Bangladesh’s healthcare sector faced another challenging year in 2024, with ongoing issues of corruption, inadequate services, and public dissatisfaction continuing to dominate headlines. Despite repeated calls for reform and efforts to improve the system, the healthcare crisis remained unresolved, affecting millions across the country.
The year saw significant unrest in the sector, especially after the fall of the Awami League government on August 5. Protests erupted as healthcare workers demanded fair treatment and better working conditions, but their grievances reflected only part of the larger systemic challenges. Patients, rights activists, and experts voiced concerns over the lack of progress in delivering quality healthcare and reforming the broken system.
Continued Calls for Reform
Advocates for healthcare reform emphasized the need for urgent changes, including legal updates, accountability, transparency, and a comprehensive master plan to address inefficiencies. Many stressed the importance of increased funding for healthcare infrastructure and services.
According to Syed Abdul Hamid, a professor at Dhaka University’s Institute of Health Economics, the student-led movement in July 2024 provided an unprecedented opportunity to fix systemic issues. However, there has been no visible improvement in healthcare delivery since then. Hamid highlighted the recommendations of the Health Sector Reform Commission, including ensuring patient safety, protecting healthcare providers, and implementing long-term policy changes.
A Troubled Start to the Year
The beginning of 2024 was marked by tragic incidents involving alleged maltreatment in healthcare facilities, leading to the deaths of several patients, including children. Public outcry prompted the Directorate General of Health Services (DGHS) to take action, shutting down nearly 1,600 hospitals and clinics in a massive month-long drive.
However, insiders revealed that many of these facilities, closed for failing to comply with regulations, resumed operations without addressing their shortcomings. This raised concerns over enforcement and accountability within the sector.
Rural Challenges in Focus
For residents in rural areas, accessing quality healthcare remains particularly difficult. Runa Khatun, a resident of Sadullapur in Gaibandha district, described how government-run hospitals often lacked doctors, forcing patients to seek treatment at private clinics. This reflects a broader divide between urban and rural areas, where city dwellers generally have better access to medical services.
Janaastha Sangram Parishad convener Faizul Hakim Lala echoed these concerns, urging authorities to address inequities in healthcare access. He emphasized the importance of ensuring doctors are present at their assigned locations, removing political influences from staffing decisions, and decentralizing healthcare services.
Lala also stressed the need for training more healthcare professionals—doctors, nurses, and technicians—to meet the growing demand for medical care across the country.
A System Without a Plan
Public health campaigner Lenin Choudhury criticized the DGHS for lacking a comprehensive strategy to address Bangladesh’s healthcare needs. He pointed out that the DGHS, one of the country’s oldest government institutions, continues to operate on an ad hoc basis without clear long-term goals.
Choudhury underscored the importance of building a healthcare system that incorporates promotive, preventive, curative, rehabilitative, and palliative care. He also called for the proper implementation of promised initiatives, such as the government’s commitment to establish 10-bed ICU facilities in every district—a goal that remains far from realization.
Burden of Healthcare Costs
While healthcare availability is a significant concern, affordability is another major issue for many Bangladeshis. Rights activists noted that healthcare services remain out of reach for a large portion of the population due to high costs associated with medicines, diagnostics, and treatment.
According to the Bangladesh National Health Account, out-of-pocket healthcare expenses accounted for 73% of total healthcare spending in 2021, up from 68.5% in 2020. This financial strain disproportionately affects lower-income families, with many forced to make difficult choices between healthcare and other necessities.
Experts also pointed out the government’s lack of control over the pricing of essential medicines and medical equipment, leaving manufacturers free to set prices as they see fit. This has added to the challenges faced by patients in accessing necessary treatments.
What Lies Ahead for 2025?
Despite the challenges, there is a glimmer of hope that 2025 could bring meaningful change to Bangladesh’s healthcare sector. Experts, activists, and citizens alike continue to push for structural reforms, better regulation, and a focus on equitable healthcare delivery. From decentralizing services to ensuring accountability and transparency, the path forward requires bold decisions and committed leadership.
As the country looks to the future, one question looms large: Can Bangladesh finally turn the corner and build a healthcare system that works for everyone, regardless of their income or location?
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