part I. An overview of the health care system in Bangladesh. Journal of Public Health22 (1): 5-9.
Ullah, A.K.M.A. 2004. Bright city lights and slums of Dhaka city: Determinants of rural-urban migration in Bangladesh. Migration Letters 1 (1): 26-41
Roy, G.S. and A.Q.M. Abduallah. 2005. Assesing needs and scopes of upgrading urban squatters in Bangladesh.BRAC University Journal 2 (1): 33-41
Riley, L., A. Ko, A. Unger and M. Reis. 2007. Slum health: Diseases of neglected populations. BMC International Health and Human Rights 7 (2): 1-6
Financial System Management Unit. 2011.Bangladesh economic review. Dhaka: Finance Division, Ministry of Finance.
Engelgau. M.M., S. El-saharty, P. Kudesia, V. Rajan, S. Rosenhouse and K. Okamoto. 2011. Capitalizing on the demographic transition: tackling no communicable diseases in South Asia. Washington, DC: World Bank.
Bleich, S.N., T.L.P. Koehlmoos, M. Rashid, D.H. Peters and G. Anderson. 2011. No communicable chronic disease in Bangladesh: Overview of existing programs and priorities going forward. Health policy 100 (2011): 282-289.
World Bank. 2011b. Bangladesh—Health Sector Development Program. Dhaka.
Bangladesh Bureau of Statistics (BBS). 2011. Statistical pocketbook of Bangladesh 2010.Dhaka: BBS.
Trading Economics. 2012a. Bangladesh GDP Annual Growth Rate. http://www.tradingeconomics.com/bangladesh/gdp-growth-annual (accessed 18 April 2012).
World Bank. 2012d. World development report 2012: Gender equality and development. Washington, DC.
World Bank. 2011. Bangladesh—Health Sector Development Program. Dhaka.
Bangladesh Health Watch (BHW). 2011. Moving Towards Universal Health Coverage.
Directorate General of Health Services (DGHS). 2010. Secondary and Tertiary Health Care Facilities in Bangladesh. Dhaka: DGHS.
World Bank. 2012b. Death rate, crude (per 1,000 people), Bangladesh 2012. : World Bank. http://data.worldbank.org/indicator/SP.DYN.CDRT.IN (accessed 19 April 2012)
Bangladesh Health Watch (BHW). 2007. Bangladesh State of Health Report: Health Workforce in Bangladesh, Who Constitutes the Healthcare System? James P grant School of Public health, BRAC University, Bangladesh.
Joint Learning Initiative (2004). Human Resources for Health: Strategies for Crisis and Sustainability.
Bangladesh Health Watch (2012). Bangladesh Health Watch Report 2011: Moving towards Universal Health Coverage.
WHO (2008). The World Health Report 2008: “Primary Health Care Now More than Ever”.
United Nations Children’s Fund (UNICEF, 2011). UNICEF Annual Report 2010.
slam, A. and T. Biswas, Health System Bottlenecks in Achieving Maternal and Child Health-Related Millennium Development Goals: Major Findings from District Level in Bangladesh.
Browse journals by subject