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Financing health care in Bangladesh: Policy responses and challenges towards achieving universal health coverage

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  • Shah Mohammad Fahim
  • Tofayel Ahmed Bhuayan
  • Md. Zakiul Hassan
  • Abu Hena Abid Zafr
  • Farhana Begum
  • Md. Mizanur Rahman
  • Shahinul Alam

Abstract

Bangladesh has attained notable progress in most of the health indicators, but still, health system of the country is suffering badly from poor funding. Issues like burden of out‐of‐pocket expenditure, low per capita share in health, inadequate service facilities, and financial barriers in reducing malnutrition are being overlooked due to inadequacy and inappropriate utilization of allocated funds. We aimed to review the current status of health care spending in Bangladesh in response to national health policy (NHP) and determine the future challenges towards achieving universal health coverage (UHC). National health policy suggested a substantial increase in budgetary allocation for health care, although government health care expenditures in proportion to total public spending plummeted down from 6.2% to 4.04% in the past 8 years. Overall, 67% of the health care cost is being paid by people, whereas global standard is below 32%. Only one hospital bed is allocated per 1667 people, and 34% of total posts in health sector are vacant due to scarcity of funds. The country is experiencing demographic dividend with a concurrent rise of aged people, but there seems no financial protection schemes for the aged and working age populations. Such situation results in multiple obstacles in achieving financial risk protection as well as UHC. Policy makers must think effectively to develop and adapt systems in order to achieve UHC and ensure health for all.

Suggested Citation

  • Shah Mohammad Fahim & Tofayel Ahmed Bhuayan & Md. Zakiul Hassan & Abu Hena Abid Zafr & Farhana Begum & Md. Mizanur Rahman & Shahinul Alam, 2019. "Financing health care in Bangladesh: Policy responses and challenges towards achieving universal health coverage," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 11-20, January.
    • Handle: RePEc:bla:ijhplm:v:34:y:2019:i:1:p:e11-e20
    DOI: 10.1002/hpm.2666
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    References listed on IDEAS

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    1. Haddad, Lawrence James & Smith, Lisa C., 2000. "Explaining child malnutrition in developing countries: a cross-country analysis," Research reports 111, International Food Policy Research Institute (IFPRI).
    2. Nazmul Chaudhury & Jeffrey S. Hammer, 2004. "Ghost Doctors: Absenteeism in Rural Bangladeshi Health Facilities," The World Bank Economic Review, World Bank, vol. 18(3), pages 423-441.
    3. Vanessa M. Oddo & Jee H. Rah & Richard D. Semba & Kai Sun & Nasima Akhter & Mayang Sari & Saskia de Pee & Regina Moench-Pfanner & Martin Bloem & Klaus Kraemer, "undated". "Predictors of Maternal and Child Double Burden of Malnutrition in Rural Indonesia and Bangladesh," Mathematica Policy Research Reports b5458d06d27e4079bf5d955b3, Mathematica Policy Research.
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    1. Afroza Begum & Syed Abdul Hamid, 2021. "Impoverishment impact of out-of-pocket payments for healthcare in rural Bangladesh: Do the regions facing different climate change risks matter?," PLOS ONE, Public Library of Science, vol. 16(6), pages 1-21, June.
    2. Md Abdullah Saeed Khan & Md Toufiq Hassan Shawon & Atonu Rabbani, 2025. "Citizens’ feedback on health service and the responses of health authorities of Bangladesh: An analysis of the Grievance Redress System," PLOS Digital Health, Public Library of Science, vol. 4(7), pages 1-12, July.
    3. Maria-Carmen García-Centeno & Román Mínguez-Salido & Raúl del Pozo-Rubio, 2021. "The Classification of Profiles of Financial Catastrophe Caused by Out-of-Pocket Payments: A Methodological Approach," Mathematics, MDPI, vol. 9(11), pages 1-20, May.
    4. Masoud Behzadifar & Maryam Saran & Meysam Behzadifar & Mariano Martini & Nicola Luigi Bragazzi, 2021. "The ‘Health Transformation Plan’ in Iran: A policy to achieve universal health coverage in slums and informal settlement areas," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(2), pages 267-272, March.

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