HB 2016 - 2nd - Edition - 13 - 01 - 17

Government of the Peoples Republic of Bangladesh
Ministry of Health and Family Welfare
HEALTH BULLETIN
2016
Management Information System

Directorate General of Health Services
Mohakhali, Dhaka 1212
Tel: 02-58816412, 58816459; Fax: 02-58813875
email: [email protected]
www.dghs.gov.bd
EDITORIAL BOARD
Advisers Parvin Akhter, Assistant Statistician, MIS, DGHS
Mohammed Nasim, MP Md. Ali Akbar, Assistant Statistician, MIS, DGHS
Honorable Minister for Health and Family Welfare Md. Zillur Rahman, Statistical Assistant, MIS, DGHS
Zahid Maleque, MP Md. Lokman Hossain, Health Educator, MIS, DGHS
Honorable State Minister for Health and Family Welfare Abdul Latif, Consultant, MIS, DGHS
Shalina Aktar, MIS, DGHS
Md. Sirazul Islam
Secretary, Ministry of Health and Family Welfare Data Management
Chairman and Chief Editor Md. Emdadul Hoque, Statistical Officer, MIS, DGHS
Md. Asaduzzaman Siddique, Assistant Programmer, MIS, DGHS
Professor Dr. Abul Kalam Azad
Md. Farhad Alam, Assistant Programmer, MIS, DGHS
Director General of Health Services
Md. Mahfuzar Rahman, Assistant Programmer, MIS, DGHS
Co-chairs Md. Munir Hossain, Assistant Programmer, MIS, DGHS
Dr. Md. Ehteshamul Huq Choudhury Md. Jasim Uddin, Statistical Assistant, MIS, DGHS
Additional Director General (Administration) Sufia Khatun, Budget Assistant, MIS, DGHS
Prof. Dr. AHM Enayet Hussain Md. Rohul Amin, Data Entry Operator, MIS, DGHS
Additional Director General (Planning & Development) Noboni Prova Sultan, Student, BIAM Model School & College, Dhaka
Dr. Nazimun Nessa Special Thanks to:
Director (MIS), DGHS
Professor Ashrafunnessa, BSMMU
Dr. Samir Kanti Sarker
Dr. Rashidun Nessa, Director (Planning and Research), DGHS
Director (Administration), DGHS
Dr. Kartic Chandra Das, Director, IPH
Managing Editor Dr. Sheikh Md. Hasan Imam, AD (Co-ord), DGHS
Md. Moyeen Uddin, CRVS Country Coordinator, Bangladesh
Dr. Sultan Shamiul Bashar
Dr. Md. Jahangir Alam, CRVS Country Coordinator, Bangladesh
Officer on Special Duty, MIS, DGHS
Dr. Selina Ahmed, WHO Country Office, Bangladesh
Consultant Editor Dr. Tanbirul Islam, WHO Country Office, Bangladesh
Abid Anwar Dr. Pabitra Kumar Sikder, Deputy Director, DGHS
Poet, Writer, and Science Editor Dr. Md. Shamsuzzaman, Program Manager, DGHS
Dr. Md. Azizul Alim, Program Manager, DGHS
Co-editors Dr. Shah Mahfuzur Rahman, Associate Professor, IPH
Dr. Meerjady Sabrina Flora, Director, IEDCR Dr. Shah Ali Akbar Ashrafi, Asstt. Professor, DGHS
Dr. Md. Ziaul Islam, Assistant Director (HIU), MIS, DGHS Dr. ASM Alamgir, Sr. Scientific Officer, IEDCR
Md. Ashraful Islam Babul, Deputy Chief (Non-medical), MIS, DGHS Dr. Kh. Mahbuba Jamil, Virologist, IPH
Dr. Jeenat Maitry, Medical Officer, MIS, DGHS Dr. Jannatul Ferdous, SHARE Project, icddr,b
Dr. Saima Sultana, Research Investigator, SHARE Project, icddr,b
Members Monjur Ahmed, Communication Specialist, SHARE Project, icddr,b
Dr. Md. Lokman Hakim, Assistant Director, MIS, DGHS Paritosh Kumar Deb, Project Coordinator, COIA Secretariat, DGHS
Dr. AFM Kamruzzaman, Deputy Chief (Medical), MIS, DGHS Dr. Shaikhul Arafat, COIA Secretariat, DGHS
Engineer Sukhendu Shekhor Roy, System Analyst, MIS, DGHS Dr. Masud Reza Khan, DPM, DGHS
Dr. Mohammad Adnan Khan, Assistant Chief, MIS, DGHS Dr. Md.Mizanur Rahman Arif, DPM, DGHS
Dr. Md. Marufur Rahman, Medical Officer, CMBT, MIS, DGHS Mohammad Ali Jinnah, Administrative Officer, IPH
Dr. Ahmedur Rahman Sabuj, Medical Officer, DGHS SM Khairul Ahsan, Office of the Honble Minister, MOHFW
Dr. Aninda Rahman, Medical Officer, DGHS Md. Alauddin Chowdhury, Manager (Data & IT), NASP
Burhan Uddin Ahmad, Programmer, MIS, DGHS Reboti Tahsin Sultan, Student, BIAM Laboratory School, Dhaka
Md. Ruhul Amin, Programmer, MIS, DGHS Cover Design and Page Layout
Md. Razi Uddin, Statistician, MIS, DGHS
Syed Rajib Rahman, Senior IT Consultant, MIS, DGHS Ibrahim Khalil Babu
Md. Ferdous Alam, Consultant, MIS, DGHS Secretarial Assistance
ShekhNazim Uddin Linkon, IT Consultant, MIS, DGHS
Nargis Akter, Office Assistant, MIS, DGHS
Nawsiba Rahman, IT Consultant, MIS, DGHS
AFM Abdul Halim Lasker, Investigator, MIS, DGHS
Md. Nezam Uddin Biswas, Consultant, MIS, DGHS
Niranjan Kumar Roy, Technical Assistant, MIS, DGHS
Team Mobilization and Data Collection
Logistics
Dr. Mizanur Rahman, Consulting Adviser, MIS, DGHS
Dhaneshwar Roy, IT Support Staff, MIS, DGHS
Dr. Md. Bashirul Islam, Consulting Adviser, MIS, DGHS
Md. Murshed Alam Polash, Office Attendant, MIS, DGHS
Md. Shahjahan Fakir, Administrative Officer, DGHS
Md. Saiful Islam, Office Attendant, MIS, DGHS
Farida Begum, Statistician, MIS, DGHS
--------------------------------------------------
Md. Wasiqur Rahman, Statistician, MIS, DGHS We acknowledge the contributions of all other personnel
Abdur Rahman Miah, Assistant Statistician, MIS, DGHS who were involved directly or indirectly in the production of
SM Rezaul Hoque, Assistant Statistician, MIS, DGHS this bulletin by sending data or providing logistical support
Honorable Minister
MESSAGE
I am pleased to know Health Bulletin 2016 is going to be published
soon. This publication of the MIS-Health is an authentic and
benchmark document for us to assess the overall healthcare situation
in the country and identify our priority areas for future attention
and actions.
Development is a collaborative process. With this spirit, let us work

in harmony with one another for a better public health situation in
Bangladesh. It is the need of time for effective partnership among
the community people, local government institutions, government
agencies, UN agencies, NGOs, CBOs, development partners, mass
media, civil society, the policy-makers, and other stakeholders to
achieve the targets of Sustainable Development Goals (SDGs). Since
Bangladesh has become a role model for other developing countries
in achieving the MDGs, I hope our collaborative efforts will
continue the momentum in achieving the targets of SDGs also.
Over the last few years, Bangladesh made tremendous progress in

the health sector under the present pro-people government led by
our Honorable Prime Minister Sheikh Hasina. These achievements
are the results of visionary planning and good monitoring and
evaluation of health interventions.
Our goal to establish a Digital Bangladesh has been achieved more

markedly in the health sector due to innovative efforts made by the
personnel of MIS-Health under the leadership of Professor Dr. Abul
Kalam Azad. I congratulate him and his colleagues and expect to see
more of such innovations in the coming days.
Joy Bangla, Joy Bangabandhu.
Mohammed Nasim, MP
Honorable State Minister
MESSAGE
I am happy to know the 2016 Health Bulletinour flagship
publication to highlight the overall health scenario in Bangladesh
will be published on time. The Health Bulletin is a concise, relevant
and well-structured publication of the DGHS. This would clearly
meet the information need of the target audience of the health
sector and will be a source of learning for us.
I recall with gratitude that our government and non-government

partners have contributed in impressive gains in the health sector
over the past years. It is a matter of pride that our health services
to the nation are continuously drawing global attention. These
achievements and recognitions are the results of benchmark
initiatives led by Honorable Prime Minister Sheikh Hasina whose
leadership has yielded remarkable positive impacts on having a
healthy population. A great deal of work still needs to be done.
We need to consolidate the gains that have been made in the last
few years in the health sector under the present government. We
need to sustain our commitment to the disadvantaged people
while advancing our development efforts in line with Sustainable
Development Goals set by the United Nations.
I congratulate the health personnel in all organizations under the

Ministry of Health and Family Welfare for their dedication and
achievements. The hard-working personnel of the MIS-Health
under the leadership of Professor Dr. Abul Kalam Azad deserve
special appreciation for their persistent efforts in strengthening
health services through dissemination of information. I am sure
the information contained in this bulletin will help us in decision-
making to prioritize health issues that deserve our special attention.
Joy Bangla, Joy Bangabandhu.
Zahid Maleque, MP
Secretary
MESSAGE
The Health Bulletin published by the Management Information
System of the Directorate General of Health Services appears
as a yearbook that helps us understand what we have done in
the past year(s) and what remains to be done. I hope Health
Bulletin 2016 will serve the same purpose.
Our historic achievements in the Millennium Development

Goals (MDGs) and smooth transitioning towards SDGs will
guide us in the coming days. Digitalization of the data-
collection and record-keeping system has been of enormous
help in visiting and revisiting our actual situations of the
healthcare services in the country. I would like to extend my
special thanks to Professor Dr. Abul Kalam Azad and his staff at
the DGHS whose remarkable achievements in this digitalization
process have garnered international recognitions.
I not only endorse but also appreciate drive of the DGHS for
sharing year-long health interventions through the Health
Bulletin. This, in turn, has encouraged the sharing of best
development practices, building trust and relationships among
the development partners in the health sector.
I am confident that information contained in this publication

will be rewarding and will enable us to achieve a better and
more sustainable development in Bangladesh.
Md. Sirazul Islam

Director General
Mohakhali, Dhaka
MESSAGE AND EDITORIAL

Both as Director General of the DGHS and as Chief Editor, I am delighted
to present Health Bulletin 2016 to our distinguished readers on time. This
annual publication of ours has been recognized as a useful document for
all in the health sector, ranging from policy-makers and planners to the
health managers and field workers.
2016 has been a year of special significance as the development partners

have reiterated their commitment to continue efforts with us at all levels to
enhance cooperation in health services. Successful holding of the Regional
Conference on Measurement and Accountability for Health appears to have
brought a ray of hope for strengthening health information at a heightened
level. The DGHS will continue utilizing its vast experiences earned through
working with the concerned government bodies, NGOs, CBOs, private
sector, civil society actors, media, national and international agencies, and
other stakeholders to promote better health outcomes.
I am grateful to the Honorable Minister, State Minister for Health, and the
Secretary for their constant support to and guidance in our journey.
I extend my heartiest congratulations to the members of the production

team for their hard work in bringing out the Bulletin on time. I also
acknowledge my colleagues working under the DGHS across the country
and others who contributed data that constitute the heart of this bulletin.
It needs to be specially mentioned that the readers may, in some cases,

encounter differences between data in the main chapters and those in
Annexes to the relevant chapters. The underlying cause of these differences
is: the Annexes include raw data but, during analysis for reporting, we
exclude the outliers following statistical methods.
We are committed to dedicating more efforts to improve the quality of

this publication. Any constructive feedback from readers will be highly
appreciated.
Professor Dr. Abul Kalam Azad

Director General
and
Chief Editor
Health Bulletin 2016
Director (MIS)
Mohakhali, Dhaka
MESSAGE
For years, Health Bulletin published by Management
Information System (MIS) of the DGHS, has been a vital
and authentic source of information on healthcare situation
of Bangladesh. I am very lucky to be a part of this colossal
endeavor so early after my joining as the Director of MIS. All
personnel behind publication of the Health Bulletin worked so
hard to collect and gather accurate information from health
facilities of the country as well as analyze the data. As the
Director of MIS, I thank all of them whole heartedly.
Bangladesh is continuously developing its health indicators.

We have been very successful in achieving most of the targets
of Millennium Development Goals, and we are looking forward
to accomplishing Sustainable Development Goals within 2030.
With this in our mind, the coming years will be very important
for the policy-makers and health personnel of our country. The
Health Bulletin 2016 will give us a true picture of overall health
status of our people and the services they receive. We will be
able to identify all the shortcomings and will be able to set our
priorities.
We want to ensure Universal Health Coverage within 2029.

Quality healthcare for all is our utmost priority. With all the
data presented in this bulletin, we will get an authentic scenario
of our health workforce as well as disease burden. We want to
ensure proper facility, adequate manpower, and the highest
quality of health services for people of our country.
Management Information System of the DGHS is continuously

working on health system digitization, data collection, storing,
and analysis. We hope to do more innovative work in future and
make our health system an example for other countries to follow.
Despite best efforts of all the personnel behind publication

of this bulletin, there can remain areas of improvements. We
welcome any constructive criticism from our readers for further
improvement of this bulletin in the coming years.
Dr. Nazimun Nessa

