4. Country Profile (Cont.)
• Name: People Republic of Bangladesh
• Population: 152.4 million
• Area: 143,998 sq km (55,598 sq miles)
• Major language: Bengali
• Major religion: Islam
• Life expectancy: 69 years (men), 70 years (women)
• Currency: Taka
8. Bangladesh Health Status
• Population growth rate: 1.05%
• Birth rate: 19 births/1,000 population
• Death rate: 5.3 deaths/1,000 population
• Mother's mean age at first birth: 18.5
• Maternal mortality rate: 176 deaths/100,000
live births
• Infant mortality rate: 32.9 deaths/1,000 live
births
(Source: CIA)
9. Bangladesh Health Status (Cont.)
• Life expectancy at birth: 73.2 years
• Total fertility rate: 2.19 children born/woman
• Contraceptive prevalence rate: 61.2%
• Obesity - adult prevalence rate: 3.3%
• Children under the age of 5 years underweight:
32.6%
• Health expenditures: 2.8% of GDP (2014)
• Hospital bed density: 0.6 beds/1,000 population
(Source: CIA)
10. Morbidity Ranking According to Prevalence
of Morbidity per 1000 Population
Disease Rank Prevalence
Fever (FUO) 1 52.5
Arthritis 2 14
Peptic Ulcer 3 13.4
High Blood Pressure 4 12.4
Dysentery 5 8.3
Diabetes 6 7.8
Diarrhoea 7 6.6
Acute respiratory infection 8 4.9
Skin Disease 9 4.3
Conjunctivitis 10 4.2
(Source: HMSS, Bangladesh Bureau of Statistics)
11. Prevalence of Morbidity per 1000
Infants (<1 year)
72
35
22
0
10
20
30
40
50
60
70
80
Acute respiratory
infection (ARI)
Diarrhoea Measles
Series 1
(Source: HMSS, Bangladesh Bureau of Statistics)
12. Prevalence of Morbidity per 1000
Children (<5 years)
40
29
10
ARI
Diarrhoea
Measles
(Source: HMSS, Bangladesh Bureau of Statistics)
13. Prevalence of Morbidity per 1000
Elderly Population (64+ years)
77
52
36
0 20 40 60 80 100
Arthritis
High blood pressure
Diabetes
Series 1
(Source: HMSS, Bangladesh Bureau of Statistics)
14. Treatments Received by Types of
Treatment Facility
22
68.9
1.70.27.3
Sales
Government
Private
NGO
Abroad
Othre
(Source: HMSS, Bangladesh Bureau of Statistics)
15. Coverage of Vaccination by Doses
Among Children (12-23 months)
Vaccine Percentage
BCG 88
Measles 79
All vaccines 70
16. Bangladesh Health Status (Cont.)
• Infant mortality rate : Total 50.73
deaths/1,000 live births
• Number of live births(thousands): 3137.7
• Number of deaths(thousands): 886.2
• Life expectancy : Men 69 years
• Physicians > Per 1,000 people 0.26 per 1,000
people
17. Top 10 Cause of Death
Disease Percentage
Tuberculosis 7.9
Lower respiratory infections 7.8
Chronic obstructive
pulmonary disease
7.6
Ischaemic heart disease 5.7
Strok 5.1
Diabetes mellitus 3.1
Preterm birth complications 2.9
Kidney diseases 2.9
Cirrhosis of the liver 2.3
Birth asphyxia and birth
trauma
2.1
(Source: WHO)
19. • There are few stages of health care system in
Bangladesh. It includes both government and
non government institution which works to
provide health care facilities and to improve
the health condition of our people. These are
–
( 1) Primary level
(2) Secondary level
(3) Tertiary level
20. Primary Level
Community Clinic:
• -Only in village
• -Total 1400 in number
• -Each clinic for six thousand people
• -Limited facilities
Union health and family welfare center:
• -For people of union
• -Limited facilities
• -Gives primary treatment
Upazila health complex:
• -For the people of upazila
• -Called complex since they provide variety of treatment.
21. Secondary level
• District hospitals-
• There are around 50 to 250
beds in such hospitals.
District hospitals
constituted the second level
of health care. There were
14 general hospitals, 43
general district hospitals, 12
tuberculosis hospitals and 1
mental hospital
22. Tertiary Level
• Tertiary level curative care is mostly
provided at national and divisional
levels through large hospitals affiliated
with medical teaching institutions.
• Medical college- It provides a huge
amount of medical facilities. There are
59 Medical colleges (41 of them are
private). along with government
hospitals there are also some non
government hospitals and medical
colleges which provides medical
facilities .
