Bangladesh's health sector not patient-friendly: Hossain Zillur

Bangladesh's healthcare system is not patient-friendly and needs urgent reform to better serve patients, said Hossain Zillur Rahman, executive chairman of the Power and Participation Research Centre (PPRC).

"The main weakness of the country's health sector is the lack of coordination, which often leaves patients confused and forces them to move from one facility to another in search of care," he said at a high-level policy dialogue on the Draft Primary Health Care Law Review at the Dhaka Reporters Unity today (5 February).

To address this inefficiency, he stressed the need for a well-planned referral system to ensure patients receive timely and appropriate treatment.

While Bangladesh has built an extensive health infrastructure, its functional capacity remains weak, Zillur said.

"A 500-bed hospital often delivers services equivalent to just 50 beds," he said, arguing that investment in skilled human resources and leadership is more critical than large-scale construction projects.

Warning that neglect of the health sector would undermine economic growth, Zillur said a significant number of people fall into poverty every year due to high out-of-pocket medical expenses.

Referring to the 2024 student-led public movement, he said, "Healthcare inequality has emerged as one of the main drivers of overall inequality in the country.

"Healthcare should not be treated merely as a project but embraced as a social initiative through wider social mobilisation."

He urged parties to prioritise primary health care, school health programmes and water, sanitation and hygiene (WASH) initiatives in their election manifestos, rather than focusing on large development symbols.

Expressing deep concern over unethical commercialisation in the health sector, he said, "The rate of unnecessary caesarean deliveries in Bangladesh has reached 70%," and urged the government to take a firm stance to stop such practices.

The dialogue was organised by PPRC and the UHC Forum with support from Unicef.

Md Aminul Hasan, member secretary of the UHC Forum, cited Thailand's universal health coverage model as an example of strong political ownership.

"Under Thailand's Universal Coverage Scheme, patients' out-of-pocket expenses have fallen from 50% to 10%. Bangladesh also needs firm political commitment to ease the financial burden on patients," he said.

Former director general of the Directorate General of Health Services MA Faiz said Bangladesh's health sector is currently unstructured and disorderly, warning that expanding infrastructure alone has failed to ensure quality care.

"Despite having more than 116 medical colleges, we are still failing to produce competent doctors. Without skilled management and capable leadership, this crisis cannot be addressed, and the medical education system itself needs fundamental reform," he said.

Doctors Association of Bangladesh Secretary General Md Zahirul Islam Shakil said there had been little visible progress on key health reforms despite proposals being submitted to the reform commission.

"Grassroots healthcare has nearly collapsed due to a shortage of over 100,000 personnel. In many upazilas, two or three doctors cannot serve 400 to 500 patients a day," he said.

Representatives from political parties, academia, the government, civil society, development partners and the media took part in the dialogue.