ACRONYMS
A2I Access to Information CC Community Clinic
ADB Asian Development Bank CDC Communicable Disease Control
ADP Annual Development Program CDD Control of Diarrheal Diseases
AEFI Adverse Events Following Immunization CES Coverage Evaluation Survey
AFP Acute Flaccid Paralysis CFP Conceptual Framework Paper
AHI Assistant Health Inspector CGA Comptroller General of Accounts
AIDS Acquired Immunodeficiency Syndrome CHCP Community Healthcare Provider
ALS Average Length of Stay CIDA Canadian International Development Agency
AMC Alternative Medical Care CIDD Control of Iodine-deficiency Disorder
AMR Antimicrobial resistance CMCH Chittagong Medical College Hospital
ANC Antenatal Care CME Centre for Medical Education
APIR Annual Program Implementation Report CMMU Construction, Maintenance and
APR Annual Program Review Management Unit
ARC American Red Crescent CMNS Child and Mother Nutrition Survey
ARI Acute Respiratory Infection CMSD Central Medical Stores Depot
ART Antiretroviral Treatment/Antiretroviral Therapy CNP Community Nutrition Promoter
CNS Child Nutrition Survey
BBS Bangladesh Bureau of Statistics COPD Chronic Obstructive Pulmonary Disease
BCC Behavior Change Communication COIA Commission on Informationd and
BCG Bacillus Calmette Guerin Accountability
BCPS Bangladesh College of Physicians and Surgeons CPR Contraceptive Prevalence Rate
BCS Bangladesh Civil Service CRF Chronic Renal Failure
BDHS Bangladesh Demographic and Health Survey CS Civil Surgeon
BDS Bachelor of Dental Surgery CSG Community Support Group
BDT Bangladeshi Taka CSBA Community-based Skilled Birth Attendant
BEOC Basic Emergency Obstetric Care CS Cesarean Section
BGC Bangladesh Geographic Survey CSO Community Support Organization
BHE Bureau of Health Education
BIDS Bangladesh Institute for Development Studies DAB Diabetic Association of Bangladesh
BINP Bangladesh Integrated Nutrition Project DALY Disability Adjusted Life Years
BOR Bed-occupancy Ratio DBRH Demand-based Reproductive Health
BMA Bangladesh Medical Association DEPB Develop Evidence-based Planning &
BMI Body Mass Index Budgeting
BMMS Bangladesh Maternal Mortality Survey DCA Development Credit Agreement
BMDC Bangladesh Medical & Dental Council DCM Dilated Cardiomyopathy
BMRC Bangladesh Medical Research Council DGDA Directorate General of Drug Administration
BNC Bangladesh Nursing Council DDC&H Dhaka Dental College & Hospital
BNHA Bangladesh National Health Accounts DF Dengue Fever
BRAC Bangladesh Rural Advancement Committee DFID Department for International
BSA Bangladesh Society of Anesthesiologists Development
BSL Bio-safety Level DG Director General
BSMMU Bangabandhu Sheikh Mujib Medical University DGFP Directorate General of Family Planning
BST Bangladesh Standard Time DGHED Directorate General of Health Engineering
BTOR Bed Turnover Rate Department
BTRC Bangladesh Telecommunication DGHEU Directorate General of Health Economics
Regulatory Commission Unit
DGHS Directorate General of Health Services
CBHC Community-based Healthcare DH District Hospital
CABG Coronary Artery Bypass Grafting DHF Dengue Hemorrhagic Fever
CBN Cost of Basic Needs (method) DLH District-level Hospital
CRVS Civil Registration and Vital Statistics DMC Dhaka Medical College
DMCH Dhaka Medical College Hospital HA Health Assistant
DNS Directorate of Nursing Services HDI Human Development Index
DUMS Diploma in Unani Medicine & Surgery HDS Health and Demographic Survey
DAMS Diploma in Ayurvedic HEB Health Education Bureau
DHMS Diploma in Homeopathic HEU Health Economics Unit
DOTS Directly-observed Treatment-Short Course HFWC Health and Family Welfare Center
DP Development Partner HI Health Inspector
DPA Direct Project Aid HIES Household Income and Expenditure
DPHE Department of Public Health Engineering Survey
DSF Demand-side Financing HIU Health Information Unit
DTCC District Training Coordination Committee HIS Health Information System
HIV Human Immunodeficiency Virus
ECNEC Executive Committee of National HKI Helen Keller International
Economic Council HLIC High-level Inter-ministerial Committee
EDPT Early Diagnosis and Prompt Treatment HSM Hospital Services Management
EmOC Emergency Obstetric Care HMPD Health Manpower Development
EOC Essential Obstetric Care HNP Health, Nutrition and Population
EPI Expanded Program on Immunization HNPSIP Health, Nutrition and Population Strategic
EPI-CES Expanded Program on Immunization Investment Plan
HNPSP Health, Nutrition and Population Sector
Coverage Evaluation Survey
Program
EPR Emergency Preparedness
HPNSDP Health, Population and Nutrition Sector
ERD Economic Relations Division
Development Program
ESD Essential Service Delivery
HR Human Resource
ESP Essential Service Packages
ETT Exercise Tolerance Test
IAPB International Association for Prevention
EU European Union
of Blindness
IANPHI International Association of National
FCPS Fellow of College of Physicians and Surgeons
Public Health Institutes
FEP Filariasis Elimination Program
ICD-10 International Statistical Classification of
FMAU Financial Management and Audit Unit Diseases and Related Health Problems,
FMRP Financial Management Reforms Project 10th Revision
FP Family Planning icddr,b International Centre for Diarrhoeal
FPO Family Planning Officer Disease Research, Bangladesh
FSNSP Food Security Nutritional Surveillance ICMH Institute of Child and Mother Health
Project ICOVED Integrated Control of Vector-borne
FSW Female Sex Worker Diseases
FWA Family Welfare Assistant ICT Information and Communication
FWV Family Welfare Visitor Technology
FY Financial Year IDA Iron-deficiency Anemia
IDD Iodine-deficiency Disorder
GAVI Global Alliance for Vaccine and IDH Infectious Diseases Hospital
Immunization IEC Information, Education and
GDP Gross Domestic Product Communication
GFTAM Global Fund to Fight AIDS, Tuberculosis IEDCR Institute of Epidemiology, Disease Control
and Malaria and Research
GHDCH Government Homeopathic Degree College IHSM Improved Hospital Services Management
Hospital IHT Institute of Health Technology
GO Government Organization IHR International Health Regulations
GOB Government of Bangladesh IMCI Integrated Management of Childhood
GMT Greenwich Mean Time Illness
GTC Government Tibbia College IMED Implementation, Monitoring and
GUADCH Government Unani and Ayurvedic Degree Evaluation Division
College & Hospital IMF International Monetary Fund
IMHR Institute of Mental Health and Research MSA Management Support Agency
IMR Infant Mortality Rate MSD Medical Subdepot
IOL Intraocular Lens MSM Men who have sex with men
IPH Institute of Public Health MSW Male Sex Worker
IPHN Institute of Public Health Nutrition MTR Mid-term Review
IPM Individual Performance Management MWM Medical Waste Management
i-PRSP Interim Poverty Reduction Strategy Paper
IRS Indoor Residual Spraying NASP National AIDS/STD Control Programme
ISP Internet Service Provider NCD Non-communicable Diseases
IST In-service Training NEMEW National Equipment Maintenance and
IT Information Technology Engineering Workshop
ITHC Integrated Thana Health Complex NFSL National Food Safety Laboratory
ITMN Insecticide-treated Mosquito Net NGO Non-governmental Organization
IUD/IUCD Intra-uterine Device/Intra-uterine NICRH National Institute of Cancer Research and
Contraceptive Device Hospital
IVM Integrated Vector Management NICVD National Institute of Cardiovascular Diseases
IYCF Infant and Young Child-feeding NIC National Influenza Centre
NID National Immunization Day
JICA Japan International Cooperation Agency NIDCH National Institute of Diseases of Chest and
Hospital
KMCH Khulna Medical College Hospital NIKDU National Institute of Kidney Diseases and
Urology
LAN Local Area Network NICRH National Institute of Cancer Research &
LBW Low Birthweight Hospital
LD Line Director NIMHR National Institute of Mental Health and
LHB Local Health Bulletin Research
LLIN Long-lasting Insecticidal Net NINH National Institute of Neurology &
LLP Local-level Planning Hospital
LTSO Long-term Strategy Options NIO National Institute of Ophthalmology
NIPORT National Institute of Population Research
M&E Monitoring & Evaluation and Training
M/F Male/Female Ratio NIPSOM National Institute of Preventive and Social
MATS Medical Assistant Training School Medicine
MBDC Mycobacterial Disease Control NITOR National Institute of Traumatology,
MC Medical College Orthopedics and Rehabilitation
MCH Medical College Hospital nm Nautical mile
MCPS Member of College of Physicians and NMSS National Micronutrients Status Survey
Surgeons NNS National Nutrition Services
MCWC Maternal and Child Welfare Center NNP National Nutrition Program
MCEE Maternal Child Epidemiology Estimation NTP National TB Program
MDA Mass Drug Administration NVAC National Vitamin A Campaign
MDG Millennium Development Goal
MICS Multiple Indicator Cluster Survey OP Operational Plan
MIS Management Information System OPD Outpatient Department
MMR Maternal Mortality Ratio ORS Oral Rehydration Salt
MNC Maternal, Neonatal and Child Health ORT Oral Rehydration Therapy
MNH Maternal and Neonatal Health OT Operation Theater
MNHC Maternal and Neonatal Healthcare
MO Medical Officer PH Public Health
MOHFW Ministry of Health and Family Welfare PKDL Post-kala-azar Dermal Leishmaniasis
MOLGRDC Ministry of Local Government, Rural PLIV People living with HIV
Development and Cooperatives PMIS Personnel Management Information
MoU Memorandum of Understanding System
MP Member of Parliament PMMU Program Management & Monitoring Unit
PRSP Poverty Reduction Strategy Paper TC Trauma Centers
PRS Population Registration System TTU Technical Training Unit
PSM Preventive and Social Medicine
PSTN Public Switched Telephone Network UESDS Utilization of Essential Service Delivery Survey
PWID People who inject drugs UHC Upazila Health Complex
UHC Universal Health Coverage
RDU Research and Development Unit UHO Sadar Upazilla Health Offices
RADP Revised Annual Development Program UHFPO Upazila Health and Family Planning Officer
RPA Reimbursable Project Aid UHFWC Union Health and Family Welfare Center
RCHCIB Revitalization of Community Healthcare UNICEF United Nations Childrens Fund
Initiative in Bangladesh UNFPA United Nations Population Fund
RHC Rural Health Center UNAIDS Joint United Nations Programme on HIV/
AIDS
SAM Severe Acute Malnutrition UNGASS United Nations General Assembly Special
SACMO Sub-Assistant Community Medical Officer Session
SBTP Safe Blood Transfusion Program USC Union Subcenter
SDG Sustainable Development Goals USD US Dollar
SEARO South-East Asian Regional Office USI Universal Salt Iodization
SHRs Shared Health Records
STD Sexually Transmitted Diseases VAC Vitamin A Capsule
SIH Specialty Institute Hospitals VAD Vitamin A Deficiency
SVRS Sample Vital Registration System
SWAp Sector-wide Approach WAZ Weight-for-age z-score
WB World Bank
TAST Technical Assistance Support Team WCBA Women of Childbearing Age
TEMO Transport & Equipment Maintenance Unit WHO World Health Organization
TB Tuberculosis WiMAX Worldwide Interoperability for Microwave
TT Tetanus Toxoid Access
CONTENTS
Messages and Editorial 3
Acronyms 8
Chapter 1 Bangladesh country profile with health indicators 13
Chapter 2 Healthcare Network in Bangladesh 19
Chapter 3 Health-related Sustainable Development Goals 24
Chapter 4 Primary healthcare 49
Chapter 5 Secondary and tertiary healthcare 63
Chapter 6 Utilization of public health facilities 67
Chapter 7 Healthcare for Admitted Patients in Public Hospitals 76
Chapter 8 Mortality in Public Hospitals 85
Chapter 9 Communicable disease control in Bangladesh 101
Chapter 10 Preparedness and response in health emergencies 130
Chapter 11 Non-communicable diseases 134
Chapter 12 Safe blood transfusion 144
Chapter 13 Nutrition situation in Bangladesh 148
Chapter 14 Institute of Epidemiology, Disease Control and Research 159
Chapter 15 Institute of Public Health 164
Chapter 16 Health workforce situation in Bangladesh 170
Chapter 17 Health information system, ehealth, and MBT 183
Chapter 18 Financing healthcare 198
Annexes 203
Chapter
1
Country profile with health indicators
BANGLADESH
Under the leadership of Bangabandhu Sheikh
Mujibur Rahman, Bangladesh emerged as
a sovereign nation on 16 December 1971
through a glorious victory in the War of
Liberation.
Under the leadership of Bangabandhu Sheikh Mujibur Rahman, Bangladesh emerged as a sovereign
nation on 16 December 1971 through a glorious victory in the War of Liberation. Before that Bangladesh
was a province of Pakistan and used to be called East Pakistan. After the fall of Nawab Sirajuddowla in
the Battle of Plassey on 23 June 1757, this wealthy part of the Indian Subcontinent was ruled by the
British from 1757 to 1947. In 1947, the British colonial rule ended, and the Indian Subcontinent was
divided into two independent nationsIndia and Pakistan. Profound disparities in governance between
East and West Pakistan led to the craving for independence among the East Pakistanis. The unique
Language Movement of 1952 and a series of mass upsurge at various times during the 1960s and early
1970s led to the War of Liberation.
Geographical location 100% and is the highest during the monsoon

and the lowest in the winter.
Bangladesh has a total land area of 147,570
square kilometers (56,977 square miles). The Religion and Culture
country borders India on three sides with the
Indian states of West Bengal, Tripura, Assam, Majority (approx. 89%) of the population is
and Meghalaya. Only a small strip in the Muslim. Hindus, Buddhists, and Christians
southeast shares a border with Myanmar. The comprise 9.6%, 0.6%, and 0.3% of the
Bay of Bengal lies to the south. Bangladesh population respectively. Over 98% of the
comprises primarily floodplains, with scattered people speak Bangla. English is also widely
hills in the eastern and northern parts. Large spoken. Bangladeshs rich cultural traditions
rivers and an intricate web of canals and rivers are displayed in archaeological sites, sculptures,
form this Ganges Delta, the largest delta in the terracotta, architecture, museums, archives,
world. libraries, classical music, dance, paintings,
dramas, folk arts, festivals, and ethnic cultural
Climate activities.
Bangladesh is a tropical country with a hot Population and Demography
and rainy summer (March to June), a warm
and rainy monsoon (June to October), and a Bangladesh Bureau of Statistics (BBS) conducted
mildly- dry winter (October to March). January the national population census in 2011 and,
is the coldest month. Average temperatures in according to the census, total population of
the winter range from 11oC to 20oC. April is the Bangladesh was 149,772,364 on 15 March
hottest month. The summer temperatures range 2011. According to the SVRS 2015, the
from 21oC to 38oC. Major part of Bangladesh estimated population on 1 July 2015 was 158.1
receives more than 1,525 mm of rainfall a year, million, with a density of 1,077 per square
with areas near the hills receiving more than kilometer. Bangladesh is now going through a
5,000 mm, primarily during the monsoon (June- demographic transition, and the proportion of
September). The humidity varies from 55% to the population in the agile labor force (1559
Health Bulletin 2016 13

years age-group) has increased. The steady Governance
economic growth even during spells of global
recessions indicates that the hard-working Bangladesh has a parliamentary form of
people of Bangladesh are efficiently taking government. President is the head of the
advantages of the demographic dividend. State, and the Prime Minister is the head of
Although the majority of people still live in the Government. The National Parliament is
rural areas, the urban population is rapidly called Bangladesh Jatiya Sangsad. Each ministry
growing. According to a UN study (World is headed a by a minister, with a secretary
Urbanization Prospects: 2014 Revision), the to head the bureaucrats. Some ministries are
majority of citizens will be urban-dwellers by divided into functional divisions. As of now
the year 2039. (December 2016), the total number of ministries
and functional divisions is 61. The Ministry of
Map of Bangladesh showing administrative Health and Family Welfare is one of the largest
divisions ministries of the Government of Bangladesh.
Currently the country is divided into 8

administrative divisions. Each division is
divided into several districts; each district is
subdivided into several upazilas (sub-districts),
and each upazila into several unions (Table
1.1). Each union is further subdivided into nine
wards and, thus, there are 40,977 such wards
under 4,553 unions till December 2016. Finally,
the wards are divided into several villages; the
approximate number of villages is 87,310.
However, ward is the lowest administrative unit
of the local government, having at least one
representative elected for 5 years by popular
vote. The city corporations and municipalities
are designated as urban areas, with 12 city
corporations and 324 municipalities across the
country.
Economy
The agrarian sector still dominates the countrys

economy, accounting for majority of the
Table 1.1. Number of districts, upazilas, and unions under 8 divisions of Bangladesh with area,
estimated mid-year population of 2016, and population density in each of the divisions
Adminstrative units Population
Area 2016
District Upazila Union density
Division (sq. km)1 Population2
(No.) (No.) (No.) (per sq. km)
Barisal 6 42 333 13,225.20 9,145,000 691
Chittagong 11 100 339 33,908.55 31,980,000 943
Dhaka 13 89 1,833 20,593.74 40,171,000 1,951
Khulna 10 59 270 22,284.22 17,252,000 774
Mymensingh 4 34 350 10,584.06 12,368,000 1,169
Rajshahi 8 68 558 18,153.08 20,412,000 1,124
Rangpur 8 58 536 16,184.99 17,602,000 1,088
Sylhet 4 39 334 12,635.22 11,291,000 894
1
Population and housing census 2011, BBS
2
Projected population scenario as described in Population Projection of Bangladesh, Dynamics and Trends: 2011-2061, BBS
14 Health Bulletin 2016

