In Bangladesh, nearly 46.2 lakh people -- 2.8% of the population -- live with some form of disability (BBS, 2021). Yet, for them, healthcare remains not just difficult to access but structurally exclusionary. Public health facilities across the country routinely fail to meet even the most basic standards of accessibility and responsiveness.
According to a national assessment of 150 public health centres, infrastructure readiness scored just 29.3%, while the capacity of healthcare providers to offer disability-friendly care was a shocking 0.93% (Torsha et al, 2022). Such figures reveal a system that has left persons with disabilities on the margins -- not by oversight, but by design.
Despite the existence of disability legislation and constitutional guarantees, Bangladesh lacks a dedicated, enforceable policy for disability-inclusive healthcare. In practice, this means that most healthcare providers have received no formal training in how to communicate with or care for persons with disabilities. Over 87% of provider-patient communication for persons with disabilities is mediated through caregivers, and not a single surveyed facility had staff proficient in sign language or trained in alternative communication methods (Rahman et al, 2024). For individuals with hearing, visual, intellectual, or psychosocial disabilities, this disconnect leads to underdiagnosis, miscommunication, and avoidable suffering.
The physical barriers are just as stark. Many hospitals lack ramps, elevators, accessible toilets, or even appropriate signage. Toilets, in particular, were cited as the most inaccessible area in 88% of facilities surveyed. For someone with a mobility impairment, the act of simply entering a building or reaching a consultation room can become an ordeal, often requiring the assistance of others and stripping away any semblance of privacy or independence. These are not just operational gaps -- they are violations of dignity and fundamental rights.
But the greatest failure lies in the system’s invisibility of disability itself. Health policy planning and resource allocation rarely account for the unique needs of this population. Persons with disabilities are often treated as passive recipients of charity rather than as equal citizens entitled to inclusive and respectful care. While some disability-related provisions exist across different ministries, they suffer from poor coordination, limited budgets, and virtually no enforcement. The Ministry of Social Welfare, which holds primary responsibility, is often disconnected from the Ministry of Health and Family Welfare, resulting in fragmented and ineffective services.
Bangladesh cannot afford to treat disability inclusion as an afterthought. If the healthcare system is to serve all its citizens, two immediate actions must be taken. First, all healthcare professionals -- from doctors to nurses to support staff -- must undergo mandatory training on disability sensitivity and communication. This includes basic awareness of different types of disabilities, respectful interaction, and tools such as sign language or visual aids. Such training should be embedded in medical and nursing education and required for professional certification. Without this, no infrastructure improvement will matter.
Second, Bangladesh must develop and implement a national disability-inclusive healthcare policy with clear service standards, accountability mechanisms, and a dedicated budget. This policy must go beyond rhetoric, assigning responsibility across ministries, mandating accessible infrastructure in all public facilities, and introducing systems for independent audits and grievance redress. The policy should be grounded in global standards, such as the UN Convention on the Rights of Persons with Disabilities and the International Classification of Functioning, Disability and Health, but tailored to the local context.
Inclusion is not optional. The cost of inaction is not just inefficiency -- it is exclusion, indignity, and, in many cases, preventable deaths. A healthcare system that routinely fails persons with disabilities fails in its most basic function: To care. If we are serious about universal health coverage and equitable development, the reform must start now -- with policies that see, hear, and serve those who have waited too long outside the ward.
Moumita A Mallick, Ulfatara Bejori, and Ismiat Zerin are freelance contributors.
