Bangladesh is one of the most densely populated countries in the world. For around 170 million people, the country doesn’t have a good public healthcare system and the country is way behind to achieve the SDG 3. 

Dengue Patients in DMCH
Image Source: Daily Star/Pinaki Roy

Let’s explore some key factors regarding the problems and challenges in the public healthcare system. 

    1. Size of the population is quite large to handle. The density is 1103 per Sq/k.m and the growth rate is 1.37% (Ref: Bangladesh Economic Review) 
    2. Allocated amount in the health sector is not sufficient to meet the expenditures and requirements. In FY 19-20, the Government allocated only 4.9% (June 13, Daily Star) to the Health Sector. Where the total amount of the Budget is BDT 5,23,190 Crore. Surprisingly the Government spends more money on Public Order & Security than Public Healthcare! 
    3. Number of doctors and staff nurses are not justified by the number of patients. According to the Bangladesh Economic Review, only one registered physician is available for 1724 people.  
    4. Most of the civilians live their life below Standard or just up to the average level. Such lifestyle causes serious long term effects on public health.
    5. Lack of knowledge in sanitation and personal hygiene also creates complex health problems.
    6. No health insurance is provided by the Government to the civilians. People with affordable income avail health insurance benefits from private sectors.
    7. Number of Government owned Hospitals is not justified by the size of the population. These Hospitals don’t have sufficient tools, medicines and equipment. Only a very few hospitals can provide emergency health services and operations. Mainly Dhaka based hospitals provide the emergency services. Even divisional hospitals fail to provide basic health services at critical times. 
    8. In the context of community health care, we can not expect more than a tiny little health center with some basic medicines. Community Clinic is a great idea even after most of the Clinics are heavily under-equipped.
    9. The Dengue outbreak in 2019 proved that the country has the worst healthcare management.

10. Corruption seems to be one of the key impediments while implementing healthcare policies. According to TIB’s National Household Survey (2012), 40.2% of the recipients of health services from public institutions became victims of irregularities and corruption while receiving services. According to this survey the estimated amount of bribes at the national level in this sector was Tk 703 million. News reports on irregularities such as absenteeism of doctors, lack of quality of services, irregularities in getting bed and medicines, active presence of middlemen luring patients to private health facilities, financial corruption of the health professionals and hospital staff are regularly published in the print media.  Ref: TIB Report

The Government has taken some initiative to rejuvenate the situation of the publi healthcare system and has made some progress too. But one thing which is obvious is that the Government is not increasing the healthcare budget proportionate to the increase of healthcare needs and demands.

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