CHAPTER 1: BANGLADESH COUNTRY PROFILE WITH HEALTH INDICATORS
rural labor force. The principal industries of Rainfall: 1,100 to 3,400 mm (June-August);
the country include readymade garments, Average 203 mm/month
textiles, chemical fertilizers, pharmaceuticals, Humidity: Highest 100% (July); Lowest 55%
tea-processing, sugar, and leather goods. The (December-January)
principal minerals include natural gas, coal, Standard time: BST (GMT+ 6 hours)
white clay, and glass-sand. Bangladesh has been Demography
utilizing a mixed system of public and private (SVRS 2015)
development, which operates on free-market
principles. Population: Estimated population on 1 July
2015 158.1 million; Projected (2016) population
According to a BBS publication (National 160.221 million (Projected population in
Account Statistics published on May 2016), scenario as described in Population Projection
the provisional estimates of GDP for FY2016 of Bangladesh, Dynamics and Trends:, 2011-
indicate an expansion of the economy, with 2061, BBS, available at www.bbs.gov.bd)
a growth of 7.05% in real term compared to Population density (per sq. km): 1,077; in land
6.55% in FY2015. The per-capita GDP and GNI area 1,236.811 (in 2015; WB 2016)
for FY2016 were estimated to be BDT 108,172 Population growth rate: 1.37%
(USD 1,384) and BDT 114,547 (USD 1,466) Sex ratio (M/F): 100.3/100.0
respectively at current prices. At constant prices
(2005-2006) the per-capita GDP and GNI for Table 1.2. Percent population by broad age-group
FY2016 were estimated to be BDT 55,229 and Age-group Both
BDT 58,484 respectively. The value of GDP Male Female
(years) sexes
at current market prices was provisionally
estimated to be BDT 17,296 billion which is 00-14 30.8 31.3 30.2
about 14.10% higher than that of FY2015. GDP 15-49 53.7 52.5 55.0
at constant market prices was provisionally
50-59 7.8 8 7.6
estimated to be BDT 8,831 billion.
____________________________________________
60+ 7.7 8.2 7.2
Summarized basic information and health Dependency ratio (percentage): Total 55;
indicators
Rural 59, Urban 49
[See List of Acronyms for the abbreviations]
Child-woman ratio (per 1,000 women of 15-49
Administrative Units years): Total 325; Rural 350, Urban 290
Crude birth rate (per 1,000 population): Total 18.8;
Division :8
Rural 20.3, Urban 16.5
City Corporation : 12
Total fertility rate (per woman of 15-49 years):
Metropolitan city :4
Total 2.10, Rural 2.30, Urban 1.72
Municipality : 324
District : 64 Table 1.3. Age-specific fertility rate (per 1,000
Upazila : 489 women of reproductive age)
Union : 4,553 Age-group (years) Rate
Ward : 40,977
15-19 75
Village (approx.) : 87,310
20-24 137
Geography
25-29 105
Location: Latitude between 2034 and 2638
North, Longitude between 8801 and 9241 East 30-34 56
Boundary: North and West: India; South: Bay of 35-39 25
Bengal; East: India and Myanmar 40-44 9
Border: 4,246 km, Coastline: 580 km
45-49 3
Area: 147,570 sq. km (56,977 sq. miles),
Land: 133,910 sq.km, Water: 10,090 sq.km General fertility rate: Total 69, Rural 77, Urban 57
Maritime boundary: Contiguous zone 18 nm, Net reproduction rate (per woman of 15-49
Economic zone 200 nm, Territorial sea 12 nm years): Total 1.00, Rural 1.10, Urban 0.84
Average temperature: Winter 11oC-20oC; Crude marriage rate (per 1,000 population):
Summer 21oC-38oC Total 13, Rural 14.9, Urban 10.2

Table 1.4. Mean age at marriage (years) Mobile Internet: 58.375 million
WiMAX : 0.104 million
Stratum Male Female
ISP+PSTN: 3.769 million
Total 26.3 18.7
Rural 25.9 18.3
Mobile phone subscribers
Urban 27.2 19.8 Total : 117.758 million
Economy Literacy
(SVRS 2015)
Per-capita GDP at current market prices (in
USD): 1,384 (2015-2016P), Growth rate of GDP Literacy rate of population aged 7+ years
at constant prices (percentage): 7.05 (2015- (percentage): Both sexes 63.6, Female 61.6, Male 65.6
2016p) (BBS, May 2016) Adult literacy rate of population aged 15+ years
(percentage): Both sexes 64.6, Female 61.6,
Principal crops: Rice, jute, tea, wheat, sugarcane, Male 60.6
pulses, mustard, potato, vegetables
Health Service and Medical Education
Principal industries: Garments and textiles (2nd (DGHS 2016)
largest in the world), tea, ceramics, cement, Hospitals and beds
leather, jute (largest producer in the world),
chemicals, fertilizers, shrimp cultivation and Total number of government hospitals under
processing, sugar, paper, electric and electronics, the DGHS: 610
medicines, fishing. Government hospitals of secondary and tertiary
levels under the DGHS: 128
Principal exports: Garments, knitwear, frozen Government hospitals under the DGHS at the
shrimps, tea, leather and leather products, jute upazila and union levels: 482
and jute products, ceramics, IT outsourcing. No. of registered private hospitals and clinics
under the DGHS: 4,596
Principal imports: Wheat, fertilizers, petroleum
No. of registered private diagnostic centers
goods, cotton, edible oil.
under the DGHS: 9,741
Principal minerals: Natural gas, oil, coal, white No. of hospital beds under the DGHS: 48,934
clay, glass sand. No. of hospital beds in the private-sector (in
private hospitals registered by the DGHS: 78,426
Household Characteristics and Utilities Total DGHS-run hospitals and registered private
(SVRS 2015) hospitals: 127,360
Household-size (no. of persons): 4.4 Population per hospital bed: 1,528 (total beds
Male-headed (%): 87.3 in the DGHS-run public and registered private
Female-headed (%): 12.7 hospitals in 2016 against projected mid-year
Water and sanitation (% households) population of 2016 as estimated by BBS)
Drinkingwater: Access to tap and tubewell Teaching/training institutions for healthcare
water 97.8%
No. of postgraduate medical teaching
Toilet facility (%): Sanitary 73.5; Others 23.2; institutions: Total 33; Government 23; Private 10
None 3.3
No. of medical colleges: Total 104; Government
Table 1.5. Source of light (% households) 36; Private 68
No. of dental colleges: Total 34; Government 9;
Source Total Rural Urban
Private 25
Kerosene 16.3 23.6 5.8 No. of nursing colleges offering Basic BSc Nursing
Electricity 77.9 67.6 92.9 course: Total 38; Government 14; Private 24
Others 0.4 0.4 0.2 No. of nursing colleges offering Post-basic BSc
Nursing course: Total 24; Government 5; Private 19
Information Technology
No. of medical assistants training schools: Total
(BTRC 30 November 2016; all figures as of
176; Government 8; Private 168
August 2016)
No. of institutes of health technology (IHT):
Internet subscribers Total 116; Government 8; Private 104;
Total: 62.248 million Government-Private 4

CHAPTER 1: BANGLADESH COUNTRY PROFILE WITH HEALTH INDICATORS
Seats for medical degrees Immunization (valid vaccination coverage)

Postgraduate medical degree (EPI-CES 2015)
(MD, MS, Diploma, M Phil, MPH, MTM, 12 months old children: BCG 99.3%; OPV1
MMED): Total 2,237; Autonomous 476, 99.1%; OPV2 94.5%; OPV3 93.6%; Penta1
Government 1,592; Private 169 93.9%; Penta2 94.5%; Penta3 93.6%; Measles
(Fellowships/memberships offered by BCPS do 87.4%; Full vaccination: 82.5%
not have any fixed number) 23 months old children: BCG 99.4%; OPV1
MBBS: Total 9,957; Government 3,812; 94%; OPV2 94.7%; OPV3 94.1%; Penta1 94%;
Private 6,145 Penta2 94.7%; Penta3 94.1%; Measles 91.7%;
BDS: Total 1,917; Government 532; Full vaccination 86.5%
Private 1,385 Tetanus toxoid coverage (%) among women of
Bachelor of Unani and Ayurvedic Medicine: 50 childbearing age: TT1 96%; TT2 94%;
Bachelor of Homeopathic Medicine: 50 TT3 83.6%; TT4 66.7%; TT5 46.1%
Seats for other courses Life-expectancy at birth (years)
For medical assistants: Total 13,051;
Both sexes 71.8; Female 73.1; Male 70.6 (in
Government 716; Private 12,335
2015, WB 2016)
For medical technologists: Total 16,042;
Government 2,596; Private 13,266; Malaria
Government-Private 180
Malaria positive cases/1,000 population (in
Health Status endemic areas): 3.00 (in 2015, NMCP 2016)
Coverage of vitamin A capsule Malarial mortality/100,000 population (in
(EPI-CES 2015) endemic areas): 0.0068 (in 2015, NMCP 2016)
Infant (6-11 months): 79.6% Maternal and child health, obstetric care
Children (12-59 months): 87.3%
Postpartum women: 37.6% Antenatal care coverage (at least 4 visits) (%): 31
(in 2014, UNICEF, February 2016), 31.2
Family planning (BDHS 2014)
Antenatal care coverage (at least one visit by
Contraceptive prevalence rate (%): 62.1 skilled health professional) (%): 63.9 (in 2014,
(SVRS 2015) WB 2016)
Unmet need for family planning (%): 12.0 Births attended by skilled health personnel (%):
(BDHS 2014) 42.1 (BDHS 2014)
HIV/AIDS C-section rate (%): 22.9% (BDHS 2014)
Home delivery rate: 62.2% (BDHS 2014)
Antiretroviral treatment (ART) coverage among Infant mortality rate (per 1,000 livebirths): 29
adults needing ART: 14% (UNFPA 2015) (SVRS 2015)
ART recipients (estimated number) in 2015: Institutional delivery rate (%): Total 37.4; Public
1,428; in 2014: 1,287 (UNFPA 2015) facility 12.8; Private facility 22.4; NGO facility
HIV prevalence among key populations in 2014: 1.9 (BDHS 2014)
PWID 1.1 %; FSW 0.3%; MSW 0.4%; MSM 0.4%;
Hijra 1% (UNAIDS 2015) Maternal mortality ratio (per 100,000 livebirths):
HIV prevalence among most-at-risk population 176 (in 2015, WB 2016)
group: <0.1% (NTP 2016) Neonatal mortality rate/1,000 livebirths: 20
Knowledge of all modes of transmission of HIV/ (SVRS 2015)
AIDS among population (%): 25.8 (SVRS 2015)
Under-5 mortality rate (per 1,000 livebirths): 36
Knowledge of at least one mode of transmission
(SVRS 2015)
of HIV/AIDS among population (%): 66.1
(SVRS 2015) Tuberculosis
Mortality rate among HIV+ve TB patients/
100,000 population: 0.11 (WHO 2015) Cure rate with DOTS (%): 94 (in 2014, NTP 2016)
New HIV infection reported in 2015 (up to Death rate/100,000 population: 51 (in 2014,
November): 469 (NASP 2016) NTP 2016)
People living with HIV (PLIV) in 2014: 8,900 Incidence rate of HIV-positive TB cases/100,000
(NASP 2015) population: 0.36 (in 2014, NTP 2016)

Incidence rate of TB (all forms)/100,000 DNS
population: 227 (in 2014, NTP 2016) (DNS 2015)
Prevalence rate of TB (all forms)/100,000 No. of nurses: 16,840 (22,157)
population: 404 (in 2014, NTP 2016) No. of non-nursing officials and staff: 931 (1,093)
Proportion of new TB cases with MDR-TB (%):
1.4 (in 2014, NTP 2016) Registered professionals
Proportion of retreated cases with MDR-TB (%): Dental surgeons and physicians
29 (in 2014, NTP 2016) (BMDC, 24 July 2016)
No. of registered dental surgeons (BDS): 7,015
Health Workforce
No. of registered physicians (MBBS): 78,572
Personnel currently working under different
Nurses and paramedics
agencies of MOHFW
(BNC, 30 June 2016)
(No. of sanctioned posts are given in parentheses) No. of registered BSc nurses: 4,600
DGHS No. of registered diploma nurses : 41,697
(DGHS, June 2016) No. of registered nurses with Diploma in Cardiac
Nursing/Intensive Care Nursing: 210
No. of personnel: 106,104 (127,841) No. of registered assistant nurses: 2,425
No. of doctors: 22,374 (24,028) No. of registered family welfare visitors (FWV):
No. of medical technologists: Total 5,945 6,364
(7,790); Dental 484 (540); EPI 462 (500); No. of registered junior midwives: 2,125
Lab 1,629 (2,172), Pharmacy 2,106 (2,944); No. of registered community skilled birth
Physiotherapy 171 (286); Radiography 623
attendants: 7,858
(785); Radiotherapy 38 (66); Sanitary
inspection 432 (497) Population-Health Workforce Ratio
No. of Sub-Assistant Community Medical (DGHS 2016)
Officers (SACMO): 4,578 (5,411)
(The BBS-projected 2016-mid-year-population
No. of Community Healthcare Providers
of 160.221 million was considered as the
(CHCPs) for community clinics: 13,622
denominator in applicable cases)
No. of Domiciliary Workers: Total 22,455 (26,455);
Health Inspectors (HI) 1,232 (1,399); Assistant Annual number of enrolment in graduate
Health Inspectors (AHI) 3,891 (4,205); Health (MBBS) program to produce physicians per
Assistants (HA) 17,332 (20,877) 100,000 population: 6.21
Population per registered physician: 2,039
DGFP No. of registered physicians per 10,000
(DGFP 2015) population: 4.90
No. of doctors: 526 (1,079) No. of registered nurses per 10,000 population:
No. of Family Planning Officers: 375 (485) 2.90
No. of Assistant Family Planning Officers: 263 (485) No. of doctors working under MOHFW per
No. of Sub-Assistant Community Medical 10,000 population: 1.43
Officers (SACMO): 2,307 (2,500) No. of nurses working under DNS per 10,000
No. of Family Welfare Visitors (FWV): 3,962 population: 1.05
(4,500) No. of medical technologists working under
No. of Domiciliary Workers: Total 24,679 DGHS per 10,000 population: 0.37
(29,210); Family Planning Inspectors (FPI): 5,096 No. of community and domiciliary health
(5,710); Family Welfare Assistants (FWA): 19,583 workers working under MOHFW per 10,000
(23,500) people: 4.04

Chapter An intricate web
2 HEALTHCARE NETWORK
IN BANGLADESH
The national-level policies, plans, and decisions
in the provision of healthcare and education
are translated into actions by various
implementing authorities and healthcare
delivery systems across the country.
Spread across the country, the intricate web of healthcare network comprises entities ranging from the
Ministry of Health and Family Welfare (MOHFW) to healthcare facilities down to the community level.
Along with the public health departments of the Government, various NGOs and private institutions
constitute a large proportion of this web. The Ministry is responsible for formulating national-
level policy, planning, and decision-making. The national-level policies, plans, and decisions in the
provision of healthcare and education are translated into actions by various implementing authorities
and healthcare delivery systems across the country. The Ministry and its relevant regulatory bodies also
have an indirect control over the healthcare systems of the NGOs and the private sector. However, this
chapter gives a brief description of the organizational structure of the Directorate General of Health
Services (DGHS) only.
Hierarchy of personnel in the Ministry of 4. Directorate General of Drug Administration

