Healthcare confidence erodes amid systemic weaknesses

Bangladesh's healthcare system continues to face mounting pressure from low public spending, rising treatment costs and slow adoption of modern technologies, experts and stakeholders said on Saturday.
These systemic shortcomings that also include weak regulation and shortages of skilled professionals, they warned, have steadily eroded public confidence in healthcare services across both public and private facilities.
Restoring trust will require stronger governance, effective enforcement of existing policies, expansion of primary healthcare, wider digitisation and closer collaboration between the public and private sectors, they stressed.
Without coordinated reforms, the gap between public expectations and service delivery is likely to widen further.
The observations were made at a seminar titled "Strengthening Confidence in the Healthcare System in Bangladesh: A Strategy for Quality Assurance", organised by the Dhaka Chamber of Commerce & Industry (DCCI) at its auditorium in Dhaka.
National Professor A K Azad Khan, president of the Diabetic Association of Bangladesh, attended the event as the chief guest.
In his welcome remarks, DCCI President Taskeen Ahmed said structural gaps persist in ensuring quality and patient-friendly healthcare services in the country.
He highlighted stark disparities in service quality between public and private hospitals, shortages of skilled manpower, the proliferation of unauthorised clinics and pharmacies, inaccurate diagnostic reports, counterfeit medicines and weak regulatory oversight.
Limited use of modern medical technologies and poor implementation of existing laws, he added, continue to undermine public health security and erode trust in the system.
To ensure a sustainable healthcare sector, Mr Ahmed stressed the need for foreign investment, strengthened public-private partnerships, adoption of modern medical technologies, development of skilled professionals in nursing, laboratory sciences and health management, and more effective policy implementation and management.
Prof A K Azad Khan acknowledged Bangladesh's notable achievements in healthcare but said desired quality standards have yet to be achieved.
To bridge this gap, he called for stronger government involvement and observed that healthcare quality in Bangladesh lags behind that of developed countries and even several neighbouring nations.
While establishing universal healthcare may not be feasible at present, he stressed the importance of strengthening primary healthcare. Alongside improvements in overall management, decentralisation is crucial for improving service delivery, he said.
He also underscored the need to expand digital healthcare to improve rural access, modernise medical education curricula and create a more conducive environment for medical research.
In his keynote speech, Malik Talha Ismail Bari, Managing Director and CEO of United Hospital Limited and former senior vice-president of DCCI, said the government's per capita annual health expenditure stands at Tk 1,070.
Citing World Health Organization data, he noted that nearly 49 per cent of the population remains deprived of quality healthcare services.
Mr Bari said the sector's current market size is estimated at around $14 billion and is projected to reach $23 billion by 2033.
However, low budget allocations, inefficient management, urban-rural disparities in access, gaps in service quality and public trust, shortages of skilled professionals, rising costs, inadequate infrastructure and weak regulatory systems remain major challenges.
To improve the situation, he emphasised the need to attract both local and foreign investment and simplify access to financing.
Professor Syed Atiqul Haq, Chief Consultant at Green Life Centre for Rheumatic Care and Research, said that since most citizens rely on public hospitals, there is no alternative to ensuring the highest quality standards in government healthcare facilities, along with transparency and accountability at all levels.
Priti Chakraborty, Chairman of Universal Medical College & Hospital, said the domestic healthcare market is steadily expanding, but restoring trust will require concerted efforts from both the government and the private sector.
Dr Shafiun Nahin Shimul, Professor and Director at the Institute of Health Economics, University of Dhaka, said negative public perceptions have contributed to declining confidence in the healthcare sector.
Wider digitalisation and use of technology, he added, could help rebuild patients' trust.
Dr Md Zakir Hossain, Secretary General of the Bangladesh Association of Pharmaceutical Industries, said 97 per cent of medicines are produced locally and exported to 160 countries, reflecting international confidence in Bangladesh's pharmaceutical products.
However, he noted that despite having a national health policy since 2011, no update has been made in the past 14 years.
Dr Md Mustafizur Rahman, Senior Scientist at the Infectious Diseases Division of icddr,b, said the organisation provides diarrhoeal care to nearly 300,000 patients annually and that its service model could be replicated elsewhere.
Dr Fida Mehran, Health Systems Specialist at UNICEF Bangladesh, and Dr Murad Sultan, National Professional Officer for Patient Safety and Blood Safety at the World Health Organization (WHO) Bangladesh, both stressed that effective public-private collaboration, restoration of trust in domestic healthcare services, reform of service delivery processes and enforcement of appropriate policies are critical to strengthening the healthcare system.

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