Health

1. Health Problems in Bangladesh
Mohammad Shahjahan
Lecturer
Institute of Social Welfare and Research
University of Dhaka
shahjahanswcox@gmail.com

2. Health Problems in Bangladesh
 Communicable Disease:
- Tuberculosis (TB) The estimated incidence of TB per 100,000 is 221 in
Bangladesh, with a mortality rate of 24 per 100,000 population (WHO;2020).
- HIV/AIDS (only 0.1% of the population is reported to be HIV-positive. Total
of 1,588 people who died of AIDS (UNAIDS; 2021)
- Malaria (Malaria is endemic in 13 of 64 districts in Bangladesh. Over 17
million people at risk (over 8% of the total population)
- Dengue (In 2017, the country reported 2,769 cases and in 2018, annual
incidence increased to 10,148 cases. In 2019, the Directorate General of
Health Services reported an incidence rate 10 times higher than the previous
year, with 101,354 cases and at least 179 deaths.)
- Tetanus, Measles, Leprosy
• Common Diseases

3. Health Problems in Bangladesh
 Non-communicable Disease:
- Cardiovascular diseases (According to non-communicable disease risk factor survey 2018,
some 15.5 percent of Bangladeshis, aged 40-69 years, are at risk of cardiovascular diseases.
The number of such hospitals is 20 (four public and 16 private)
- Cancer (There are around 1.5 million cancer patients in Bangladesh with 150,000 dying each
year. The report shows that every year two lakh people are attacked by cancer (WHO;2022).
- Diabetes (Bangladesh has the eighth highest population of people with diabetes, at 13.1
million. There were 8.4 million adults living with diabetes in 2019, and projected to almost
double (15.0 million) by 2045 (IDF; 2019)
- Road accidents (At least 6,284 people were killed and 7,468 others were injured in road
accidents across the country, whereas in 2020, 5,431 people were killed and 7,379 others
were injured in road crashes, according to an annual report of the Bangladesh Road Safety
Foundation (RSF).
- Hypertension, Stroke
- Mental Health disorders
• Common Diseases

4. Health Problems in Bangladesh
 Others:
- Malnutrition (The present per capita intake is only 1850 kilocalorie. 28
percent of children under five years are stunted (have low height-for-age) and
10 percent are acutely malnourished or wasted (have low weight-for-height)
(BBS and UNICEF Bangladesh 2019)
- Diarrhea (Admission mark exceeded the 1,000 mark on March 16 for the first
time in 60 years of Icddr,b).
- Pneumonia (Around 28% of the deaths of children under five years of age.
Around 50,000 children die of pneumonia every year. An estimated 80,000
children under five years of age are admitted to hospital. (UNICEF)
• Common Diseases

5. Health Problems in Bangladesh
 No. of government facilities under the
DGHS 2,258 (Primary- 2003 except
Community Clinic; Secondary & Tertiary-
255)
 No. of hospital beds 54,660 under DGHS
 No. of hospital beds in private hospitals
91,537
 No. of doctors 25,594
 Community clinic 13,907 (Health Bulletin;
2019);
 3,900 UHFWCs
 424 Upazila Health Complex (Health
Bulletin; 2019)
 255 public hospitals;
 5,321 private hospitals and clinics;
 9,529 diagnostic centers;
 106 Medical Colleges (36-Public; 70-Private)
 39 Postgraduate medical teaching institutions;
 24 Specialized Hospitals, Institutes etc.;
 35 Dental Colleges and Unit (9-Public; 26-
Private);
 60 Nursing institutions (15-Government & 45
Private);
 02 Bangladesh Homeopathic Medical College and
Hospital;
 04 Govt. Unani & Ayurvedic Medical College
Hospital;
• Limited public facilities

6. Health Problems in Bangladesh
 Availability of Drugs;
 Medical supplies;
 Family planning commodities;
 Shortage of logistics;
 X-ray Machines and incubators;
 Lab facilities;
• Lack of essential commodities
• Lack of community empowerment at the
local level
 UHCs dominated by bureaucrats;
 So called community leaders;
 Homogenous community members;
 Absence of community participation

7. Health Problems in Bangladesh
• Lack of Devolution
 Power and decision making concentrated
in MoHFW;
 UHFPO simply carrying out plans and
programmes assigned by MoHFW.
• Misuse or misappropriation of resources
 Medicines and drugs disappear from
UHCs;
 X-ray films remain unavailable;
 65% ambulances are inoperable or non-
functional;
 Antibiotics consumption in Bangladesh
has increased by 30.81 per cent in the last
two years

8. Health Problems in Bangladesh
• Unavailability of health workforce
Source: DGHS; 2019
 Doctor Patient ratio- 5:10000 WHO
recommended 1: 1000
 Doctor Nurse ratio-2:1 but WHO requirement
1:3
 Population-Nurse ratio- 5000:1 but 1:3 in
teaching hospitals and 1:5 in general hospitals
and a post of senior nurse.
 Bed-nurse ratio- 13:1 but international
standard for bed-nurse ratio of 4:1
 Teacher-student ratio 1:57, where a ratio of
1:20 is considered to be the standard.

9. Health Problems in Bangladesh
• Lack of public health and
management expertise at the
District and Upazila levels
 Very little knowledge or expertise on
public health or in management;
 Absence of ethics guiding behaviour of
health professionals;
 Have their own office hours;
 Patients are neglected and abused by
health workers;
 ‘Normal’ delivery transformed
‘Cesarean’
• Inadequate financial resources
 Less than 1.0 per cent (0.95%) of Gross
Domestic Product (GDP) for over a
decade;
 Only 5.42 per cent of the total budget for
FY22;
 Lack of capacity of the public health
authorities in utilizing the budget allocation
efficiently;
 Only around 0.05 per cent of the total
health budget or US$0.08 per capita
spending for mental health services;
 Health insurance is not existence;

10. Health Problems in Bangladesh

11. Health Problems in Bangladesh
• Growing and continuing inequity within the
health system
 Poor and disadvantaged group still have
deprived rather than rich people;
• Political instability and lack of commitment
 Hartal, shutdown, vandalism etc.
 Intolerable corruption in health sector;
• Weak health information system
 Only raw data available but not enough
managed, analyzed, disseminated data;
 Small scale surveys conducted;

12. How to solve these problems?
• Increasing public awareness about public health through seminar,
symposium, workshop etc. and ensure community participation;
• To ensure proper utilization of available resources and distribution
of equipment's equally;
• Recruiting huge number of quality doctors, nurses, technicians, lab
attendants etc. in field level;
• To create an integrated database management systems for public
health;
• To increase allocation of health budget rather than other sector;
• To introduce health insurance for all;
• To apply bottom-up approach in health administration
management;

13. Thank you all