Health and Family Welfare (DGDA)
The Ministry of Health and Family Welfare 5. Directorate General of Health Economics
is headed by the Honorable Minister and is Unit (DGHEU)
assisted by the Honorable State Minister. As the
6. Directorate General of Health Engineering
principal executive of the Ministry, the Secretary
Department (DGHED)
works with a team of officials, including
Additional Secretary, Joint Secretaries/Joint 7. Directorate of Nursing Services (DNS)
Chiefs, Deputy Secretaries/Deputy Chiefs, Senior
8. Transport & Equipment Maintenance
Assistant Secretaries/Senior Assistant Chiefs, and
Organization (TEMO)
others (Figure 2.1).
9. National Electro-medical & Engineering
Implementing authorities
Workshop (NEMEW)
There are 9 implementing authorities under the
Regulatory bodies
MOHFW. These are as follows:
The regulatory bodies under the MOHFW
1. Directorate General of Health Services include:
(DGHS)
1. Bangladesh Medical & Dental Council
2. Directorate General of Family Planning (BMDC)
(DGFP)
2. Bangladesh Nursing Council (BNC)
3. National Institute of Population Research &
Training (NIPORT) 3. State Medical Faculty (SMF)

Figure 2.1. Hierarchy of personnel in the MOHFW
(Discipline)
Senior/ Senior/ Senior/ Senior/ Senior/ Senior/ Senior/ Senior/

Assistant Assistant Assistant Assistant Assistant Assistant Assistant Assistant
secretaries secretaries secretaries secretaries secretaries secretaries secretaries chiefs
Number of personnel
Core personnel Other personnel
Secretary :1 Administrative Officer : 53 Cataloger :1
Additional Secretary :1 Personnel Officer : 21 Computer Operator :4
Joint Secretary :6 Steno-typist : 39 Draftsman :2
Joint Chief :1 Office Assistant/Upper Division Assistant : 10 Lower Division Assistant :1
Deputy Secretary : 13 Office Asstt.-cum-Computer Operator :6 Cash Sarker :2
Deputy Chief :2 Typist : 12 Stenographer :1
PS to Secretary :1 Data-entry Control Supervisor :2 Plain Paper Copier Operator :1
Senior/Assistant Secretary : 35 Data-entry Operator :1 Duplicating Machine Operator :2
Senior/Assistant Chief :19 Accountant :2 Dispatch Rider :2
System Analyst :1 Assistant Accountant :3 Driver :2
Programmer :3 Cashier/Accounts Assistant :4 Daftary :1
Maintenance Engineer :1 Audit Super :4 Office Assistant/MLSS : 89
Assistant Programmer :4 Auditor :8 Sweeper :3
Assistant Maintenance Engineer :1 Statistician :1 Total :277
Senior Computer Operator :2
Accounts Officer :4
Librarian :1
Total : 96

CHAPTER 2: HEALTHCARE NETWORK IN BANGLADESH
4. Homeo, Unani and Ayurvedic Board The activities are implemented under regular
revenue setups and the development programs.
5. Bangladesh Pharmacy Council The development programs are designed
Directorate General of Health Services following a sector-wide, multi-year approach.
The Directorate General of Health Services As presented in Figure 2.2, the administrative
(DGHS), with more than one hundred thousand setup of the DGHS indicates the diversity of
activities carried out by the Directorate.
Along with the operation of Management structure and type of health

facilities under the DGHS
healthcare-delivery systems in
The healthcare infrastructure under the DGHS
the country, the DGHS provides comprises six tiers: national, divisional, district,
technical assistance to the upazila (subdistrict), union, and ward (Figure
2.3). At the national level, there are institutions
Ministry in undertaking new both for public health functions as well as for
postgraduate medical education/training and
programs and interventions specialized treatment to patients.
and for improvements in the A divisional director for health in each division
existing ones. governs activities and is assisted by deputy directors
and assistant directors. There is one infectious
officers and staff members, is the largest disease hospital and one or more medical college(s)
implementing authority under the MOHFW. at the divisional headquarters. Each medical
Along with the operation of healthcare- college has an attached hospital. Some divisional
delivery systems in the country, the DGHS headquarters also possess general hospitals and
provides technical assistance to the Ministry in institutes of health technologies. Divisional
undertaking new programs and interventions institutes provide basically the tertiary-level care.
and for improvements in the existing ones.The
healthcare-delivery systems under the DGHS The civil surgeon (CS) is the district health
extend from national to the community level. manager responsible for delivering secondary
Figure 2.2. Administrative setup of the Directorate General of Health Services

Figure 2.3. Types of organizations and facilities under the DGHS from national to the ward level,
with managerial hierarchy
Managerial hierarchy
Directorate General Additional

Director Deputy Assistant
of Health Services Director Directors
General Directors Directors
Generals
Type of Health Facilities
Public Health Institute

National level Director of Deputy Assistant Postgraduate Medical
Institute Director Director Institute & Hospital with
Nursing Institute
Specialized Health Center
Divisional Medical College and

Hospital, with Nursing
Director (Health)/ Deputy Assistant
Institute
Director (Medical Director Director General Hospital with
College Hospital) Nursing Institute
Division level
Infectious Disease Hospital
Principal, Vice Principal, Institute of Health
Medical College Medical College Technology
District Hospital with

Nursing Institute
Deputy Civil General Hospital with
Civil Surgeon
Surgeon Nursing Institute
Medical College & Hospital
District level with Nursing Institute
Superintendent, Resident Chest Disease Clinic
District Hospital Medical Officer Tuberculosis Clinic
Leprosy Hospital
Medical Assistant Training
School
Upazila Health & Resident

Upazila level Family Planning Upazila Health Complex
Medical Officer
Officer
Sub-assistant
Medical Community
Officer Medical Officer/
Rural Health Center
Pharmacist
Union Subcenter
Union level Union Health & Family
Welfare Center
Assistant
Health Health
Health
Inspector Assistant
Inspector
Ward level Community Healthcare Provider Community Clinic

CHAPTER 2: HEALTHCARE NETWORK IN BANGLADESH
and primary care services. In each district, there community clinic services. Currently (up to
is a district hospital. Some district hospitals 31 July 2016), 13,336 CCs are in operation.
have superintendents to look after the hospital The RCHCIB project was responsible for
management. In others, civil surgeons look operationalizing the CCs until June 2015. Now
after the district hospitals. Some of the district these are functioning under the operational
plan of community-based healthcare. These
headquarters have medical colleges with
facilities are mainly responsible for delivering
attached hospitals, medical assistants training
primary healthcare services, like EPI, treatment
schools, and nursing training institutes.
for common diseases (pneumonia, fever, cough,
The upazila health & family planning officer etc), family planning services, health education,
(UH&FPO) is the health manager at the upazila and first-aids and serve as the first contact points
level. S/he manages all public-health programs, for patients. Some of the community clinics
especially the primary healthcare services in the have also stated services for normal delivery
upazila and also looks after the upazila hospital. through CSBA at the community clinic. The
The upazila where the district headquarter is MOHFW aims to develop the CCs as the unit
located does not have an upazila hospital, and of comprehensive healthcare-seeking behavior
there, the upazila hospital service is provided by change in the respective local communities
the district hospital. through a sense of ownership and provision of
leadership by community people.
At the union level, three kinds of health
facilities exist: rural health centers, union At the ward or village level, there are also
subcenters, and union health & family welfare domiciliary health workers one for every 5,000
centers (UHFWCs). Each union-level health to 6,000 people. There are 26,481 sanctioned
facility employs a medical doctor among other posts of domiciliary workers under the DGHS:
staff. Only outdoor services are available at 20,877 health assistants (HA), 4,205 assistant
the union level. All union facilities have sub- health inspectors (AHI), and 1,399 health
assistant community medical officers to provide inspectors (HI). The Directorate General of
health services to the people. Family Planning (DGFP) also has domiciliary
family planning staff working at the ward level.
The MOHFW planned to establish one Currently, the domiciliary staff members from
community clinic for every 6,000 people, with a DGHS and DGFP share the responsibility of
total of 13,861 CCs in the country. The existing running the community clinics, along with the
union and upazila facilities (~4,500) also provide community healthcare provider (CHCP).

Chapter Transition from MDGs to SDGs
3 HEALTH-RELATED
SUSTAINABLE DEVELOPMENT
GOALS
For the Ministry of Health and Family Welfare
of the Government of Bangladesh, appropriate
planning of the 4th Sector-wide Approach
(SWAp) is important.
The Sustainable Development Goals (SDGs) as a whole, particularly Goal 3 of SDGs, created a new
opportunity to realize the dream of the highest achievable levels of health for every citizen of Bangladesh.
It provides a way forward to fulfilling the constitutional obligations of ensuring required healthcare and
nutrition for the citizens. The leader of our country-Prime Minister Sheikh Hasina has taken up the
challenge to achieve the health-related SDGs progressively within 2030.
For the Ministry of Health and Family Development will be put in place through a
Welfare of the Government of Bangladesh, solid framework of indicators and statistical data
appropriate planning of the 4th Sector- to monitor progress, inform policy, and ensure
wide Approach (SWAp) is important. The accountability of all stakeholders. Throughout
MOHFW of Bangladesh has rich experiences the SDG period, demographic transition and
of implementing SWAps for three consecutive shift of disease burden will continue to happen,
5-year periods. The SWAp or a modified SWAp which will need addressing through the three
will create opportunity for the MOHFW to take subsequent SWAps that will have to meet
managerial decisions, project implementation, increasing health service expectation of people
supervision, and monitoring quickly. The 4th and policy-makers, keeping pace with the
SWAp of the Ministry is expected to begin countrys economic progress, peoples improved
sometime in 2017. It will be at a critical quality of life, and expectations of Visions 2021
juncture of time as the 3rd SWAp designed for and 2041. The 4th SWAp will have to address
attainment of MDGs will step to the 4th SWAp the issue of acute shortage of health workforce
for attainment of health-related SDGs. The (HWF) to fulfill the dream of universal health
4th SWAp will influence the 5th and the 6th coverage as included in health-related SDGs. So,
SWAp as driving force for health-related SDGs. the MOHFW and all of its agencies will have
The SDGs have a high aspiration for inclusion to provide the highest level of attention so
and leaving no one behind. The 4th SWAp will that all issues are adequately and appropriately
have to find solutions to set the path towards addressed in the documents and plans of the
materializing this high aspiration. The SDGs 4th SWAp.
give priority to measurement and accountability,
The 17 Goals of SDGs
using reliable data generated through country-
led process. The 4th SWAp will have to address Figure 3.1 summarizes the 17 Goals of the SDGs,
this requirement. A robust follow-up and which are: (1) No poverty; (2) Zero hunger;
review mechanism for the implementation (3) Good health and well-being; (4) Quality
of the new 2030 Agenda for Sustainable education; (5) Gender equality; (6) Clean water

CHAPTER 3: SUSTAINABLE DEVELOPMENT GOALS
and sanitation; (7) Affordable and clean energy; essential healthcare services and access to
(8) Decent work and economic growth; safe, effective, quality and affordable essential
(9) Industry, innovation and infrastructure; medicines and vaccines for all
(10) Reduced inequality; (11) Sustainable
3.9 By 2030, substantially reduce the number
cities and communities; (12) Responsible
of deaths and illnesses from hazardous
consumption and production; (13) Climate
chemicals, and air, water and soil pollution
action; (14) Life below water; (15) Life on land;
and contamination
(16) Peace, justice and strong institutions; and
(17) Partnership for the Goals. Although Goal 3 3.a Strengthen the implementation of the
is directly related to health, the health sector has World Health Organization Framework
the responsibility and stake in all the other 16 Convention on Tobacco Control in all
goals to apply the principles of SDGs in its own countries, as appropriate
settings as well as to complement achievement
of the related goals by other sectors. 3.b Support the research and development
of vaccines and medicines for the
Goal 3 of SDGs states To ensure healthy lives communicable and non-communicable
and promote well-being for all at all ages. diseases that primarily affect developing
countries, provide access to affordable
Goal 3 has 13 targets as follows: essential medicines and vaccines, in
3.1 By 2030, reduce the global maternal accordance with the Doha Declaration on
mortality ratio to less than 70 per 100,000 the TRIPS Agreement and Public Health,
livebirths which affirms the right of developing
countries to use to the full extent the
3.2 By 2030, end preventable deaths of provisions in the Agreement on Trade-
newborns and children below 5 years of age, related Aspects of Intellectual Property
with all countries aiming to reduce neonatal Rights regarding flexibilities to protect
mortality to at least as low as 12 per 1,000 public health, and, in particular, provide
livebirths and under-5 mortality to at least access to medicines for all
as low as 25 per 1,000 livebirths
3.c Substantially increase health financing and
3.3 By 2030, end the epidemics of AIDS, the recruitment, development, training,
tuberculosis, malaria, and neglected tropical and retention of the health workforce in
diseases and combat hepatitis, waterborne developing countries, especially in the
diseases, and other communicable diseases least-developed countries and small island
developing States
3.4 By 2030, reduce by one-third the premature
mortality from non-communicable diseases 3.d Strengthen the capacity of all countries, in
through prevention and treatment and particular, developing countries, for early
promote mental health and well-being warning, risk reduction and management of
national and global health risks.
3.5 Strengthen the prevention and treatment of
substance-abuse, including narcotic drug- Other goals and targets related to health sector
abuse and harmful use of alcohol Table 3.1 summarizes the number of other SDGs
3.6 By 2020, halve the number of global deaths and targets related to health. It reveals that there
are 33 additional targets under 12 other goals
and injuries from road-traffic accidents
that are related to health.
3.7 By 2030, ensure universal access to sexual
The list of the targets is shown below:
and reproductive healthcare services,
including for family planning, information Goal 1
and education, and the integration of
reproductive health into national strategies 1.3 Implement nationally-appropriate social
and programs protection systems and measures for all,
including floors and, by 2030, achieve
3.8 Achieve universal health coverage, including substantial coverage of the poor and the
financial risk protection, access to quality vulnerable

Figure 3.1. The 17 Goals of SDGs
Goal 3 Health in the SDGs
Goal 2 quality technical, vocational and tertiary

education, including university degrees
2.1 By 2030, end hunger and ensure access
by all people, in particular, the poor 4.5 By 2030, eliminate gender disparities in
and people in vulnerable situations, education and ensure equal access to all
including infants, to safe, nutritious and levels of education and vocational training
sufficient food all year round for the vulnerable, including persons
with disabilities, indigenous peoples, and
2.2 By 2030, end all forms of malnutrition,
including achieving, by 2025, the children in vulnerable situations
internationally-agreed targets on 4.a Build and upgrade education facilities
stunting and wasting in children that are child-, disability- and gender-
below 5 years of age, and address the
sensitive and provide safe, non-violent,
nutritional needs of adolescent girls,
inclusive and effective learning
pregnant and lactating women and
environments for all
older persons
Goal 4 Goal 5
4.2 By 2030, ensure that all girls and boys 5.1 End all forms of discrimination against
have access to quality early childhood all women and girls everywhere
development, care and pre-primary 5.2 Eliminate all forms of violence against
education so that they are ready for
all women and girls in the public and
primary education
private spheres, including trafficking
4.3 By 2030, ensure equal access for all and sexual and other types of
women and men to affordable and exploitation

