Government unveils integrated health overhaul plan, including raising all upazila complexes to 151 beds

The government has announced an integrated plan to rebuild the country's health system by increasing the capacity of upazila hospitals, expanding primary health care at grassroots level, recruiting a large number of health workers, modernising diagnostic facilities and decentralising cancer treatment.

In the current fiscal year the government has allocated a record Tk 69,409 crore to the health sector, which is 7.4 percent of the total national budget allocation.

State Minister for Health and Family Welfare Dr M A Muhit said: 'Due to corruption during 15 years of fascist rule and mismanagement during the interim government, we inherited a broken health system. Many health care institutions at union and upazila level have not had adequate renovation for years.' He said that for this reason, after taking office, the current government has adopted an integrated plan to rebuild the overall health system.

To reduce pressure on district and divisional hospitals, the government has proposed a project of Tk 44,757 crore 38 lakh 50 thousand for the phased development of upazila health complexes and expansion of specialised and emergency health services there. The project, scheduled for implementation from December 2026 to December 2029, is currently at the final stage.

Under the project, there is a plan to upgrade 18 hospitals to 51 beds, 305 hospitals to 101 beds, 83 hospitals to 132 beds, 13 hospitals to 120 beds, 9 hospitals to 151 beds and another 15 hospitals to 151 beds. It also includes construction of integrated multi-storey service buildings in 443 upazilas and housing facilities for doctors, nurses and other staff in 15 upazilas.

Dr Muhit said: 'As the population has increased significantly, the existing 30- and 50-bed upazila health complexes in many areas are no longer adequate. At present some upazilas provide health services to 800,000 to 1 million people.' For this reason, he said, the government has taken a 'historic decision' to convert the health complexes of all 503 upazilas in the country into full 151-bed hospitals.

These upgraded institutions will provide intensive care and coronary care, one-stop emergency services, medicine, surgery, ENT, eye, child, maternal health, kidney dialysis, cancer screening and physiotherapy services. Services for stroke and paralysed patients, as well as pathological and other diagnostic facilities, will also be available.

The government has proposed another project of Tk 11,993 crore 25 lakh 82 thousand to establish 14,634 primary health care hubs and 1,631 primary health care centres at union and ward level. This project, scheduled for implementation from December 2026 to December 2029, is also currently at the finalisation stage.

When the project is completed, about 140,000 trained and properly equipped health workers will provide health services through these institutions. They will regularly visit people's homes at least once every two months and provide primary health care advice and services. They will be able to check blood pressure and blood glucose levels so that hypertension and diabetes can be detected at an early stage. Dr Muhit said: 'We want to deliver health services not only to people's doorsteps, but inside their homes.'

According to Dr Muhit, Bangladesh has only one-third of the number of nurses recommended by the World Health Organization. The government has already begun the process of recruiting 5,000 doctors through the Bangladesh Public Service Commission (PSC). The process of recruiting another 2,500 nurses has also begun. To strengthen maternal health services and ensure safe childbirth, 25,000 midwives will be recruited over the next five years. In addition, there is a plan to recruit another 100,000 health workers alongside the existing 40,000; the process of recruiting 30,000 health workers in the first phase has already begun.

The government plans to establish and launch full cancer treatment centres in the country's eight administrative divisions within the next two to three years. In addition, an initiative has been taken to establish five Institutes of Nuclear Medicine and Allied Sciences (INMAS) at the medical college hospitals of Sunamganj, Tangail, Noakhali, Patuakhali and Kishoreganj, with a proposed cost of Tk 535 crore 54 lakh and an implementation deadline of June 2030. To increase cancer treatment capacity nationwide, there is also a plan to buy 17 linear accelerators and, for the first time, five state-of-the-art robotic surgery machines.

The government is establishing a health management institute in Savar, which Dr Muhit described as the first institution of its kind in Bangladesh. The institute is being prepared for inauguration on January 1, where civil surgeons and upazila health and family planning officers will receive specialised training in health management.

In addition, the government has completed a nationwide audit of medical equipment to identify shortages and non-functional machinery. Dr Muhit said many upazila-level institutions do not even have necessary diagnostic equipment including functional X-ray and ultrasonography machines. A tender of Tk 16,000 crore will soon be called to improve health care infrastructure and service quality, under which construction, renovation and medical equipment procurement will be carried out at upazila and union level institutions.