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Healthcare in Bangladesh

In Bangladesh, the status of healthcare is similar to the one of many developing countries: medical practitioners in Bangladesh often operate in relative isolation, dealing with diverse healthcare needs. Worldwide there is difficulty in retaining specialists in non-urban areas. The distribution of specialists in Bangladesh is indeed uneven. Tertiary care hospitals are also concentrated within the capital and few other major cities with large segments of the population having no access.

The bulk of the nation's health manpower is under government control because provision of healthcare is government's responsibility. Only in cities and towns there are doctors available in private practice and in recent years, diagnostic services and hospital care have witnessed good growth in the private sector particularly in the capital city of Dhaka and a few other major cities. The bulk of the population living in rural Bangladesh and too poor to afford private medical facilities have to be cared for by government facilities which admittedly are victims of chronic funding and manpower shortage. Most rural hospitals operated by government lack adequate number of doctors and technicians; moreover, the doctors are permitted to engage in private practice which often takes away their time, time that they could otherwise devote to hospital work and medical research. Biomedical research manpower is one of the least developed sectors in the country's health manpower scenario.

The administration of primary healthcare by the Bangladesh government is carried out through a surprisingly extensive infrastructure of facilities within each of the 64 districts. The districts are divided into 460 upazillas (sub-districts) which are subdivided into unions. Each union consists of approximately 25,000 people and health services are directed by the Ministry of Health and Family Welfare (MOHFW).

The new five-year health and population sector programme (HPSP) based on the Health and Population Sector Strategy (HPSS) already under implementation since July 1998 calls for providing an essential service package (ESP) or a community based healthcare scheme to the entire population at four different levels of delivery. The levels are: community out-reaches, health and family welfare centres/rural dispensaries, upazila health complexes as first referral system and district hospital as second referral system

The number of registered doctors in the year 2000 stands at 27,546 for a population of about 130 millions and the number of registered nurses is 15804. In the year 2000, the number of hospital beds was 40,793 of which 29,402 are in the government hospitals. The number of medical colleges in private sectors was 13 and in the public sector it was also 13.





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