Table 3.1. Number of other SDG targets related to health

No. of targets No. of targets
Goal Goal Total goals Total targets
related to health related to health
1 1 9 2
2 2 10 1
4 4 11 2
12+1=13 33+13=46
5 5 13 4
6 3 16 7
7 1 17 1
5.3 Eliminate all harmful practices, such including regional and trans-border
as child, early and forced marriage and infrastructure, to support economic
female genital mutilation development and human well-being,
with a focus on affordable and equitable
5.5 Ensure womens full and effective
access for all
participation and equal opportunities for
leadership at all levels of decision-making 9.4 By 2030, upgrade infrastructure and
in political, economic and public life retrofit industries to make them
5.6 Ensure universal access to sexual and sustainable, with increased resource-use
reproductive health and reproductive efficiency and greater adoption of clean
rights as agreed in accordance with the and environmentally-sound technologies
Program of Action of the International and industrial processes, with all
Conference on Population and countries taking action in accordance
Development and the Beijing Platform with their respective capabilities
for Action and the outcome documents
of their review conferences Goal 10
Goal 6 10.4 Adopt policies, especially fiscal, wage

and social protection policies, and
6.1 By 2030, achieve universal and progressively achieve greater equality
equitable access to safe and affordable
drinking-water for all Goal 11
6.2 By 2030, achieve access to adequate and 11.5 By 2030, significantly reduce the
equitable sanitation and hygiene for all number of deaths and the number
and end open defecation, paying special of people affected and substantially
attention to the needs of women and decrease the direct economic losses
girls, and those in vulnerable situations relative to global gross domestic
6.3 By 2030, improve water quality by product caused by disasters, including
reducing pollution, eliminating water-related disasters, with a focus
dumping and minimizing release of on protecting the poor and people in
hazardous chemicals and materials, vulnerable situations
halving the proportion of untreated
wastewater and substantially increasing 11.6 By 2030, reduce the adverse per-
recycling and safe reuse globally capita environmental impact of cities,
including by paying special attention
Goal 7 to air quality and municipal and other
7.3 By 2030, double the global rate of waste management
improvement in energy efficiency Goal 13
Goal 9 13.1 Strengthen resilience and adaptive
9.1 Develop quality, reliable, sustainable capacity to climate-related hazards and
and resilient infrastructure, natural disasters in all countries

13.2 Integrate climate change measures WHOs suggested list of indicators for health-
into national policies, strategies, and related SDGs
planning
For understanding the reporting requirement
13.3 Improve education, awareness- for the health-related SDGs, it is essential to
raising and human and institutional know the indicators list of the same. Recently,
capacity on climate change mitigation, the United Nations Statistical Commission,
adaptation, impact reduction, and early which is entrusted for developing measurement
warning indicators for SDGs, recommended 230
indicators for SDGs, from which the WHO has
13.b Promote mechanisms for raising primarily identified the following indicators as
capacity for effective climate change- health-related:
related planning and management in
the least-developed countries and small Proportion of stunted U5 children
island developing States, including
Proportion of wasted and overweight U5
focusing on women, youth, and local
children
and marginalized communities
Proportion of births attended by skilled
Goal 16
health personnel
16.1 Significantly reduce all forms of
Infant mortality rate
violence and related death rates
everywhere Under-five mortality rate
16.2 End abuse, exploitation, trafficking and Neonatal mortality rate
all forms of violence against and torture
of children Maternal mortality ratio
16.5 Substantially reduce corruption and Estimated HIV incidence rate

bribery in all their forms Mortality rate attributed to cardiovascular
16.6 Develop effective, accountable and disease, cancer, diabetes, or chronic
transparent institutions at all levels respiratory disease
16.7 Ensure responsive, inclusive, Suicide mortality rate

participatory and representative Alcohol per-capita consumption (aged 15
decision-making at all levels years and older) within a calendar year in
16.9 By 2030, provide legal identity for all, liters of pure alcohol
including birth registration Death rate due to road-traffic injuries
16.10 Ensure public access to information Proportion of women married or in a union
and protect fundamental freedom, in of reproductive age (aged 15-49 years) who
accordance with national legislation have their need for family planning satisfied
and international agreements with modern methods
Goal 17 Adolescents childbirth rate per 1,000
adolescent women aged 15-19 years
17.18 By 2030, enhance capacity-building
support to developing countries, Mortality rate attributed to household and
including for the least-developed ambient air pollution
countries and small island developing
States, to increase significantly the Mortality rate attributed to unsafe water,
availability of high-quality, timely and unsafe sanitation and lack of hygiene
reliable data disaggregated by income,
Mortality rate attributed to unintentional
gender, age, race, ethnicity, migratory
poisonings
status, disability, geographic location
and other characteristics relevant in Proportion of population using improved
national contexts. drinking-water sources

Proportion of population using improved Economic, social and environmental context

sanitation facilities of health
Tobacco-use rate The period of SDGs poses challenges, like
urbanization and all related negative impacts;
International Health Regulations (IHR) environmental pollution; the youth bulge and
capacity and health emergency preparedness challenge to make a demographic dividend;
UHC tracers (hypertension treatment ageing; and migration (in- and out-country).
coverage; diabetes treatment coverage; Therefore, the SDGs emphasize on a much
cervical cancer screening; tobacco-use; broader approach to poverty reduction to
ART coverage, tuberculosis treatment, improve not only health; but also nutrition,
use of insecticide-treated nets, access to education, governance, economic reform,
safely-managed drinking-water source marginalized populations, gender discrimination,
and sanitation; hospital access, health and violence and conflict. The SDGs want a shift
workforce density by specific cadres, access from vertical programs towards more system-
to medicines and vaccines, IHR capacities; wide, cross-cutting support, consistent with the
and catastrophic and impoverishing out-of- aim of UHC. Primary prevention is the key to
pocket health spending) protecting from climate risks.
Death rate due to disasters Universal health coverage (UHC)
Data disaggregation situation The UHC has been defined as Ensuring that
all people can use the promotive, preventive,
Coverage of birth and death registration curative, rehabilitative and palliative health
services they need, of sufficient quality to
Women and girls subjected to physical,
be effective, while also ensuring that the use
sexual or physiological violence.
of these services does not expose the user to
Health in 2015 from MDGs to SDGs financial hardship. The UHC is prominent in
the SDGs declaration and has a specific target
The World Health Organization has published under the health goal. The UHC is the key to the
a book titled Health in 2015 from MDGs achievement of, all the other health-related goals.
to SDGs. The book recognized clearly that The national policy will have to decide how and
achievement of health-related SDGs will not when the three dimensions of UHC, viz. what
be possible through business as usual as we proportion of population, which health services
followed in the primary healthcare and MDGs and what proportion of cost (not out-of-pocket)
era. Health-related SDGs will require different will be covered by the national scheme.
kinds of modalities to track individual citizens
to identify their individual healthcare need and Reproductive, maternal, newborn, child,
provide tailor-made solutions on case-by-case adolescent health and undernutrition
basis as per the vision of UHC. Table 3.2 broadly
Table 3.3 compares the reproductive, maternal,
describes the difference of focus between health-
newborn and adolescent health and nutrition
related MDGs and health-related SDGs.
targets between health-related MDGs and
health-related SDGs.
Health-related SDGs will
Infectious diseases
require different kinds of
Antimicrobial resistance (AMR) is a global
modalities to track individual threat but the health-related SDGs miss to
citizens to identify their mention about it. It needs to be addressed
under UHC and WHO Global Action Plan
individual healthcare need on Antimicrobial Resistance 2015. Table
3.4 compares the infectious disease control
and provide tailor-made targets between health-related MDGs and
solutions on case-by-case health-related SDGs. Globalized pandemics
of communicable diseases, such as Ebola viral
basis as per the vision of UHC. disease, MERS-CoV, Zika viral disease, avian

Table 3.2. Difference of focus between health-related MDGs and health-related SDGs
Health-related MDGs Health-related SDGs
Focused on national progress and on Equity is at the heart of the SDGs, which are found on
specific populations, notably mothers the concept of leaving no one behind
and children, and people affected by
HIV, TB, and malaria Address health and well-being at all ages, including
newborns and children, adolescents, adult women and
Needless to say, such an approach will men, and older persons
also be relevant in monitoring progress
towards UHC Not only is the goal to be monitored much broader, but
it is also extended over time, and will thus require a
comprehensive, life-course approach
Needless to say, such an approach will also be relevant in

monitoring progress towards UHC
influenza, etc. and fear of biological weapons is US$ 11.4 billion per year while the cost for
in conflicts and terrorism are new threats to not taking responsive action is US$ 500 billion
global health security. Resilience of health per year. These facts clearly demonstrate why
system to such biological threats as well as we would need to address NCDs as one of
natural disasters, like large-scale earthquakes, the top priorities not only for health but for
floods, storms, tsunami, drought, and change rapid economic development of the country
in disease patterns due to climate change are through saving scarce resources. The WHO has
big health security issues. adopted the Comprehensive Global Monitoring
Framework for NCDs, with 9 voluntary targets
Non-communicable diseases and 25 indicators to be achieved by 2025. These
population-based targets can be categorized
The SDG Target 3.4 calls for reducing the
in three groups, viz. Mortality and Morbidity:
premature NCD mortality by one-third within
(1) premature mortality from NCDs (25%
2030. It will need strong population-based
reduction); National Health System Response:
surveillance in each country to understand the
(2) essential medicines and technologies (80%
baseline, trend, and progress in each country.
coverage); (3) drug therapy and counseling
The Global Disease Burden (2012) shows that
(50% coverage); and Risk Factors for NCDs: (4)
52% of the global deaths around the age of 70
diabetes and obesity (0% increase); (5) raised
years are due to NCDs, 34% by communicable,
blood pressure (25% reduction); (6) tobacco-
maternal, neonatal and nutritional conditions,
use (30% reduction); (7) salt/sodium intake
and 14% by injuries. The distribution within
(30% reduction); (8) physical inactivity (10%
NCDs is 38% by cardiovascular diseases,
reduction); and (9) harmful use of alcohol (10%
27% by cancers, 8% by chronic respiratory
reduction). The WHO-SEARO has added the
diseases, 4% by diabetes, and 23% by other
10th target for 50% relative reduction in the
NCDs. In Bangladesh, both morbidities and proportion of households using solid fuels as the
mortalities are dominated by NCDs (more primary cooking source.
than 60% prevalence), with cerebrovascular
accidents being the highest cause of hospital- Mental health and substance-use
reported deaths. The economic loss due to
NCDs in the developing countries is alarming. There were no MDG target for either mental
The World Economic Forum Report 2014 health or substance-use disorders but there
estimates that the combined economic loss are two SDG targets for mental health and
in the developing countries due to natural substance-abuse as follows:
and man-made disasters, all corruptions and SDG Target 3.4
crimes, all infectious, maternal and child health
and nutritional conditions is far less than the By 2030, reduce by one-third the premature
economic loss due to NCDs. According to a mortality from non-communicable diseases
WHO estimate (2011), the cost for the whole through prevention and treatment and
world for taking responsive actions for NCDs promote mental health and well-being

Table 3.3. Comparison of the reproductive, maternal, newborn, adolescent health and nutrition
targets between health-related MDGs and health-related SDGs.
MDG Target 1.C SDG Target 2.2
Halve, between 1990 and By 2030, end all forms of malnutrition, including achieving,
2015, the proportion of by 2025, the internationally-agreed targets on stunting and
people who suffer from wasting in children below five years of age, and address the
hunger nutritional needs of adolescent girls, pregnant and lactating
women, and older persons
MDG Target 4
SDG Target 3.1
Reduce by two-thirds,
between 1990 and 2015, By 2030, reduce the global maternal mortality ratio to less
the under-five mortality than 70 per 100, 000 livebirths
rate
SDG Target 3.2
MDG Target 5.A
By 2030, end preventable deaths of newborns and children
Reduce by three-quarters, below five years of age, in all countries aiming to reduce
between 1990 and 2015, neonatal mortality to at least as low as 12 per 1,000 livebirths
the maternal mortality and under-five mortality to at least as low as 25 per 1,000
ratio livebirths
MDG Target 5.B SDG Target 3.7
Achieve, by 2015, universal By 2030, ensure universal access to sexual and reproductive
access to reproductive healthcare services, including for family planning, information
health and education, and the integration of reproductive health into
national strategies and programs
Table 3.4. Comparison of the infectious disease control targets between health-related MDGs and
health-related SDGs

MDG Target 6.A SDG Target 3.3
Have halted, by 2015, and begun to reverse the By 2030, end the epidemics of AIDS,
spread of HIV/AIDS tuberculosis, malaria, and neglected
tropical diseases and combat hepatitis,
MDG Target 6.B waterborne diseases, and other
Achieve, by 2010, universal access to treatment communicable diseases
for HIV/AIDS for all those who need it SDG Target 6.1
MDG Target 6.C By 2030, achieve universal and equitable
Have already halted, by 2015, and begun to access to safe and affordable drinking-
reverse the incidence of malaria and other water
major diseases SDG Target 6.2
MDG Target 7.C By 2030, achieve access to adequate and
Halve, by 2015, the proportion of people equitable sanitation and hygiene for all
without sustainable access to safe drinking- and end open defecation, paying special
water and basic sanitation attention to the needs of women and girls,
and those in vulnerable situations

SDG Target 3.5 (b) Identify achievements, challenges, gaps, and
critical success factors purposefully;
Strengthen the prevention and treatment of
substance-abuse, including narcotic drug- (c) Open, inclusive, participatory and
abuse. In our country, as elsewhere, there is a transparent approaches for all people and by
growing prevalence of depression and suicide; all stakeholders;
dementia; and substance-use and related
disorders. During the SDGs era, we will have to (d) Adopt people-centered, gender-sensitive
address these problems. Moreover, autism and strategy, respect human rights, with a
neurodevelopmental disabilities are other issues particular focus on the poorest, most
that require health programs from humanitarian vulnerable, and those who are furthest
and developmental perspectives. behind;
Injuries and violence (e) Avoid duplication and to respond to

national circumstances, capacities, needs,
Figure 3.2 shows that, globally, the distribution and priorities; data to be of high quality,
of leading cause of deaths from different kinds of accessible, timely, reliable, and disaggregated
injuries and violence accounts for 24.4% by road- by income, sex, age, race, ethnicity,
traffic injuries, 15.6% by suicide, 13.5% by falls, migration status, disability, geographic
9.8% by interpersonal violence (also homicide), location, and other characteristics relevant
7.2% by drowning, 5.2% by fire, 3.8% by in national contexts;
poisoning, 2.3% by war and conflicts, and 18.2%
by other unintentional injuries. In Bangladesh, (f) Prepare national reports to allow
road-traffic injuries are increasing alarmingly. assessments of progress and identify
Preventable unintentional injuries and drowning challenges at the regional and global levels;
are also alarmingly high. In the public hospitals, (g) Follow-up and review of the goals and
the second leading cause of hospitalization is targets to be done using a set of global
assault. Prevalence of poisoning and suicide is indicators complemented by indicators at
also significant. In the health-related SDGs, these the regional and national levels, which will
issues will have to be addressed. be developed by Member States.
What is important to remember in the transi- The heads of the National Government
tion from MDGs to SDGs Delegation declared We commit to fully engage
in conducting regular and inclusive reviews
There is legacy of the unfinished agenda of of progress. We will draw as far as possible on
MDGs. The transition from MDGs to SDGs the existing network of follow-up and review
cannot be seen solely as the exchange of a institutions and mechanisms.
shortlist of goals and targets for a longer one.
The SDGs are fundamentally different from the DGHS to prepare itself for responding to
MDGs in many aspects. health-related SDGs
How the SDGs will be followed up and The economic development of the country,
reviewed peoples health-related awareness, purchasing
power, youth bulge, and increasing quest for
It is stated in the SDG declaration that a robust, quality of life, in one hand, and the experience
voluntary, effective, participatory, transparent and
and ability of the health sector to handle and
integrated follow-up and review framework will be
manage large-scale health programs, on the
put in place to measure and report the progress of
other hand, are our assets towards the path of
SDGs. Promotion of accountability to the citizens
health-related SDGs.
will be at the heart of the review process.
The health sector of Bangladesh has made
Follow-up and review processes will be done at
remarkable success stories in the 1980s when
all levels: local, subnational, national, regional,
there was very high prevalence of diarrhea and
and global, with the following principles:
communicable disease outbreaks, more floods,
(a) Country-led process, with global review, less awareness of people, requiring more home-
primarily based on national official data visits to encourage families to bring children
sources; to immunization camps and motivate mothers

