Healthcare Scenario of Bangladesh

Are you planning to build or restructure or venture in any healthcare venture in Bangladesh? Looking for information about the major healthcare players in Government, Private diagnostic centers that are available in Bangladesh? Are you looking to find out which part of the of the city’s is best to venture in or what all facilities are available and what all should be planned for new setup? In this article Hospaccx Healthcare Consultancy has mapped all on major players in terms of medical facilities and healthcare scenario in Bangladesh.

Below is the superficial and macro level survey if you need a refined market and financial feasibility or any other study related to healthcare is required you can contact Hospaccx Healthcare business consulting Pvt. ltd on [email protected] or [email protected] Or you can visit our website on www.hhbc.in

Overview

Bangladesh is a developing country .Bangladesh officially the People's Republic of Bangladesh, is a country in South Asia. It shares land borders with India and Myanmar. Bangladesh is the world's eighth most populous country. Dhaka is its capital and largest city. Bangladesh forms the largest and easternmost part of the Bengal region.

Most of Bangladesh is covered by the Bengal delta, the largest delta on Earth. Bengalis, who speak the official Bengali language, make up 98% of the population. Bengali Muslims make the nation the world's third largest Muslim-majority country. Islam is the official religion of Bangladesh.

Bangladesh Taka is the currency of the Bangladesh.

Bangladesh is the seventh-largest natural gas producer in Asia.

Population Mix

In 2011 the population of Bangladesh was 144,043,697; of which 72,109,796 were males and 71,933,901 were females.

Life expectancy at birth (2017) was 71.6years, male 70.3 years and female 72.9 years. 

In 2017, Birth rate and Death rate was 18.80 births/1000 population and 5.40 deaths/1000 population respectively.

Sex ratio was 970 per 1000 males.

Child sex ratio was 1040 per 1000 males.

Literacy Rate is 72.76% ; Female literacy rate was 69.90% and male literacy rate was 75.92%(2016) Compared to the rest of countries is number 114 in the ranking of literacy rate.

Mortality Rate of Bangladesh -2016

The Adult female and male mortality rate was 106.7 and 147.9 per 1000 individuals respectively. Infant mortality rate was 28.2 per 1000 live births, neonatal and child under 5 age mortality rate was 20.1 and 34.2 per 1000 live births respectively. Maternal mortality ratio was 196 per 100000 live births.   

Bangladesh Medical and Dental Council registered health workforce 2012

Source: Bangladesh Health Bulletins 1997, 2007, 2012

Connectivity

Air

Bangladesh has a number of airports: three international and several domestic and STOL (short takeoff and landing) airports. The busiest, Shahjalal International Airport connects Dhaka with major destinations.

Vulnerabilities

The majority of the territory is a low-lying delta plain traversed by an extensive network of large and small rivers vital to the socioeconomic life of the nation, with hilly areas scattered in the north and east. Bangladesh is known as the worst victim of the direct and indirect effects of global climate change. The country faces a number of natural disasters on a regular basis, chiefly floods, cyclones and tidal bores.

Economy

The market-based economy of Bangladesh is the 43rd largest in the world in nominal terms, and 30nd largest by purchasing power parity. Bangladesh's economy is the second fastest growing major economy of 2016, with a rate of 7.1%. Dhaka and Chittagong are the principal financial centers of the country

Growth Plans of Bangladesh

Padma Bridge

It is a multipurpose road-rail bridge across the Padma River under construction in Bangladesh. It will connect Louhajong, Munshiganj to Shariatpur and Madaripur, linking the south-west of the country, to northern and eastern regions. The project marked 65 percent progress in constructing approach roads at Jajira, 73 percent at Mawa, main bridge and river training, 21 percent. 

Metro Rail

20-km, Metro Rail project to be completed in 2020. The project covers the area from Uttara North to Agargaon and between Agargaon to Motijheel.

Rooppur Nuclear Power

 The 2400 megawatt nuclear power plant is under construction at Rooppur (Rupppur), adjoining Paskey, in the Ishwardi Upazila of Pabna District, on the bank of the river Padma, 87 miles (140 km) west of Dhaka, in the northwest of the country.

Rampal Power Project

The Rampal power station is a proposed 1320 megawatt coal-fired power station at Rampal Upazilaof Bagerhat District in Khulna, Bangladesh. It is a joint partnership between India.

Deep Sea Ports

 Deep water port has been planned in the area which will serve southern Bangladesh, as well as neighboring countries like Nepal and Bhutan. Project is expected to complete by 2023.

Matarbari 1,200mw Coal Power Project

The government's Coal Power Generation Company has acquired 1500 acres of land for the project. Project to complete by 2022.