• Research institutions- There are also
many research institutions .
23. Organization of the Health System in
Bangladesh
(Source: Asia Pacific Observatory on Health Systems and Policies)
24. Health Service Delivery Organizational
Structure in Bangladesh
(Source: Asia Pacific Observatory on Health Systems and Policies)
25. NGO Health Programs
• The GOB encourages the involvement of NGOs in
delivering services that address the country’s health
challenges. More than 4,000 NGOs, including
international organizations (i.e., CARE, Save the
Children and World Vision), large national NGOs
(Bangladesh Rural Development Committee (BRAC),
Concerned Women for Family Planning, and the
Grameen Kalyan Health Program), and hundreds of
small, local NGOs are active in the health sector in
Bangladesh .
(Source: Bangladesh Health Facility Survey 2014)
26. Private Health Sector
• The private health sector in Bangladesh includes large and small
commercial companies, professionals (i.e., doctors and individual
providers), and informal providers.
• The private sector includes health services provided at hospitals,
nursing and maternity homes; clinics operated by doctors, nurses,
midwives, and paramedical workers; diagnostic facilities (i.e.,
laboratories and radiology units).
• The sale of drugs from pharmacies, as well as unqualified static and
itinerant drug sellers.
• As of 2013, the DGHS has registered 8,203 private hospitals, clinics,
and diagnostic centers in Bangladesh. There are 2,983 registered
private hospitals and clinics, and 5,220 registered private diagnostic
centers. The total number of beds in the registered private hospitals
and clinics is 45,485 (MIS 2014).
(Source: Bangladesh Health Facility Survey 2014)
27. Health Financing
• Bangladesh spends US$ 2.3 billion on health, or
US$ 16.20 per person per year, of which 64%
comes from out-of-pocket payments. (MOHFW,
2010).
• WHO estimates that currently Bangladesh spends
US$ 26.60 per capita in total.
• Public funds for health are the main prepayment
mechanism for risk-pooling, and constitute 26%
of total health expenditure.
• The other major funding source is international
development partners.
(Source: Health Systems in Transition - Bangladesh Health System Review Vol. 5 No. 3 2015)
28. Physical and Human Resources
• Bangladesh has an extensive PHC infrastructure in the public sector
but these are not adequately provisioned for human and other
resources such as drugs, instruments and supplies.
• During 2007–2013, there has been a steady increase in the number
of both hospitals and total number of beds in the public sector. The
number of beds in PHC facilities at upazila level and below reached
18 880 across 472 facilities in 2013, and 27 053 in 126 facilities at
secondary and tertiary level.
• In the private sector, there were 2983 registered hospital and
clinics, with 45 485 beds.
• There is now one bed for every 1699 population which is still
inadequate.
• Community clinic for every 6000 people providing primary health-
care services.
(Source: Health Systems in Transition - Bangladesh Health System Review Vol. 5 No. 3 2015)
29. Physical and Human Resources (Cont.)
• The Bangladesh health workforce is characterized by
“shortage, inappropriate skill mix and inequitable
distribution” of health workforce.
• At present there are 64434 registered doctors, 6034 dentists,
30516 nurses, and 27000 nurse-midwives in the country.
• In addition, the health workforce is skewed towards doctors
with a ratio of doctors to nurses to technologists of 1:0.4:0.24,
in stark contrast to WHO recommended ratio of 1:3:5.
• The engagement of the health workforce in the private sector
is increasing, as revealed by an estimated 62% of the medical
doctors working in the private sector in 2013.
• The formal health workforce (doctors, dentists, nurses) is
mostly concentrated in the urban areas.
(Source: Health Systems in Transition - Bangladesh Health System Review Vol. 5 No. 3 2015)
30. Public Health Service Delivery
• Provision of public health services, including emerging and
non communicable diseases, is primarily the responsibility of
the Ministry of Health and Family Welfare provided through a
sector wide approach implemented by the Directorate
General of Health Services and Directorate General of Family
Planning.
• The SWAp provides service coordination, curative care, urban
health, NCD/CD care, and more through its Essential Services
Delivery, Operational Plan (ESD OP) (MOHFW, 2011).
• However, with rapid urbanization, addressing health issues in
urban areas is a mounting challenge. Provision of public
health services in the urban areas is a prerogative of the
Ministry of Local Government, Rural Development and
Cooperatives.
(Source: Health Systems in Transition - Bangladesh Health System Review Vol. 5 No. 3 2015)