Figure 3.2. Leading causes for 5.1 million global deaths due to injuries and violence, 2012 (Source:
WHO, retrieved on 14 September 2016 from: http://who.int/gho/publications/mdgs-sdgs/MDGs-SDGs2015_
chapter8.pdf)
War and Conflict
2.3%
Intepersonal violence
9.8% Road-traffic injury
24.4%
Suicide
15.6%
Falls
13.5%
Other unintentional injuries
18.2%
Drowning
7.2%
Poisoning Fire
3.8% 5.2%
for antenatal care. The road networks were very population of the country. There is much
poor; health managers did not have vehicles; room for improving coordination, health
there were no mobile network or Internet systems management, discipline, productivity,
connectivity. Availability of electricity in the and accountability of the health workforce
predominantly rural Bangladesh was a dream. in general. There is shortage in resource
availability, and there is also evidence of the
The current situation in 2016 is very different, wastage of scarce resources.
with diarrheal or infectious disease outbreaks
under control; less occurrence of floods,
more community awareness and demand for The pattern of disease burden
healthcare; home-visits for child immunization
and antenatal care are not required. Good
changed, with increasing
roads, multiple ways of commuting, country- prevalence of NCDs, which
wide mobile and Internet network are the
realities of current Bangladesh. The health will require huge preventive
sector has the well-distributed health facility healthcare through strong
network, which has been further strengthened
by 13,000+ community clinics with an social and community
additional human resource of 13,000+ young,
energetic, and ICT-literate community
mobilizations.
healthcare providers. The health sector and country context of
While these are the strong sides, there are the 1980s now are in better position. With
weak ones also. The pattern of disease burden determination, a bit good planning, we can
changed, with increasing prevalence of NCDs, achieve the health-related SDGs.
which will require huge preventive healthcare New requirements in health-related SDGs
through strong social and community
mobilizations. Size of the health workforce is 1. Set up the baseline of health indicators to
inadequate compared to the increased current measure and regularly review the progress

of health-related SDGs responding through ideas. In the integrated and comprehensive
appropriate interventions. primary healthcare, there should be clear
principles, such as (a) universality, i.e.
2. Achieve UHC progressively. reaching everybody; (b) comprehensive, i.e.
In the SDGs, Target 3.8 of UHC has been stated inclusion of all components of PHC, such as
as Achieve universal health coverage, including promotion, prevention, early diagnosis, early
financial risk protection and access to quality treatment, and rehabilitation; (c) holistic, i.e.
essential healthcare services; safe, effective, covering all aspects of quality of life, such as
quality and affordable essential medicines and environmental, social, economic, and familial
vaccines for all. The World Health Report 2010 matters; (d) human rights and equity; (e) quality
defines UHC as All people receiving the health of service; (f) continuity; (g) participation of the
services they need, including health initiatives service recipients/community. The integrated
designed to promote better health (such as and comprehensive primary healthcare will look
anti-tobacco policies), prevent illness (such into all individuals-sick or healthy; so, a strong
as vaccinations), and to provide treatment, domiciliary healthcare interfacing families and
rehabilitation, and palliative care (such as end- health facilities remains vital to the service. It
of-life care) of sufficient quality to be effective would need to transform behavior of the health
while at the same time ensuring that the use staff to make them more and more compliant
of these services does not expose the user to to the government programs, responsive and
financial hardship. sensitive to the citizens need, and accountable
to the health management. There should be
Central to both health-related SDGs and UHC provisions of early detection and structured
is the need for efficient measurement system to referral whenever needed, and back-referral for
make data available on overall health systems follow-up.
and track individual citizens for healthcare to
make evidence-based decisions and response. Uniform organizational structure
Providing healthcare to an individual without
The role of each level of service points,
justifying the need is a kind of wastage. Equally,
although already defined, will require to be
not providing healthcare in time of need is also
further specified clearly with written guideline.
a wastage as this can lead to complications or
The service points will be: (i) domiciliary care;
deviation from health protection. Introduction
(ii) temporary satellite camp; (iii) community
of universal electronic health-records to capture
clinic; (iv) union health facility; (v) upazila
core health data of every individual citizen
health facility; (vi) district health facility;
routinely through engaging the community
(vii) tertiary-care hospital; and (viii) super-
health workers and community clinics is the
specialized hospital. Referral method should
right path towards this direction. Fortunately,
also be described clearly and implemented.
the DGHS already achieved this technological
competence to introduce universal health- Uniform service package across healthcare
records at least in the rural settings.
It is assumed that the MOHFW will be divided
Actions that the DGHS can consider for into two divisions, tentatively as (i) health
achieving health-related SDGs division and (ii) family planning, nursing
and drugs division. In this case, the DGHS
1. Integrated and comprehensive primary
would need to define also what kind of
healthcare
service package (list of service components),
Timor-Leste, a small island country in the medicines, and drugs will be provided at
South-East Asia, introduced a good example each specific level; requirements of human
of integrated and comprehensive primary resource and equipment at each level will
healthcare. With WHOs active partnership, also need to be determined. The deliverables
Bill & Melinda Gates Foundation has started and responsible staff members, work process,
an initiative for revitalization of primary reporting requirement, monitoring and
healthcare called Primary Healthcare supervision and accountability setting will
Performance Initiative (PHCPI). These are two have to be defined clearly at each level.
recent good sources of innovations and new There will be a shortage of union-level health

facilities if the new divisions of the MOHFW iii. Visit for epidemiological surveillance: These
are established immediately. The DGHS will visits will have to be made for special
have to work out how the initial gap will be outbreak investigation or illness that
handled. One way can be signing of MoU with requires increased vigilance for any risky
the DGFP to use their union-level facilities to health event and/or health problem in
provide health services also. If so happens, the population. Collection of special
the DGFPs union-level facilities can be used community-based health data can also be
as one-stop service point. The DGHS, with a part of the epidemiological surveillance.
the help of development partners, should There should be no specific period or time
explore opportunities to hire multipurpose of visits for epidemiological surveillance,
health volunteers on pay-for-performance which will be undertaken as and when
basis to support the domiciliary team members required; however, such visits should be
(health assistants, assistant health inspectors, made with planned preparation.
and health inspectors) and the community
healthcare providers. Individual tracking through electronic health
records
Population stratification at community for better
tracking and delivering health services Bangladesh has a good readiness system to track
individual health condition electronically, in
Population stratification, according to terms of hardware and software. The health
respective health conditions, can be a good managers understanding and practice of
option for planning and implementing engaging the community-level health workers
healthcare delivery. Timor-Leste made a design
and health workers are essential to make success
of population stratification for domiciliary
in this case. Individual tracking is important
visit and healthcare delivery. In Timor-Leste,
for health-related SDGs, UHC, and CRVS. So,
the populations have been stratified into four
electronic tracking will have to be ensured on
groups as shown in Table 3.5.
annual basis or as and when required.
Mandatory and structured domiciliary visits as
Generous investment in community health and
per population stratification
primary healthcare
As per population stratification, structured and
Investments should be made in placing more
mandatory routine domiciliary visits will have
community health volunteers at the union level
to be made. Community health workers will
have to follow written guidelines to make the and below. They will provide better preventive
domiciliary visits. Domiciliary visits will be of and promotive care. The development partners
the following types: can support outsourcing for additional
community workers, introducing strong and
i. Integrated visit to family: Annual household integrated preventive and basic care for NCDs
surveys are to be done for entire community at the community level. Investments in health
catchments. Global Reference List of 100 education and awareness campaigns are also
Core Health Indicators, additional indicators essential. It is better not to place medical doctors
from that list, health-related SDG indicators, at the union health facilities and should be
indicators selected for the national context, pulled them back to the upazila level. Placing a
and health programs, etc. will have to be SACMO at the union health facility and making
considered to include in the data-collection him/her head of the union health facility is
tool. Online tracking tools, like DHIS2, SHR, reasonable, assigning him/her the leadership
OpenSRP, CHW Application, relevant apps, role for all staff members at the union level and
etc., as suitable, will be used. below. Placing a trained nurse or midwife in
each union health facility is also necessary for
ii. Routine/regular domiciliary visit: Family visits
ensuring reproductive healthcare.
based on population stratification will
have to be made when stratification can Strengthening mass health education
be updated, and necessary healthcare can
be given. Updating of data on individual Investment in mass health education program
citizens will have to be done using the will have to be increased manifolds. People
online tools as mentioned above. will have to be made more and more health

Table 3.5. Grouping of populations for domiciliary visits and healthcare delivery done in Timor-Leste
Minimum Minimum number
number of of annual visits to
Group Health condition of persons
annual home- health facility by
visits by staff a person
Supposedly healthy persons manifesting no risk
I 2 1
condition, illness, or deficiency
Persons with health risk, including pregnant
II 3* 2*
women; more vulnerable to have other diseases
Sick persons, diagnosed by a doctor as having
chronic NCDs, chronic mental illness or chronic
III infections, HIV/AIDS, TB, etc.; acute infections, 4* 3*
like malaria, dengue, URTI, diarrhea, etc. are not
included
Persons with disability, diagnosed by a doctor or
IV have temporary or permanent impairment of the 3 2
motor, sensory, psychological and mental health
*Pregnant women and children have different protocols
conscious. It should be considered to raise be used. It may be understood that the

peoples skills to a level so they can take critical community clinic will serve as a referral point
first-aid measures themselves. At the same time, for community people for treatment, preventive
it would be important to create more active and promotive care. The review will consider
community health support groups. health situation in the whole community rather
than that seen at the community clinic only.
2. Routine review meetings at all levels The context will include community health
situation, community health service, and
In each organization, there will be routine
community clinic service. Mortality patterns
weekly and monthly meetings for review of
of patients attending the community clinics
management situation, health program, and for
may give clues to the trends in the occurrence
resolving urgent issues.
of diseases in the community, which will
Weekly and monthly meetings at community also be discussed and reviewed. On monthly,
clinic quarterly, semi-annual and annual basis,
summarized view of the health situation will be
Weekly meetings will take place at community discussed, and community plans will be chalked
clinic. The CHWs both from the DGHS, the out to improve the situation. Community
DGFP, NGOs, and interested members of the resources (volunteers, finance, other material
Community Clinic Management Groups (CG contributions, etc.) will also be mobilized
and CSG) will attend these meetings. A defined through local actions. All relevant data will
community catchment will be the focus of all be reliably stored in the online system so that
discussions in all such meetings. Follow-up of union, upazila, district, divisional and national
the decisions in previous meetings, review of reports can be prepared.
the health delivery situation, service delivery,
immunization camps, satellite clinics, coverage Weekly and monthly meetings at the union level
of clients, health education program, services Weekly meetings will take place at the union
given at the community clinic, and the health facility. Head of the union health facility
overall local health situation will be reviewed; will preside, and all staff members working at the
planning of service delivery and management union health facility will attend. Management
for the next week will be made. For review, issues and patient profiles of the union health
data from online system for individual records facility will be discussed and decisions be taken.
automatically transformed into dashboard One monthly meeting will be held where
reports and also case-by-case reports will head of the union health facility, other related

staff members, all CHCPs, supervisory staff of preside and all officers and important staff
health assistants, and chairman or designated working at divisional health office will attend.
member of the Union Parishad will attend. The Divisional health management issues and local
health data, aggregated and disaggregated for office situation will be discussed and decisions
community catchments, community clinic, and be taken. In each month, one monthly meeting
union health facility, will be reviewed, decisions will be held, where all district health managers
be taken, and guidance will be given back to the will attend exclusively. If physical presence of
community-level staff. Similarly, concerns will be the district health managers appears difficult
communicated to the upazila level. every month, online meeting using video-
conference can be used. However, at least one
Weekly and monthly meetings at the upazila level meeting with physical presence must be held
every quarter. In the monthly meeting, the
Meetings will take place at the upazila health
district health managers will describe the district
office. Head of the upazila health authority
health situation using the online tools. The
will preside, and all officers and important
health data, aggregated and disaggregated for
staff members working at the upazila health
district and further in-depth, and for the health
office/facility will attend. The upazila health
facilities under the division, will be reviewed,
management issues and patient profiles of the
decisions be taken and guidance will be given
upazila health facility will be discussed and
back to district health managers. Similarly,
decisions be taken. One monthly meeting
concerns will be communicated to national
will be held where all field staff, head of the
level.
union health facility, and other related staff
members will attend. All CHCPs can attend Weekly and monthly meetings at DGHS
this monthly meeting, or there can be separate
meeting for the CHCPs. The health data of Meetings will take place at the DGHS. The
the upazila, aggregated and disaggregated for DG or one of the ADGs will preside, and all
unions, union health facilities, and community directors/line directors working at the DGHS
clinics, will be reviewed, decisions be taken, will attend. The issues relating to the DGHS
and guidance will be given back to staff at and the countrys health management will be
the union and community levels, including discussed, and decisions be taken. One monthly
meeting will be held where all divisional
those working at the union health facilities and
health managers will attend through video-
community clinics. Similarly, concerns will be
conferencing. In the monthly meeting, the
communicated to the district level.
directors, line directors, and divisional directors
Weekly and monthly meeting at the district level will describe the countrys health situation,
using the online tools. The health data of the
Meetings will take place at the district health country, aggregated and disaggregated for
office. Head of the district health authority will divisions, districts, and for the types of health
preside, and all officers and important staff facilities, will be reviewed, decisions be taken,
working at the district health office will attend. and guidance will be given back to divisional
The district health management issues and local health managers. Similarly, concerns will be
office situation will be discussed and decisions be communicated to the Ministry.
taken. One monthly meeting will be held where
all upazila health managers will attend exclusively. Weekly and monthly meetings at the
They will describe the upazila health situation, organizational level
using the online tools. The health data, aggregated Meetings will take place in each organization
and disaggregated for upazilas and other health (medical teaching institution, hospital, health
facilities under the district, will be reviewed, center, etc.) not described above. Head of
decisions be taken, and guidance will be given the organization will preside, and all top-
back to upazila managers. Similarly, concerns will level officers and important staff working at
be communicated to the divisional level. the organization will attend. Organizational
health management issues, performances,
Weekly and monthly meetings at the divisional level
targets, achievements, future plans, etc. will be
Meeting will take place at divisional health discussed and decisions be taken. One broad-
office. Head of divisional health authority will based monthly meeting will be held with

