Disadvantaged should get better healthcare for Bangladesh to achieve UHC

Those with the greatest need for healthcare in Bangladesh, particularly the poor, are most likely to receive the least benefit, finds a new icddr,b study.

Socioeconomically disadvantaged people most often cannot access services from privately-owned healthcare providers that mainly cater to the needs of the wealthy. This results in inequity in overall healthcare benefits in Bangladesh, which means a lack of fairness regarding how people of different economic status receive healthcare.


icddr,b provides free basic health services at its hospitals across Bangladesh. Photo: icddr,b / Shehzad Noorani


On Universal Health Coverage (UHC) day this year, the findings call for ensuring that the health system, including private sector care, is more equitable so that people from all economic strata can avail health benefits, says Mr Sayem Ahmed, research investigator and a co-author of the study published in Health Policy and Planning.

According to World Health Organization (WHO), UHC means that everyone can access quality health services without financial hardship.

Making healthcare available to all socioeconomic groups is one of the main UHC goals. Dr Jahangir Khan, senior lecturer in health economics at Liverpool School of Tropical Medicine and a co-author of the study says, “UHC is one of the main research themes at icddr,b where researchers have been working closely with the government on health systems, health service utilisation, healthcare cost, financing, policy and governance for achieving UHC in Bangladesh.”


Infographic: WHO


Earlier studies done by icddr,b researchers found that one of Bangladesh’s main challenges in achieving UHC goals was the inability of its health system to provide good quality care or address problems that require more than a basic level of treatment.

Healthcare costs used to be very high around 10 years ago as almost 63.3% of expenditure towards health services in Bangladesh in 2012 were paid out-of-pocket by patients and only 23.3% by the government, according to Bangladesh National Health Accounts Report quoted in a icddr,b study in 2014.

Another more recent study by icddr,b has investigated how different social aspects that are unrelated to health could contribute to health-seeking behaviour of patients in Bangladesh. These factors are important in order to facilitate pathways to healthcare for all and thus achieve UHC goals.

In order to pave a roadmap towards UHC, in 2012 the Ministry of Health and Family Welfare (MOHFW) has developed a 20-year health financing strategy on “Expanding Social Protection for Health: Towards Universal Coverage” in consultation with icddr,b and other stakeholders. Its vision is enabling the entire population of Bangladesh being entitled to public health services and benefiting from increased health.

A declaration by economists from 44 countries, published in the Lancet, reads that every country has the opportunity to achieve UHC. “It is expected that Bangladesh will overcome its challenges related to improving health systems and providing affordable healthcare for all,” says Dr Khan, who is also an adjunct researcher, at Karolinska Institutet, Sweden and associate professor at James P Grant School of Public Health, Brac University, Bangladesh.