Public health, urban governance and the poor in Bangladesh: Policy and practice

Abstract

As is the case elsewhere in Asia, urbanization is growing at a rapid pace in Bangladesh. With the increased urbanization, the basic amenities of life are not expanding for the urbanites. Rather, the increased populations have been exerting continuous pressure on the existing limited facilities. The poor, who constitute a large portion (45 per cent) of the urban population, are the principal victims of this predicament and are significantly disadvantaged in access to basic services, particularly public health services. Urban governance has yet to be efficient enough to deal with this urgent issue. The country still lacks adequate policy direction for urban public health and the management of existing services is also quite inefficient. This paper attempts to identify the weaknesses of urban governance that result in the poor having inadequate access to public and primary health services by reviewing the existing policies and institutional arrangements for the provision of services and by examining the extent to which they are put into practice in terms of ensuring access to these services for the urban poor. Thus the study seeks to identify the inadequacies of the policies and practices contributing to the lack of primary and public health services for the urban poor. It draws on the findings of an empirical study conducted in four slums of the capital city of Bangladesh.

Urban Environmental Health in Bangladesh Slum: A Comparative Study of Two Metropolitan Cities

“…Although Bangladesh has achieved some progresses in health indicators of the Millennium Development Goals, still huge gap prevails in the health conditions between the rich and the poor, and also between the urban poor and the rural poor. In some instances, the deprivation of the urban poor is worse than that of the rural poor (Osman, 2009). Abdullah, Ahmed and Rahman (1993) also reported in a study poor health services received by the slums dwellers when compared with the non-slum residents in Dhaka.…”

Right to health and social justice in Bangladesh: ethical dilemmas and obligations of state and non-state actors to ensure health for urban poor

“…In Bangladesh, the urban population’s contribution to the Gross Domestic Product (GDP) is estimated as 50% [ 14 ]. Urban slum dwellers having migrated from rural areas in search of better economic opportunities are an important part of this economic growth.…”

“…In the past few decades, the South Asian countries have experienced rapid development and urbanization, accompanied by widening inequalities in wealth and health [ 13 ]. In Bangladesh, the rate of migration into Dhaka and other urban areas [ 14 , 15 ] continues to increase, driven by perceived economic opportunity and the negative impact of climate change on coastal livelihoods [ 16 , 17 ]. Dhaka, the capital, has become the most densely populated city in the world [ 15 ], and over 30% of its residents, including female garment workers, live in urban slums, or on streets, rail stations, and railroad tracks.…”

Making information and communications technologies (ICTs) work for health: protocol for a mixed-methods study exploring processes for institutionalising geo-referenced health information systems to strengthen maternal neonatal and child health (MNCH) service planning, referral and oversight in urban Bangladesh

“…13 Lack of regulation of this sector has resulted in concerns about quality of care and financial accessibility, especially for the urban poor. 10 A fundamental first step in addressing inequities in urban healthcare access is an in-depth understanding of what services exist, their location, who provides them and who uses them. A strong health management information system (HMIS), an essential component of sound programme development and implementation.…”