wider participation. On monthly, quarterly, which they could get service in the community
semi-annual and annual basis, cumulative clinic. This situation can be transformed
performance will be analyzed and decisions gradually through promoting structured
be taken. The health data of the organization, referral system even in the existing model.
aggregated and disaggregated for departments, Under a structured referral system, patients
units, etc. will be also reviewed, decisions will be encouraged to go to nearby primary
be taken, and guidance will be given back to healthcare center first, be informed what kind of
departments and units. Similarly, concerns will health services are available in each healthcare
be communicated to the higher authority. facility, be informed that, in case of need for
better treatment, the health facility by its own
3. Rationalization of health workforce
responsibility will refer the patients to the
distribution
higher health facility where the referred patients
Distribution of doctors and other staff at the will get special preference. If not an emergency,
upazila, district and other levels is necessary, the SACMO will not see patients without
with no consideration whether sanctioned posts referral by CHCP. The upazila hospital will not
exist or not. The rational need may be given see patients without referral by union facility.
the first priority. The principles and set rules Higher centers will also emphasize on the
should be strictly followed. For placement of all referrals. Vertical approach and fragmentation
staff, the same principles and set rules should should be discouraged and coordination
be followed. Staff distribution should be seen be improved. Patients may be given special
as an urgent and priority task. At the upazila incentives if they take the opportunity of
level, each MBBS doctor should be assigned for referral service. However, promise to the patients
one or more specific union(s) to improve the must be fulfilled. Otherwise, mistrust will be
local health situation through giving proper created, and the efforts will go in vain.
leadership to the union-level officers and
staff. S/he will be accountable to the upazila As per World Health Report 2010, wastage
health manager for the assigned tasks. His/her occurs usually in several areas that can be
accomplishments will be recognized through avoided: underuse of generic medicines; use
incentives in the form of career development of over-priced medicines; use of substandard or
opportunity. Stringent maintenance, use, and counterfeit medicines; and inappropriate and
adherence to the norms of human resource ineffective use of medicines; overuse or supply
management information system are of great of equipment, investigations and procedures;
concern. Inappropriate health workforce or costly staff-
mix or unmotivated workers; inappropriate
4. Efficiency gain hospitalization and length of stay; medical
errors and suboptimal quality of care; wastage,
Our aims should be to improve coordination, corruption and fraud in the health systems
prevent wastage, gain efficiency, and establish leakage; inefficient mix/inappropriate level of
an efficient DGHS. This can be accomplished strategies in Health interventions.
by undertaking a holistic approach in program
planning and implementation; not allowing 5. Campaign for non-communicable diseases
directors, line directors, projects, development
partners, and NGOs to work in isolation that Major non-communicable diseases (NCDs)
will duplicate same work; making common include cardiovascular diseases, such as high
package of service equitably distributed in all blood pressure, diabetes, cancer, and obstructive
areas in the country; implementing programs respiratory diseases. Certain lifestyles, such
together as member of a common team; as less physical activity, unhealthy dietary
preventing wastage of scarce resources; and habit, smoking, alcohol-abuse are responsible
by uncompromised placement of dedicated, for these health problems. Many NCDs co-
sincere, honest and competent personnel. exist in the same person. Data show that over
60% of both morbidities and mortalities in
In our country, we unnecessarily waste time Bangladesh are due to NCDs. The burden is
of skilled human resource due to absence of much higher in urban settings. NCDs, once
structured referral system. Patients in basic these affect, stay for rest of the life and require
healthcare can visit tertiary-care hospitals for costly treatment, and if not controlled, may end

in serious complications. In the past decades, of healthcare delivery through telemedicine,

the disability-adjusted life years (DALYs) due call center, mobile phone health service, etc.
to NCDs has increased in some cases by 85% Many health-related NGOs and development
to 200%. In Bangladesh, about 8 lakh 37 partners facilitate governments efforts to
thousand people die annually due to diseases improve healthcare and technology transfer.
or natural reasons. About sixty percent, i.e. over The care providers in the private sector create
5 lakh of them die due to NCDs. Due to the room for additional access to healthcare and
consequences of longer average life-expectancy, peoples freedom of choice. One/common
the burden of NCDs will further increase and mother tongue means easy and cost-effective
will exert pressure on our healthcare systems training for health workforce and conduction of
and hospitals. Premature death or disability of easy health awareness campaign. Peoples health
a family member due to NCDs leads the family consciousness in Bangladesh is increasing. We
to a helpless situation. It would be needed to should focus on bringing more patients to the
introduce social mobilization programs for existing healthcare facilities rather than building
the prevention and control of NCDs; Physical more new health facilities. Promotion of strong
activity promotion programs, such as daily ambulance service, both in the government
morning/evening walk or jogging on streets or private sectors, is an urgent priority. The
and open spaces, will have to be undertaken Government will fix standard fees and protocols.
for mass participation. Small businesses and It will ensure quicker patient transportation in
law enforcement agencies will have to play case of emergency to the appropriate health
their roles in keeping the urban pedestrians facility. The community health workers should
walkways free of obstacles. In fact, if large have the ability to identify emergency condition
numbers of people walk through the footpaths, of patients, should know how to call ambulance
we will have no other ways than to keep the and to which health facility the patient should
footpaths obstacle-free. Inclusion of physical be sent to.
exercise programs in each government and
non-government meeting place may be 7. Improving quality of health service and
introduced. We would need to work with other medical education
ministries to promote and improve sports and Revisit training plans, adopt appropriate
sports venues. It would be needed to introduce, strategies, identify needs in the context of SDGs
sustain, and strengthen communication in Bangladesh, and institutionalize training
programs and campaigns for promotion of the accordingly are imperative. Harmonize training
prevention and control interventions for NCDs between programs. revisit medical education,
(physical activity; avoiding risk behaviors, teaching curriculum, and methodology seriously
adopt positive food habit, etc.). The DGHS are important steps to be taken immediately.
will have to work for implementing the Global We have to institute regulations; engage medical
Monitoring Framework for voluntary targets associations, BMDC, and other regulatory bodies
and indicators of NCDs (adopted by WHO) to enhance quality of medical education and
and mobilize multisectoral involvements medical practice; and promote ethical practice.
(government, political and social, leaders, The DGHS should play a proactive role in
individuals, champions, etc.) to join in the NCD providing timely and effective policy suggestions
interventions. to the MOHFW. The MOHFW oversees over
6. Better response to health emergencies 16,000 health facilities and organizations. The
DGHS should assist the MOHFW in placing
The high population density creates more a strong monitoring mechanism instead to
accessibility to healthcare. Good healthcare play role mainly as the policy-maker, enabler,
network provides basic and referral healthcare innovator, and regulator. It should work
near the homes of people. Good road network for enforcing stringent national healthcare
allows quicker patient transportation to health quality standards and protocols. Rather than
facilities. Wider mobile penetration also provides establishing own health facilities and teaching
opportunity to people and care providers to avail institutions, it is better to pay attention to
easier health communication support. Good encourage private care providers to deliver
use of ICT in health ensures efficient health health service and medical education and to
systems management and additional channel make sure that they follow ethical practice.

8. Moving towards UHC progressively healthcare. Government will have to explore
new innovative funding model to pool resource
UHC means ensuring optimum healthcare to for UHC. In some countries, the general tax
each citizen in time of need. It does not allow system provides 2.5% to 3.0% of the revenue
direct payment at the time of provision of as earmarked for health. For example, general
healthcare. However, those citizens who can VAT in these countries in all commodities is
pay are not exempted from payment; they will 15%, of which 2.5 to 3% go to the health sector.
pay as per their ability. Those citizens who Some countries apply extra health surcharge or
cannot pay will be even fully exempted. So,
levy on widely-used commodities, like charge
the rich or well-to-do people will pay even for
for mobile phone calls, tickets of bus, ferry,
primary healthcare and, of course, for elective
railway, and airplane. Introduction of pay-for-
healthcare. The society, media, policymakers,
performance or incentives package in the health
and people will have to be motivated gradually
facilities can make efficiency gains and improve
that they will have to take part in financial
ability to serve more people with better quality
provision of healthcare. The DGHS will have
but within the same resource. For example, in
to lead advocacy and discussion in this regard.
Turkey, the Government has introduced a social
In China, a transition stage towards UHC has
insurance system where all citizens need to pay
been started through cost-sharing at the health
12% of their monthly income for healthcare
facilities to make the habit of people to pay.
coverage. Citizens at marginal level are covered
Now China plans to shift to social insurance
by the Government. Others, if not insured, only
gradually. The UHC has three dimensions: (i)
get free primary and emergency healthcare;
what proportion of population will be covered;
they need to pay for elective treatment. The
(ii) what proportion of health services will be
hospitals have been given autonomy. Electronic
covered; and (iii) what proportion of cost (out-
record for each patient given healthcare from
of-pocket payment) will be covered.
the hospital is updated instantly in the health
The MOHFW is already providing free routine ministrys database and, accordingly, the
immunization coverage; primary healthcare hospital is reimbursed each month. The hospital
medicines from community clinics, from returns 15% of the earning to the ministry for
union health facilities, and from all other giving regular salary to the staff, uses 40% to
government health facilities. The emergency give to staff as incentives on the basis of pay-for-
lifesaving support is also being provided from performance, and uses 45% for patients diet,
health facilities where this service is available. investigations, and medicines. After introduction
All citizens will get the service if they come of this kind of system in 2005, Turkey has shown
to the government health facilities. However, remarkable improvement in healthcare and
the routine preventive healthcare, such as health situation in only 5 years by 2010. Patient
domiciliary visits, screening and control satisfaction level has increased to an all-time
program for the selected health conditions, high. Revenue level of the ministry rose to such
including NCDs, will also be part of the first a high level that the Government could build
UHC package. In the community, there can be 600 new tertiary hospitals in 5 years between
social mobilization and campaign to urge well- 2005 and 2010. The minimum standard of
to-do people to buy prepaid health-cards for general ward of a hospital is to have a maximum
these services as well as for extra health services of two beds with an attached bath. The numbers
beyond the basic or first UHC package. Having a of private clinics and hospitals have been
card will guarantee them that the listed services reduced from 22,000 in 2005 to only 2,000 in
will be made available to them. To start with, 2010. Hundred percent doctors stopped private
the ultra-poor section of the population may practice as they earn sufficiently in the public
also be provided healthcards free of charge, hospitals under pay-for-performance scheme. No
which will guarantee them to get the listed doctor or staff member comes to the ministry
health services for free. Others not having for better placement as this is managed by the
health-cards will also not be denied health hospitals themselves. Some government health
service provision but will not have guaranteed facilities can be given administrative autonomy
health service under the full UHC package. By in the same model as present in Turkey to see
encouraging citizens to pay for health services whether this fits to Bangladesh. If successful, the
will gradually build financial resources for public model can be scaled up.

Table: 3.6. Global and national targets on SDG indicators
National targets
Targets to be achieved Baseline values for
SDG targets Name of the indicators ( HNPSIP 2016-2021 and other
by 2030 Bangladesh
strategic documents)
3.1.1: Maternal mortality ratio Less than 70 per 100,000 176 per 100,000 105 per 100,000 livebirths by 2021
3.1 : Maternal (MMR) livebirths livebirths (WB 2016) (HNPSIP 2016-2021)
health 3.1.2: Births attended by skilled
- 42.1 (BDHS 2014) 65% by 2021 (HNPSIP 2016-2021)
health personnel
Less than 25 per 1000 37 per 1000 livebirths by 2021
3.2.1: Under-five mortality rate 46 (BDHS 2014)
3.2 : Newborn livebirths (HNPSIP 2016-2021)
and child health Less than 12 per 1000 21 per 1000 livebirths by 2021
3.2.2: Neonatal mortality 28 (SVRS 2015)
livebirths (HNPSIP 2016-2021)
Keep the AIDS epidemic from expanding
3.3: Communicable diseases
beyond this current level (<1%)
3.3.1: Estimated HIV incidence rate
Avoid a gradual spread of HIV infection
By 2030 end the endemic of AIDs
from high-risk groups to the general
<1 (WHO 2014)
population.
3.3.2: TB case detection rate/TB End epidemics of TB by 53% (GTBR 2014
75% (HNPSIP 2016-2021)
incident rate per 100,000 population 2030 estimates)
Malaria-positive
cases per 1,000
3.3.3: Malaria incidence rate per Reduce malaria morbidity and mortality
population (in
1000 population End epidemics by 2030 until the disease is no longer a public-
endemic areas): 3.00
health problem in the country
(in 2015, NMCP
2016
3.3.4: Hepatitis incidence per
Combat hepatitis - -
100,000 population
3.3.5: Neglected Tropical Kala-azar: Annual incidence rate to

Diseases ( NTDs): people <1/10,000 population in all endemic
requiring intervention End epidemic by 2030 - upazilas (subdistricts) by 2015
(preventive+ new cases) against Elimination of filiariasis
NTDs Prevention and control of dengue
Table: 3.6Contd.

Table continued...
National targets
by 2030 Bangladesh
18% (World Health

3.4.1: Mortality rate attributed Reduce one-third of
3.4: Non- Organization- Non-
to cardiovascular disease, premature mortality by Reduce one-third of premature mortality
communicable communicable Dis-
cancer, diabetes, or chronic 2030 due to NCDs from current rate
diseases eases (NCD) Country
respiratory disease
Profiles, 2014)
Reduce one-third of
3.4.2: Suicide mortality rate (per 8 per 100,000
premature mortality by Reduce one-third of premature suicidal
100,000 ) according to WHO
2030 death from current level
2014 report
3.5.1: Coverage of treatment Strengthen the

interventions (pharmacological, prevention and treatment
3.5: Substance- psychosocial and rehabilitation of substance-abuse,
- -
abuse and aftercare services) for including narcotic drug-
substance-abuse disorders abuse and harmful use of
alcohol
Strengthen the
3.5.2: Alcohol per-capita
prevention and treatment Almost zero alcohol
consumption (aged 15 years
of substance-abuse, consumption (0.2 in Committed to global target
and older) within a calendar
including narcotic drug- 2010)
year in liters of pure alcohol
abuse and harmful use of (WHO report 2014)
alcohol
Table: 3.6Contd.
Table continued...
National targets
by 2030 Bangladesh
According to World
Bank statistics, annual
fatality rate from road
accidents is found to
be 85.6 fatalities per
10,000 vehicles (WB,
World development
indicators 2002)
3.6.1: Deaths due to road-traffic By 2020, halve the According to the
3.6: Road- accidents/Mortality rate from number of global deaths Accident Research Committed to global targets
traffic injuries road-traffic injuries (per 100 and injuries from road- Institute (ARI),
000 population) traffic injuries Bangladesh University
of Engineering and
Technology, (BUET),
road accidents claim,
on average, 12,000 lives
annually and lead to
about 35,000 injuries
(Road safety facts 2012
through 2014)
By 2030, ensure
3.7.1 Proportion of women universal access to
married or in a union of sexual and reproductive
reproductive age (15-49 years) healthcare services,
who have their need for family including for family
3.7: Sexual and planning satisfied with modern planning, information
12% (7% for limiting Reduce unmet need to 7% by 2021
reproductive methods (met need) and education, and the
and 5% for birth (FP2020 commitment, Govt. of
health Unmet need for family integration of reproductive
spacing) Bangladesh )
planning health into national
strategies and programs
3.7.2: Adolescents childbirth Universal access to
30.8% in 2014
rate per 1,000 adolescent sexual and reproductive 25% by 2021 (HNPSIP 2016-2021)
(BDHS)
women aged 15-19 years healthcare by 2030
Table: 3.6Contd.

Table continued...
National targets
by 2030 Bangladesh
Achieve universal health

coverage, including
3.8.1: Coverage of essential
financial risk protection,
health services
access to quality essential
healthcare services and 2.1 (SVRS 2015) 1.7 by 2021(HNPSIP 2016-2021)
Total fertility rate
access to safe, effective,
quality and affordable
essential medicines and
vaccines for all
Contraceptive prevalence rate Achieve universal health 75% by 2021, (CPR in lagging region)
62.1 (SVRS 2015)
(CPR) coverage 60% by 2021 (HNPSIP 2016-2021)
Achieve universal health ANC 4 coverage 50% by 2021 (HNPSIP
ANC 4 coverage 31.2 (BDHS 2014)
coverage 2016-2021)
Achieve universal health 12 months: 87.4%
Measles immunization coverage 95% (HNPSIP 2016-2021)
3.8: Universal coverage 23 months: 86.5%
health coverage 3.8.1 % of children aged less
than 6 months receiving 55.3% (BDHS 2014) 65 % (HNPSIP 2016-2021)
coverage
exclusive breastfeeding
% of infants aged 6-23 months
are fed with 22.8% (BDHS 2014) 45 % ( HNPSIP 2016-2021)
coverage
minimum acceptable diet
Estimated prevalence of
Diabetes: 11.2%;
diabetes and hypertension Achieve universal health Diabetes: 10% Hypertension : 30%
Hypertension: 31.9%
among adult men and women coverage (HNPSIP 2016-21)
(BDHS 2011)
aged 35 years and older
3.8.2 Number of people covered
by health insurance or a public
coverage, including - -
health system (per 1,000
financial risk protection
population)
Table: 3.6Contd.
Table continued...
National targets
by 2030 Bangladesh
By 2030, substantially
reduce the number of
3.9.1: Mortality rate attributed
deaths and illnesses from
to household and ambient air
hazardous chemicals, - -
pollution
and air, water and
soil pollution and
contamination
3.9 : Mortality
for environ-
3.9.2: Mortality rate attributed reduce the number of
mental
to unsafe water, unsafe deaths and illnesses
pollution - -
sanitation, and lack of hygiene due to unsafe water,
sanitation and lack of
hygiene
3.9.2: Mortality rate attributed reduce the number of
- -
to unintentional poisonings deaths and illnesses due
to poisoning
3.a.1: Tobacco-use rate (Age- Strengthen the
standardized prevalence of implementation of World Tobacco-use by male:
3.a : Tobacco current tobacco-use among Health Organization 48%, female: 2%, Reduce tobacco-use from current
control persons aged 15 years and Framework Convention total: 25% in 2011 prevalence
older/Tobacco-use among on Tobacco Control in all (2014 WHO Report)
persons aged 18+ years (WHO) countries as appropriate
3.b : Provide
3.b.1: Percentage of health Facilities with
access to Facilities with essential drugs: 75%; FP
facilities with essential Ensure availability in all essential drugs: 66%;
all essential methods: 90% by 2021 (HNPSIP 2016-
medicines and lifesaving facilities FP methods: 84.4%
medicines and 2021)
commodities (HFS 2014)
vaccines
Table: 3.6Contd.