Healthcare Scenario of Bangladesh

The health system of Bangladesh is a pluralistic system with four key actors that define the structure and function of the system: government, private sector, nongovernmental organizations (NGOs) and donor agencies.

The Government or public sector is the first key actor which by constitution is responsible not only for policy and regulation but for provision of comprehensive health services, including financing and employment of health staff.

The Ministry of Health and Family Welfare, through the two Directorates General of Health Services (DGHS) and Family Planning (DGFP), manages a dual system of general health and family planning services through district hospitals, Upazila Health Complexes (with 10 to 50 beds) at subdistrict level, Union Health and Family Welfare Centres at union level, and community clinics at ward level.

In addition, the Ministry of Local Government, Rural Development and Cooperatives manages the provision of urban primary care services.

Quality of services at these facilities, however, is quite low due to insufficient allocation of resources, institutional limitations and absenteeism or negligence of providers.

Dual practice by physicians in the public sector is a common behaviour in Bangladesh.

Diseases

According to the Bangladesh Maternal Health Services and Maternal Mortality Survey (BMMS), major direct causes of maternal deaths in Bangladesh include postpartum haemorrhage, eclampsia, obstructed or prolonged labor, complications of unsafe abortion, and other direct and indirect causes. significant progress in improving child health has reduced the child mortality rate.

Simultaneously with the demographic transition, Bangladesh is undergoing a health transition and manifesting the double burden of disease (the combination of communicable and noncommunicable diseases). NCDs such as asthma and COPD, stroke/paralysis, heart disease, hypertension, diabetes, drowning, accident/injuries, and cancers were amongst the top 20 causes of death

The National Institute of Cancer Research and Hospital (NICRH), the national and referral centre for cancer treatment in Bangladesh, reported that the most frequently cancer-affected organs among their male patients were lungs (27.1%), lymph nodes (9.6%), and oesophagus (6.15%), while for females the most frequently cancer-affected organs were breast (26.3%), cervix (21.1%) and lymph nodes and lymphatics (5.2%).

The estimated prevalence of diabetes is at 6.9%, with the vast majority being Type 2 diabetes. The International Diabetes Federation estimates that by 2025, 7.4 million people in Bangladesh will have diabetes, placing Bangladesh among the top ten countries for number of people living with diabetes.

Bangladesh has one of the highest fatality rates internationally due to motor vehicles.

Mental health: There is no specific authority or commission to operate or supervise the mental health service nationwide and no day treatment facilities for mental health care either. There is only one mental hospital available in the country for a total of 0.4 beds per 100,000 population. So, most of the patients seeking mental health care are managed in the usual health care service delivery system. Depression, schizophrenia and mood disorders are the most prevalent mental disorders there.

Distribution of health workforce

The existing health workforce in Bangladesh is very inequitably distributed. All significant health institutions are located in the capital city which shows great centralization, while health workers are concentrated in urban secondary and tertiary hospitals, although 70% of the population lives in rural areas. The overwhelming urban bias of the distribution of qualified professionals remains a persistent phenomenon. They are mainly concentrated in the urban areas, and disproportionately in Dhaka division including the capital city.

On the other hand, unqualified/semiqualified allopathic practitioners such as village doctors and Community Health Workers (CHWs) are mainly concentrated in rural areas. Drug shop attendants are evenly distributed. There are also the usual stock of traditional healers and trained/traditional birth attendants in rural areas.

Distribution of Beds in Secondary and Tertiary Public Health Organizations - 2013

Distribution of Beds in Public Sector at Upazila Level and Below - 2013

The number of hospital beds indicates resources available for delivering care to patients admitted to hospitals. A more recent estimate reported by the government is that on average there is one bed for every 1699 people which is quite inadequate (2013). The public sector health facilities in Bangladesh are poorly equipped with medical devices, instruments and supplies.

Health system organization in Bangladesh

Public sector health services

The Ministry of Health and Family Welfare has an extensive health infrastructure. The service delivery structure follows the country’s administrative pattern, starting from the national to the district, upazila, union and finally to the ward levels. It provides promotive, preventive, and curative services such as outdoor (outpatient), indoor (inpatient), and emergency care at different levels – primary, secondary and tertiary.

Private sector health services

In the private sector, providers can be grouped into two main categories. First, the organized private sector (both for-profit and nonprofit) which includes qualified practitioners of different systems of medicine. Apart from modern medicine, traditional medicine is widely practiced in the private sector. Second, the private informal sector, which consists of providers not having any formal qualifications such as untrained allopaths, homeopaths, kobiraj, etc., known as Alternative Private Providers

Diagnostic Center

Along with private clinics and hospitals, the number of diagnostic centres in the private sector is growing. There are some large diagnostic centers in the cities (Lab-aid, Popular Diagnostics) providing laboratory and specialized radiological tests.

