Universal Health Coverage for Inclusive and Sustainable Development: Country Summary Report for Bangladesh

Bangladesh is a low-income country with gross national income of $1,940 per capita in purchasing power parity (PPP) in 2011. It has made great strides in economic and social development outcomes, particularly in health, and is on track to achieving most of the health-related Millennium Development Goal (MDG) targets. Under-five mortality has been cut by half in the last decade (to 46 deaths per 1,000 live births in 2011). It has also strongly invested in and promoted family planning programs since the 1950s. Fertility rates have fallen sharply to 2.2 births per woman in 2011. But despite this drop, its population is projected to grow to 202 million by 2050 (Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat 2013). About one-third of the population is still poor. Bangladesh spends about 3.8 percent of GDP on health, while public spending accounts for one-third of total health expenditures (THE). Out-of-pocket (OOP) spending constitutes about 60 percent of THE, with evident implications for financial protection, especially among the worse off. The country faces multiple challenges in improving efficiency and quality across health, human resources for health (HRH) being a key bottleneck at all levels. However, it provides an example of a country that is in the initial phases of exploring mechanisms to improve health services coverage and financial protection to its population, with a commitment to achieving universal health coverage (UHC) by 2032, and one that has innovative approaches to addressing key health care issues, including equity and citizen engagement