The government is planning a major overhaul of Bangladesh's healthcare system by shifting its focus from treatment to prevention, with a proposal to establish a Primary Healthcare Unit in every union and urban ward and recruit 100,000 additional community health workers.
The announcement was made on Monday by Dr SM Ziauddin Hyder, special assistant on health affairs to Prime Minister Tarique Rahman, at a national roundtable titled "Integration of Nutrition Actions in Primary Healthcare Systems through Public-Private Platforms in Bangladesh," organised by Max Foundation Bangladesh in Dhaka.
Dr Hyder said Bangladesh has made notable progress in reducing malnutrition and child stunting, but the pace of improvement remains inadequate.
"We have made progress in reducing malnutrition and stunting, but the pace has not been sufficient. We need a stronger, government-led and coordinated approach," he said.
He noted that nutrition programmes in the past were largely driven by development partners and donor agencies, stressing the need for greater government ownership and stronger coordination.
Nationwide primary healthcare network
Under the proposed plan, every union and every ward in city corporations and municipalities will have a Primary Healthcare Unit staffed by nine community health workers.
Bangladesh currently has about 43,000 frontline health workers deployed under various government programmes. The proposed recruitment of 100,000 additional workers would increase the workforce to around 143,000. According to government estimates, around 152,000 community health workers will ultimately be required to provide nationwide coverage.
The community health workers will visit households every two to three months to provide preventive healthcare services, including blood pressure and blood sugar screening, mental health assessments, child growth monitoring, pregnancy detection and referrals to appropriate healthcare facilities when necessary.
The initiative also proposes introducing digital health cards and an electronic referral system to connect patients with integrated health records and healthcare services.
According to Dr Hyder, the programme aims to detect diseases at an early stage, reduce out-of-pocket healthcare costs and ease pressure on overcrowded secondary and tertiary hospitals.
Nutrition to be integrated across sectors
Emphasising the importance of nutrition, Dr Hyder said it should no longer be treated as a standalone health intervention but integrated into agriculture, education, social welfare and other sectors through a coordinated national strategy.
To strengthen institutional coordination, the government is considering establishing a National Food and Nutrition Authority or National Food and Nutrition Commission.
The proposed body would oversee nutrition-related policies, coordinate interventions across ministries, monitor implementation, generate evidence and strengthen institutional capacity.
Calling for collective action, Dr Hyder said improving nutrition outcomes would require close collaboration among the government, academia, civil society, development partners, NGOs and the media.
"We want to build a healthier Bangladesh where no child suffers from stunting and no girl is forced into early marriage or early motherhood," he said.
Experts call for integrated nutrition services
The roundtable brought together senior government officials, representatives of UN agencies and development partners, researchers, academics, civil society organisations and private-sector stakeholders to discuss integrating nutrition services into routine primary healthcare.
Speakers said Bangladesh is facing a triple burden of malnutrition—undernutrition, micronutrient deficiencies, and the rising prevalence of overweight and obesity.
While acknowledging the country's progress in reducing child stunting and improving maternal and child health, they noted that nutrition services remain fragmented and are often delivered through vertical programmes rather than being fully integrated into primary healthcare.
Participants called for stronger public-private partnerships to improve service delivery, strengthen referral systems, enhance supply chains, promote behaviour change and generate evidence to support policymaking.
They also stressed the need to institutionalise community-based nutrition interventions within government systems to improve the quality, accessibility and sustainability of primary healthcare services.
The discussion concluded with a call for stronger coordination among government agencies, development partners, research institutions, civil society organisations and the private sector to make nutrition a core component of Bangladesh's primary healthcare system and national health planning.
Prof Dr Pravath Chandra Biswas, director general of the Directorate General of Health Services (DGHS), attended the event as the special guest. The keynote paper was presented by Saiqa Siraj, Public Health and Nutrition Specialist, while the session was chaired by Dr ATM Tariqul Islam, country director of Max Foundation Bangladesh.
Senior officials from the Health Services Division, the Institute of Public Health Nutrition (IPHN), DGHS, Dhaka University, icddr,b, BRAC James P Grant School of Public Health, GAIN, WHO, UNICEF, Social Marketing Company and several other organisations also participated.