Prioritise health sector reforms
Our health sector is in a fragile state, marked by service disruptions, weak governance, shortages of manpower, and high costs of care. People continue to suffer from limited access to quality services, particularly at the primary level, while preventable illnesses and systemic inefficiencies take a heavy toll on ordinary people. This has resulted from decades of neglect by successive governments. With the election less than a month away, we hope to see clear commitment from political parties in their manifestos to ensure affordable, accessible and quality healthcare for all.
Years of underinvestment, weak governance, shortages of skilled health workers, and policy inconsistency have left millions of people in Bangladesh without reliable access to healthcare. Out-of-pocket health expenditure remains among the highest in the region, pushing countless families into poverty or forcing many to avoid treatment altogether. The recent rise in the total fertility rate, the first in five decades, has further exposed setbacks in preventive and reproductive healthcare. At the core of these failures lies inadequate primary healthcare. Despite being the most cost-effective way to protect households from catastrophic medical costs, primary care remains weak and underfunded, particularly in urban areas. Experts emphasise that primary healthcare must be prioritised everywhere, with doctor-led teams serving defined populations to ensure no one is excluded. Equally important is the integration of health into all government policies.
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The Health Sector Reform Commission’s recommendations offer a clear roadmap out of this crisis. Declaring primary healthcare a constitutional obligation, providing services free at the point of use, and reorganising the system under separate clinical, academic, and public and primary healthcare directorates could improve coordination, accountability, and service delivery. However, political commitment and timely implementation of these recommendations are essential for real change.
Finance is also a major challenge to this end, with experts calling for increasing health spending to at least 15 percent of the national budget or five percent of gross national income. Ensuring full and efficient utilisation of allocated funds is just as crucial, and so is reducing out-of-pocket expenditure. Public hospitals must be made fully functional by improving governance and manpower planning, while private facilities should be brought under effective accreditation and oversight. We urge the political parties to prioritise these issues in their election manifestos and call on the next government to act decisively on these proposals to ensure quality, affordable healthcare for all.
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