Government Hospitals in Bangladesh

Comilla Medical College and Hospital

205 bedded hospital established in 1979.

M Abdur Rahim medical college Hospital

It is one of the largest hospitals in the Northern part of Bangladesh. It is a 500-bed teaching hospital. There are 17 operation theatres in the hospital, of which, 12 are general, two emergency, one labour and two daily.

Medical College for Women and Hospital

Established in 1992, 500 bedded hospital.

Chittagong Medical College and Hospital

200 bedded Chittagong General Hospital established in 1901.

Private Hospitals in Bangladesh

Square Hospital

Located in the middle of Dhaka, this hospital serves patients with number of foreign institutes which work efficiently. It is spread across 18 stories with around 320 beds.

 Apollo Hospital

This hospital is a part of the famous global firm which runs Apollo hospitals in many countries. It is located in Dhaka and accredited by the world class JCI. It has the capacity to have 450 beds and provides medical services in many domains.

 Labaid Hospital

One of the very famous hospitals run by the Labaid Group, this has created a revolution in cardiac treatment in Bangladesh. It is located in Dhaka with specialized facilities to treat various kinds of ailments.

 Ibn Sina Hospital

This hospital was established in the year 1983, in a small mode. Since then, it has grown to the current position providing medical services in many areas, using top class facilities

Popular Hospital

This is a hospital attached to the “Popular Medical College” in Dhaka. It has a dedicated treatment center as well as a world class lab.

 Birdem Hospital

Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, shortly Birdem is a comprehensive health care provider located in the city of Dhaka. 

 BSMMU Hospital

Bangabandhu Sheikh Mujib Medical University, shorting BSMMU has this attached hospital which is located in Dhaka. This 10 storied building provides a casualty department, along with many specialized treatment centers

Single Specialty Hospitals

National Institute of Kidney Diseases and Urology

The hospital provides treatment facilities to the patients with kidney and urology diseases, dialysis and transplantation. The hospital is financed by Government of People’s Republic of Bangladesh. 

National Institute of Neurosciences & Hospital

It started its journey from September, 2012. 350 bedded hospital is situated in the health hub of Sher-e-Bangla Nagar, Dhaka. This is the only Govt. run tertiary care neuroscience center in Bangladesh. 

Medical Colleges in Bangladesh

1. Monno Medical College & Hospital, Dhaka 

It is a non-profit private medical college in Bangladesh which was established in 2011. It is affiliated with University of Dhaka.

2. Dhaka National Medical College (Oldest College)

It is an educational institution in Dhaka, Bangladesh. It was founded in 1925 as the Dhaka National Medical Institute which was then situated near Bahadur Shah Park.

3. Southern Medical College & Hospital (SMCH), Chittagong

It was established in 2005 aiming to give nation a group medical graduates. 

4. Khwaja Yunus Ali Medical College

It came into existence in the year 2005. The college has got a 500 (five hundred) bedded sophisticated teaching hospital providing all kind of medical services. This college is affiliated with the Rajshahi University.

5. Bangladesh Medical College, Dhaka 

It was established in 1986, The College is affiliated with the Dhaka University as a constituent college since 10 May 1988. Recognized by WHO.

Diagnostic centers in Bangladesh

IBN-Sina Medical Imaging Center

It was one of the largest diagnostic center in Bangladesh. It was established on May 1st, 1981 

Lab Aid Diagnostic Center Ltd.

It has been in existence since 1989. s

Life Diagnostic Center

The medical centers providing the services in Dhaka are fully equipped with modern Medical Check-up facilities and technologies are as per requirements of G.C.C (Gulf Co-operation Council).

Conclusion

Bangladesh has made enormous progress in healthcare. But mortality rate is still quite high, there are emerging and re-emerging infectious diseases in the country. The poor governance, inadequate health resources, disproportionate health service coverage impact on quality of care. These are number of factors that hinder the healthcare improvement and which makes it a needy nation in healthcare sector.

Due to a critical shortage of qualified healthcare providers and the costs of medical care, a large proportion of poor patients seek treatment from informal providers who are mostly untrained.

Rural area that has major population has insufficient number of hospitals. There are needs of fully equipped hospitals in rural areas with trained medical workers to provide them quality service at affordable price. Co-ordination across systems delivering health services needs to be improved in order to expand the service coverage across all segments of the population.