The Government of Bangladesh (GoB) has unveiled a comprehensive plan to rebuild the country's healthcare system through upgrading upazila hospitals, expanding grassroots primary healthcare, recruiting a massive health workforce, modernising diagnostic facilities and decentralising cancer treatment.
The government has allocated a record Tk 69,409 crore to the health sector in the current fiscal year, equivalent to 7.4 percent of the total national budget, as part of its efforts to overhaul the sector.
"We have inherited a collapsed healthcare system due to corruption over the past 15 years of fascist regime and mismanagement during the interim government. Many healthcare facilities at union and upazila levels had not received adequate repair or renovation for years," State Minister for Health and Family Welfare Dr MA Muhit told BSS.
Therefore, after assuming office, the present government has made comprehensive plans to rebuild the country's total healthcare system, he said, adding that, "This is not about one or two projects; we have to reconstruct the health system through an integrated plan."
Upazila hospitals to get major upgrade
The government has proposed a Tk 44,757.385 crore project to progressively upgrade upazila health complexes and expand specialised and emergency services there aimed at reducing pressure on district and divisional level hospitals.
The project, scheduled for implementation from December 2026 to December 2029 and currently under finalisation, includes upgrading 18 hospitals to 51 beds, 305 hospitals to 101 beds, 83 hospitals to 132 beds, 13 hospitals to 120 beds, nine hospitals to 151 beds and another 15 hospitals to 151 beds.
It also includes integrated multistorey service buildings at 443 upazilas and residential facilities for doctors, nurses and other staff at 15 upazilas.
"Existing 30- and 50-bed upazila health complexes are no longer adequate for many areas where populations have increased substantially. Some upazilas now serve eight to 10 lakh people," Dr Muhit said.
He said the government has therefore taken a "historic decision" to transform health complexes in all 503 upazilas into full-fledged 151-bed hospitals.
The upgraded facilities will provide intensive and coronary care, one-stop emergency services, medicine, surgery, ENT, ophthalmology, paediatrics, maternal care, kidney dialysis, cancer screening and physiotherapy, including services for stroke and paralysis patients, alongside pathological and other diagnostic facilities.
Primary healthcare to move closer to households
The government has also proposed a Tk 11,993.2582 crore project to establish 14,634 primary healthcare hubs and 1,631 primary healthcare centres at union and ward levels.
The project, also scheduled for implementation from December 2026 to December 2029 and currently under finalisation, includes rebuilding 5,936 facilities, repairing or remodelling 8,348 and constructing 350 new facilities for the hubs. For the centres, it proposes rebuilding 428 facilities, repairing or remodelling 605 and constructing 598 new ones.
The project also provides for furniture at 6,286 new or rebuilt hubs and 1,026 new or rebuilt centres, alongside medical equipment for 1,026 centres. Supporting infrastructure would include safe water, electricity or solar power, sanitation, drainage, waste management, fire safety and accessible entrances.
The government has undertaken the project with primary healthcare at the center of its reform plan, Dr Muhit said.
Once the project is completed, around 140,000 health workers, trained and equipped with toolkits, would deliver healthcare services at those facilities.
They will visit households regularly- at least once every two months- to provide basic healthcare advice and services and will be able to check blood pressure and blood glucose levels to help detect hypertension and diabetes early and refer patients requiring advanced treatment to upazila facilities.
"We want to take healthcare not merely to people's doorsteps, but inside their homes," Dr Muhit said.
Recruitment of doctors, nurses and midwives
Since the country faces a serious shortage of healthcare professionals, the government has taken extensive plans to recruit healthcare workers, including doctors, paramedics, nurses, midwives and health workers.
According to Dr Muhit, Bangladesh has only about one-third of the number of nurses recommended by the World Health Organization, while medical technologists and other health professionals are also in short supply.
Therefore, he said, the government has already initiated recruitment of 5,000 doctors through the Bangladesh Public Service Commission, while several thousand doctors have already been recruited and posted at upazila level during the first eight months of the government.
Recruitment of another 2,500 nurses has also begun, while 25,000 midwives will be recruited over the next five years to strengthen maternal healthcare and ensure safer childbirth.
Besides, the government also plans to recruit 100,000 additional health workers, on top of the existing 40,000, taking the total to around 140,000, who will deliver healthcare services at union and ward levels.
The recruitment process for the first 30,000 health workers has already begun, Dr Muhit said.
Cancer treatment to be decentralized
The government is taking major steps to decentralise cancer treatment, with plans to establish and operationalise comprehensive cancer treatment facilities in all eight administrative divisions within two to three years.
The government is also moving to establish five Institutes of Nuclear Medicine and Allied Sciences (INMAS) at medical college hospitals in Sunamganj, Tangail, Noakhali, Patuakhali and Kishoreganj at a proposed cost of Tk 535.54 crore.
According to officials, the project would be implemented by June 2030.
Besides, the government plans to procure 17 linear accelerators to expand cancer treatment capacity nationwide and is working to procure five major robotic surgery machines for the first time.
Dr Muhit said cancer patients and their families were facing severe financial hardship as specialised cancer treatment remained concentrated in Dhaka and a few major cities, forcing many to travel long distances and incur high transportation costs. Thus, he said, the government has taken steps to make cancer treatment available closer to patients' homes.
New Health Management Institute and equipment procurement
The government is establishing a Health Management Institute in Savar, which Dr Muhit described as the first of its kind in Bangladesh.
He said doctors were generally trained to provide clinical care but did not receive adequate education in management and finance, although many later become health managers as upazila health and family planning officers or civil surgeons.
Therefore, the institute is being prepared for inauguration on January 1 next, where civil surgeons and upazila health and family planning officers will receive specialised training in health management.
Besides, the government has audited medical equipment nationwide to identify shortages and non-functional machines.
Dr Muhit said many upazila facilities lacked even essential diagnostic equipment, including functioning X-ray and ultrasonography machines.
Thus, a Tk 16,000 crore tender is going to be floated soon for a programme to improve healthcare infrastructure and services, which will cover construction and development works at upazila facilities, renovation of union-level institutions and procurement of medical equipment, he said.
Priority would be given to urgently needed equipment, particularly functional X-ray and ultrasonography machines, so that essential diagnostic services can reach patients at the upazila level without delay.