The Local Government Division (LGD) plans to extend the government's urban primary healthcare services from city corporations to all municipalities nationwide.
It has sent to the Planning Commission a preliminary development project proposal (PDPP) titled "Urban Primary Health Care Sustainable Project (UPHCSP)" with an estimated cost of Tk 30.89 billion.
Of the amount, the government will provide Tk 6.89 billion, while Tk 24 billion is expected to be managed from the Asian Development Bank (ADB) as loan support.
At present, urban primary healthcare services are focused on city corporations and a few select large municipalities.
LGD officials said the division also sent a copy of the PDPP to the Economic Relations Division (ERD) to expedite the process of loan negotiations with the ADB.
They said the LGD is currently implementing the second phase of the "Urban Primary Health Care Services Delivery Project (2nd Revised)". Its implementation started on April 1, 2018 and is scheduled to finish in December this year.
The ongoing project has a total cost of Tk 12.09 billion, with an annual expenditure of Tk 1.51 billion.
On the other hand, the proposed project set to run from July this year to June 2030 will require an annual budget of Tk 6.18 billion.
The ongoing project is being implemented in 11 city corporations and 18 municipalities covering 17 million people.
Such services were introduced in Bangladesh in July 1998 with the project titled "UPHCP 1st Phase". It was completed in June 2005 in four city corporations at a cost of $60 million and covered 5.2 million people.
The cost of the proposed project is set to reach $256 million, 4.27 times the first one.
The project aims to enhance urban primary healthcare services by increasing access to skilled birth attendants, nutritional screening for children, and modern contraceptive use among women of reproductive age, reveals the documents.
Once it is implemented, births attended by skilled health personnel in urban areas are expected to rise from 63.4 per cent to 70 per cent, while the proportion of under-five children receiving nutritional screening at health centres will increase from 64 per cent to 80 per cent.
Additionally, the project seeks to improve family planning services by raising the use of modern contraceptives among married women from 56.2 per cent to 70 per cent.
A senior LGD official said, "To ensure equitable healthcare access, at least 80 per cent of urban poor households will be properly identified as eligible for free healthcare services."
The initiative also aims to extend public health services to 90 per cent of the urban population, with a strong emphasis on client satisfaction, targeting a 90 per cent approval rate.
Furthermore, the project aims to achieve 70 per cent coverage of the Expanded Programme on Immunisation (EPI), ensuring better healthcare outcomes for children in urban areas.
It will provide a total of 18 types of health-related services, including maternal care (antenatal, delivery, and postnatal), neonatal and child healthcare, reproductive and adolescent health services, and family planning.
It will also address menstrual regulation, post-abortion care, nutrition, communicable and non-communicable disease control, and limited curative care.
Additionally, the programme will offer diagnostic services, behavioural change communication, gender-based violence support, and emergency transportation to ensure accessible and inclusive healthcare for urban population.
Health economist Dr Abdur Razzaque Sarker, senior research fellow at the Bangladesh Institute of Development Studies (BIDS), said the number of people in urban areas is rising faster than that in rural ones.
The majority of these urban people are poor and not capable of receiving healthcare services, he told The Financial Express.
However, the structure of basic health services in rural areas is relatively stronger, thanks to community clinics and union health centres, which are absent in cities, Dr Sarker noted.
He also said increasing the coverage of primary health services in urban areas is necessary, but the initiative should be implemented in co-operation with the health ministry.
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