Bangladesh - Health

Health

Health and education levels remain relatively low, although they have improved recently as poverty (31% at 2010) levels have decreased. Most Bangladeshis continue to live on subsistence farming in rural villages. For those in rural areas, village doctors with little or no formal training constitute 62% of the healthcare providers practising modern medicine and the formally trained providers are occupying a mere 4% of the total health workforce. A survey conducted by Future Health Systems revealed significant deficiencies in treatment practices of village doctors, with a wide prevalence of harmful and inappropriate drug prescriptions. There are market incentives for accessing health care through informal providers and it is important to understand these markets in order to facilitate collaboration across actors and institutions in order to provide incentives for better performance.

A 2007 study of 1000 households in rural Bangladesh found that direct costs (payment to formal and informal health care providers) and indirect costs (loss of earnings associated with workdays lost due to illness) associated with illness were important deterrents to accessing health care from qualified healthcare providers. A community survey with 6183 individuals in rural Bangladesh found a clear gender difference in treatment seeking behaviour, with women less likely to seek treatment compared to men. The use of skilled birth attendants, however, has risen between 2005 and 2007 by women in all wealth quintiles except the highest quintile. A pilot community empowerment tool, called a health watch, was successfully developed and implemented in south-eastern Bangladesh in order to improve uptake and monitoring of public health services.

The poor health conditions in Bangladesh is attributed by the lack of healthcare and services provision by the government. The total expenditure on healthcare as a percentage of their GDP was only 3.35% in 2009, according to a World Bank report published in 2010. The number of hospital beds per 10 000 population is 4. The General government expenditure on healthcare as a percentage of total government expenditure was only 7.9% as of 2009 and the citizens pay most of their health care bills as the out-of-pocket expenditure as a percentage of private expenditure on health is 96.5%.

Malnutrition has been a persistent problem for the poverty-stricken country. The World Bank estimates that Bangladesh is ranked 1st in the world of the number of children suffering from malnutrition In Bangladesh, 26% of the population are undernourished and 46% of the children suffers from moderate to severe underweight problem. 43% of children under 5 years old are stunted. One in five preschool age children are vitamin A deficient and one in two are anemic. Child malnutrition in Bangladesh is amongst the highest in the world. Two-thirds of the children, under the age of five, are under-nourished and about 60% of them, who are under six, are stunted. More than 45 percent of rural families and 76 percent of urban families were below the acceptable caloric intake level.