Only 22% of public health facilities have essential medicines in stock: PPRC study
The report said Essential Drugs Company Limited supplies about 62% of medicines, and timely, adequate deliveries alone could raise availability to nearly 90%.
Bangladesh's public healthcare system is failing to turn allocated budgets into quality services because of governance failures, procurement delays and administrative bottlenecks rather than funding shortages, according to a study by the Power and Participation Research Centre (PPRC).
Commissioned by the Health Economics Unit (HEU) under the Ministry of Health and Family Welfare, the study found that only about 22% of public health facilities had essential medicines in stock, while nearly 40% of sanctioned medical technologist posts remained vacant.
The findings were presented on Tuesday at the International Mother Language Institute during the dissemination of the report, Bridging Gaps in Bangladesh's Public Health System: A Rapid Facility-Level Assessment of Expenditure Efficiency towards Ensuring UHC-Compliant Health Service Delivery.
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Health Minister Sardar Md Sakhawat Hossain attended as chief guest, while PPRC Chairman Hossain Zillur Rahman presented the report.
Researchers assessed 22 public health facilities across primary, secondary and tertiary levels in all eight divisions. They reviewed FY25 budget and procurement records, surveyed 95 officials, and interviewed facility managers, policymakers, suppliers, academics and patients.
Essential medicine availability ranged from 11.5% at tertiary hospitals to 23.9% at secondary facilities. The report said Essential Drugs Company Limited (EDCL) supplies about 62% of medicines, and timely, adequate deliveries alone could raise availability to nearly 90%.
Diagnostic and imaging services were disrupted by reagent shortages, malfunctioning machines and a lack of trained technologists despite the availability of equipment. Imaging services remained operational only 17-33% of the time, while shortages of emergency supplies, including tourniquets and bag-valve-mask resuscitators, further affected care.
Presenting the findings, Zillur Rahman said Bangladesh's biggest challenge is not increasing health budgets but building institutions capable of using them effectively.
He recommended recruiting medical technologists, simplifying procurement and strengthening digital monitoring, alongside longer-term reforms including a dedicated health management cadre, decentralised financial authority, flexible budget codes, modernising EDCL and strengthening the Central Medical Stores Depot to ensure a reliable medicine supply.
Department of Family Planning Audit Director Mahfuza Khanam said medical equipment procured by doctors often goes without proper audits at the district, upazila and central levels.
HEU Director General Dr Md Enamul Haq called for accurate patient databases, integrated management information systems and real-time budget monitoring to improve planning, resource allocation and accountability.
Health Minister Sakhawat said meaningful reform requires institutional integrity, transparency and accountability, stressing that access to healthcare is a constitutional right.
