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Dhaka Tribune

Focus on the urban poor

Prioritizing universal health coverage and urban health system in Bangladesh

Update : 10 May 2023, 05:57 AM

Universal health coverage (UHC) is a fundamental principle aimed at providing equitable access to quality healthcare services without causing financial strain on individuals and communities. For a country like Bangladesh, which faces various health challenges, achieving UHC is of paramount importance, particularly for the urban poor.

In urban areas, where population density is high and poverty is concentrated, ensuring access to healthcare services is a critical challenge. The urban poor often face barriers such as limited financial resources, lack of awareness, and inadequate healthcare infrastructure. UHC in urban settings must focus on overcoming these challenges by strengthening healthcare infrastructure, expanding coverage, and improving service quality.

Over the past few decades, Bangladesh has undergone a remarkable process of urbanization, with cities and towns experiencing rapid growth. However, this urban expansion has brought forth a range of challenges, particularly in the realm of healthcare delivery.

The urban health landscape in Bangladesh is marked by distinct issues that require immediate attention. Urban areas face a multitude of health concerns, stemming from factors such as overcrowding, substandard sanitation infrastructure, environmental pollution, and limited access to crucial services, including healthcare facilities.

These challenges are especially pronounced among the impoverished population residing in slums and informal settlements, where essential amenities and healthcare services are often lacking. The overcrowded living conditions and inadequate sanitation facilities in these areas create fertile grounds for the spread of infectious diseases. Furthermore, the absence of accessible and affordable healthcare exacerbates the vulnerability of the urban poor, leading to poorer health outcomes and heightened financial burdens.

To address these pressing issues, it is imperative for Bangladesh's healthcare system to prioritize urban health and invest in infrastructure development, including the establishment of well-equipped healthcare facilities in urban areas. Additionally, efforts should be directed towards improving sanitation infrastructure, promoting environmental sustainability, and implementing targeted healthcare initiatives to ensure equitable access to quality services for the urban poor.

By addressing the unique challenges of urban health and directing resources towards the most vulnerable populations, Bangladesh can take significant strides towards achieving universal health coverage and improving the overall well-being of its urban communities.

Universal health coverage (UHC) is of utmost importance in tackling healthcare disparities in urban areas of Bangladesh. It serves as a critical mechanism to ensure equitable access to healthcare services, leaving no one behind. UHC goes beyond mere access, aiming to provide a comprehensive package of essential health services that encompasses preventive, curative, rehabilitative, and palliative care.

By implementing UHC, individuals and communities in urban areas can receive the care they need without facing financial burdens. This inclusive approach is vital for addressing the healthcare challenges faced by the urban population and promoting a healthier and more equitable society.

Several challenges hinder the achievement of UHC for the urban poor in Bangladesh. Firstly, there is a shortage of healthcare facilities in urban areas, leading to overcrowding and limited availability of services. Additionally, the cost of healthcare, including out-of-pocket expenses, remains a significant burden for the poor population. Inadequate health infrastructure, coupled with a shortage of healthcare professionals, exacerbates these challenges. Furthermore, the lack of awareness and low health literacy among the urban poor impede their ability to access and utilize healthcare services effectively.

Bangladesh has made commendable efforts to overcome challenges and make significant progress in achieving Universal Health Coverage (UHC) in urban areas, with a particular emphasis on addressing the healthcare needs of the poor. The government has implemented a range of programs and policies to expand access to healthcare services and ensure equitable healthcare provision.

One notable initiative is the Urban Primary Health Care Services Delivery Project, which has played a vital role in improving healthcare delivery in urban areas. This project focuses on strengthening primary healthcare services, enhancing infrastructure, and deploying trained community health workers to provide essential healthcare services to underserved populations.

Additionally, the Urban Health Equity Strategy has been instrumental in addressing the healthcare disparities faced by slum-dwelling populations in urban areas. This strategy aims to bridge the gaps in healthcare access by providing services at affordable rates or free of charge, ensuring that the urban poor can avail themselves of necessary healthcare without facing financial hardship.

These efforts collectively contribute to the advancement of UHC in urban areas, ensuring that even the most vulnerable populations have access to essential healthcare services. Numerous NGOs, civil society organizations, and community-based initiatives have played a pivotal role in supporting healthcare services for the urban poor. These organizations work closely with communities to address their healthcare needs, enhance health literacy, and facilitate access to services.

Additionally, collaborations between the government, private sector, and international development partners have contributed to the overall progress of UHC in urban Bangladesh.

Universal health coverage is a vital goal for ensuring the well-being of the urban poor in Bangladesh. By addressing the unique healthcare challenges faced by the population of urban poor, UHC can play a transformative role in improving health outcomes and reducing disparities.

To achieve UHC in urban areas, it is imperative to strengthen health systems, increase investment in healthcare infrastructure, enhance human resources for health, and promote community engagement. By doing so, Bangladesh can pave the way for a more inclusive and equitable healthcare system, ensuring that no one is left behind in the pursuit of better health.

Prioritizing UHC for the urban poor will not only improve their health outcomes but also contribute to the overall development and prosperity of the nation. Only through concerted efforts and collaborations among the government, healthcare providers, NGOs, and the community can universal health coverage (UHC) become a reality for the urban poor in Bangladesh, empowering them to lead healthier and more prosperous lives.


Dr Md Shamim Haider Talukdar is CEO, Eminence Associates for Social Development and Consultant, UNICEF. Shuhail Hussain is Research Assistant, Eminence Associates for Social Development.

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