Table continued...
National targets
by 2030 Bangladesh
Substantially increase

health financing
3.c.1: Health workers density and the recruitment,
and distribution per 1,000 development, training,
Physician : 15% by 2021
population : Reduction in and retention of the
3.c : Health Nurse: 4% by 2021
functional vacant positions health workforce in -
workforce Paramedic: 4% by 2021
in public facilities by category developing countries,
( HNPSIP 2016-2021)
(physician, nurse/midwife, especially in the least-
paramedics) developed countries and
small island developing
States
3.d.1: International Health Strengthen the capacity
Regulations (IHR) capacity of all countries, in
and health emergency particular, developing
3.d : National
preparedness: International countries, for early
and global - .-
Health Regulations (IHR) core warning, risk reduction
health risk
capacity index/number of and management of
attributes attained out of 13 national and global
core attributes health risks
By 2030, end all forms of
malnutrition, including
Prevalence of stunting in
achieving, by 2025, the
under-5 children
internationally-agreed
Proportion of stunted U5 targets on stunting and
2.2 : Child children 25% by 2021
wasting in children 36.1 in 2014 (BDHS)
malnutrition ( HNPSIP 2016-2021)
Proportion of wasted and below 5 years of age, and
overweight U5 children address the nutritional
needs of adolescent girls,
pregnant and lactating
women and older persons
Table: 3.6Contd.
Table continued...
National targets
by 2030 Bangladesh
By 2030, achieve universal
Proportion of population
6.1 : Drinking- and equitable access
using improved drinking-water 98% (BDHS 2014) 100%
water to safe and affordable
sources
drinking-water for all
By 2030, achieve access
to adequate and equitable
sanitation and hygiene % of households
Proportion of population using
6.2 : Sanitation for all and end open using sanitary toilet
improved sanitation facilities -
and Hygiene defecation, paying special facility 73.5
attention to the needs of (SVRS 2015)
women and girls and those
in vulnerable situations
7.1: Clean Percentage of population with primary By 2030, ensure universal
18% (BDHS 2014) -
household energy reliance on non-solid fuels (%) access
By 2030, reduce the
Ambient air pollution adverse per-capita
11.6: Clean Percentage of urban solid waste environmental impact of
regularly collected and well- cities, including by paying - -
cities
managed (disaggregated by type special attention to air
of wastes) quality and municipal and
other waste management
Number of deaths, missing Strengthen resilience and
13.1: Natural people, injured, relocated or adaptive capacity to climate-
- -
disasters evacuated due to disasters per related hazards and natural
100,000 people disasters in all countries
Prevalence of intimate
Homicide partner violence:
Conflicts 15-71% (WHO multi-
16.1: Violence Women and girls subjected to country study on
physical, sexual or physiological womens health and
violence domestic violence,
Lancet 2006)

UHC will bring all people under optimum 9. Increasing use of the third window
healthcare coverage gradually. When citizens
will see that they have access to optimum Bangladesh has become the global champion in
healthcare, they will feel encouraged to come promoting innovative use of ICT in healthcare.
to the health facilities. The government Multiple ICT channels will have to be promoted
health facilities will not be enough to meet to receive free flow of feedback from the citizens
this increased demand from people. However, and clients of health servicepublic or private.
The feedback must be acted on to build the
private health facilities can complement the
citizens trust. Alternative channels of service
government health facilities. In Turkey or in
delivery, like mHealth, eHealth, etc. will have to
countries where there is good presence of health
be promoted.
insurance, the health facilities are reimbursed
for the health services they render to the insured Conclusions
patients or individuals with problems. These
countries usually follow a model called DRG The health-related SDGs as a whole is not a
(Diagnosis-related Group) where a group of business as usual. So, we will not be able to
diseases that involve similar cost for treatment achieve health-related SDGs if we consider
is put in a list. Treatment cost for each disease everything in the conventional way. However, if
in the DRG is standardized. Hospitals are we use the existing health system innovatively
reimbursed based on the cumulative cost of all and efficiently, we will make more success in
DRGs and the number of cases treated under achieving health-related SDGs compared to
each DRG. In Bangladesh, we can allow the what we did in health-related MDGs.
insured or card-holder individuals to go to
The global and national targets for SDG
private health facilities and pay back these
indicators are shown in Table 3.6. Available
health facilities according to the total size of
latest figures are also provided as the baseline
DRGs they treated.
values for Bangladesh.

Chapter
4
Healthcare at the grassroots level
PRIMARY HEALTHCARE
Located at the ward level, the community
clinics are the lowest-level static health
facilities.
Through various public health facilities, Bangladesh provides free medical services to people at the
community level. The primary healthcare is provided through an extensive network of health facilities.
Located at the ward level, the community clinics are the lowest-level static health facilities. These have
upward referral linkages with health facilities located at the union and upazila levels. There are 482
primary-care government hospitals at the upazila level and below, which have 19,508 hospital beds.
Counting the hospitals and outdoor-only centers together, there are 16,968 public health facilities at
these levels. Table 4.1 presents the breakdown by type of facility.
Number of beds is shown as zero in some of the Community Clinics

upazila health complexes because these were at
Community Clinic (CC) is the brain child of
different stages of construction at the time of
Honble Prime Minister Sheikh Hasina. It is
this publication. At the union level, there are
being branded in her name. It is the lowest-
51 primary-care hospitals with 830 beds and
tier public health facility. It is a one-stop
3,083 health facilities for outpatient services
service outlet on health, family planning
only. So, at the union level, there are 3,134
and nutrition, each covering around 6,000
primary-care health facilities. Moreover, there
rural population. It is a unique example of
are 5 trauma centers at this level; these are
public-private partnership as all the CCs have
included in the list of secondary and tertiary-
been constructed on land donated by the
care centers. At the ward level, there are13,336
community. Costs incurred for construction,
community clinics in operation till 31 July medicine, service providers, logistics, and all
2016. other inputs are given by the Government but
Due to the flagship nature of the program, these are managed by both community and
community clinics deserve special mention. In the Government through Community Group
addition to the community clinics, important (CG). The Government planned to establish
CCs at the door-steps of rural people all over
components of primary healthcare, among
the country to ensure the provision of quality
others, include domiciliary healthcare, essential
primary healthcare.
service delivery, along with urban primary
healthcare, maternal healthcare (inclusive of The CG for each CC comprises 13-17 members
some screening programs for womens health), and is headed by Elected Member of the Union
child healthcare, school health program, and Parishad; other members in the CG are from
adolescent health program. The MIS-DGHS is different walks of life. To support CG in the
playing the leading role in providing computers management and for community engagement,
with Internet connections, which now extends there are 3 Community Support Groups (CSGs)
down to the grassroots-level health facilities for each CC. In both CG and CSG, at least
as well as the health workers. The union onethird of the members are female, including
health centers and community clinics have adolescents. All the CGs and CSGs have been
laptop computers and wireless modems, and made functional. During 1998-2001, more than
the community health workers have android 10,000 CCs were constructed, of which about
tablets. 8,000 started functioning but, in 2001, shortly

Table 4.1. Primary healthcare facilities run by the DGHS at the upazila level and below, 2016
Type of Total no. of Total no. of
Level Type of facility
service facilities beds
Upazila health complex (50-bed) Hospital 297 14,850
Upazila health complex (31-bed) Hospital 113 3,503
Upazila health complex (10-bed) Hospital 11 110
Upazila health complex (0-bed)* Hospital 3 0
Subtotal of upazila health complexes 424 18,463
Upazila
Upazila health office Outdoor 60 -
31-bed hospital Hospital 5 155
Subtotal of hospitals outside health complexes 7 215
Total of upazila-level facilities 491 18,678
Subtotal of union-level hospitals 51 830
Union Union subcenter Outdoor 1,498 -
Union health and family welfare center Outdoor 1,585 -
Subtotal of union outpatient centers 3,083 -
Total of union-level facilities 3,134
Ward Community clinic (functional at present) Outdoor 13,336 -
Grand total of primary-care hospitals (Upazila and below) 482 19,508
Grand total of primary health facilities (Upazila and below) 16,968 19,508
*Hospital not yet started
after commissioning, CC activities were closed

due to political change in the Government and In 2009, the Government took
continued as such till 2008.
the initiative for revitalization
In 2009, the Government took the initiative
for revitalization of CC as the topmost
of CC as the topmost priority
priority under a project titled Revitalization under a project titled
of Community Healthcare Initiatives in
Bangladesh (RCHCIB) setting implementation Revitalization of Community
period from 1 July 2009 to 30 June 2015.
Under this project, the closed CCs were made
Healthcare Initiatives in
functional in phases after necessary repairing, Bangladesh (RCHCIB)
recruitment, and capacity-building of a new
category of service provider (a Community Thousands of villagers, particularly the poor
Healthcare Provider or CHCP for each CC). and the underprivileged mothers and children,
Medicines, with all necessary logistics, were are getting services from the nearby CCs. On
provided. Many new CCs were also constructed an average, 9.5-10.00 million patient-visits
under the RCHCIB. At present (31 July 2016), take place monthly in the CCs nationwide.
13,036 CCs are operational. From July 2015, As a large proportion of the service-seekers is
all the activities of CCs are being carried out getting primary healthcare services from the
by an operational plan of the DGHS, namely nearby CCs, outpatient attendance at the UHCs
Community-based Healthcare (CBHC), under is decreasing. As a result, doctors at the UHCs
the Health, Population and Nutrition Sector are getting more time for the management
Development Program (HPNSDP) 2011-2016. of emergency and complicated cases. It is to

CHAPTER 4: PRIMARY HEALTHCARE
be mentioned that, in a good number of CCs supplied in 2009-2010, and now the number of
(about 8% of the functional CCs), normal child supplied items is 30.
delivery is being conducted at demand of the
community, decision of the CG, availability Figure 4.2 shows the number of service-
of skilled manpower (CSBA), committed local seekers at CCs and cases referred from
management and wherefrom cases can be community clinics to higher facilities for proper
referred easily to the nearby UHC, if necessary. management. From 2011, with the deployment
From 2009 till March 2016, more than 28,000 of CHCPs after basic training, number of
normal deliveries were conducted in CCs service-seekers has been increasing. From April
without notable casualties to the mother and 2009-December 2015, there were 460.88 million
babies. visits by rural people to CCs all over the country
(on an average, 9.5-10 visits per month), and
The use of ICT by CCs for data management 9.071 million emergency and complicated
and service provision is quite impressive. The cases were referred to higher facilities for better
Management Information System (MIS) of the management.
DGHS is providing all out support to develop
and maintain the ICT backbone and its usage by Community clinic is an unprecedented
CCs. By April 2014, all the community clinics instance of community participation and
were provided laptop and Internet modem public-private partnership. Being inspired by
to send service-related data online. In some community participation, some UN agencies
upazilas, monitoring of CCs is being done and NGOs have started working for the
through Skype; telemedicine services are also community clinics. Many other organizations
being organized between CCs and UHCs with a are also coming forward to working as the days
patient at the CC and a doctor at the other end. are passing.
It will be scaled up in all areas of the country in Community clinic is certainly a pro-people
the near future. health initiative led by the Government. If
Figure 4.1 shows the government expenditure quality health services can be ensured near
for supply of medicines per community clinic doorsteps even at the remotest corner of
per year in different fiscal years. The amount of the country, people will spontaneously seek
allocation per community clinic for medicine necessary service from the well-trained care
supply was BDT 0.072 million in 2009-2010, providers at the health facilities, instead of the
BDT 0.085 million in 2010-2011, BDT 0.11 untrained traditional healers. It is expected
million in 2011-2012, BDT 0.111 million in that community clinics will ensure provision
each of 2012-2013 to 2014-2015, and 0.113 of quality healthcare for the mass people
million in 2015-2016. Twenty-five items were of rural Bangladesh, particularly the poor,
Figure 4.1. Government expenditure (BDT in million) for supply of medicines to community clinics
2015-2016 0.113
2014-2015 0.111
2013-2014 0.111
2012-2013 0.111
2011-2012 0.11
2010-2011 0.085
2009-2010 0.072

Figure 4.2. No. of clients (in million) treated at (total 460.86 million) and referred from (total 9.07
million) community clinics in different periods
120
107.36
100.4 105.28
100
80
72.23
60
40 37.3
23.69
20
14.2
0.223 0.44 0.671 1.66 2.137 2.213 1.726
0
2009 2010 2011 2012 2013 2014 2015
vulnerable, and the underprivileged and will is principally the responsibility of the Ministry
contribute to the achievement of the health of Local Government, Rural Development and
development targets envisaged in the just- Cooperatives (MOLGRD), carried out through
started SDG era as these did in achieving the the city corporations and municipalities. These
MDGs. local bodies run a number of small to medium-
sized hospitals and outdoor facilities. Besides,
Domiciliary health service in rural Bangladesh
large-scale primary healthcare activities under
There are domiciliary workersone for every Urban Primary Healthcare Project (UPHCP) and
5 to 6 thousand people at the ward or village Smiling Sun Franchise Program are run by NGOs
level. Under the DGHS, there are 26,482 in collaboration with the city corporations
sanctioned posts of domiciliary workers, of and with the financial assistance from donors.
which 20,881 are for health assistants (HA), The clients in the latter also share a part of the
4,202 for assistant health inspectors (AHI), cost through service-charge. There is a concern
and 1,399 for health inspectors (HI).As of now, among the public health communities that
83.25% posts were filled up. Like the DGHS, the there is a need for better coordination between
DGFP also has domiciliary workers to work at the two ministries, viz. MOHFW and MOLGRD,
the ward or village level. These staff members with regard to urban primary healthcare,
are called family planning inspectors (FPI) and although MOHFW contributes to urban
family welfare assistants (FWA). primary healthcare through outpatient services
distributed through its secondary, tertiary
Essential service delivery and urban primary and specialized hospitals located in the urban
healthcare settings. Besides, there are 35 urban dispensaries
Under the Health, Population and Nutrition and 23 school health clinics in some of the
Sector Development Program (HPNSDP) 2011- bigger cities and municipalities. To respond to
2016, there is an operational plan, namely the concerns for the need of better coordination
Essential Service Delivery mainstreamed under between MOHFW and MOLGRD with regard
the DGHS to help improve service, particularly to urban primary healthcare, the MOHFW
at the upazila level and below and complement included in its HPNSDP 2011-2016 a component
urban primary healthcare. The areas of services named urban health under the operational
include limited curative care, support services plan Essential Service Delivery. This urban
and coordination, medical waste management, health component aims at designing programs
urban health, mental health, and tribal health. through maintaining better coordination
The urban primary healthcare in Bangladesh and collaboration with the city corporations,

municipalities, UPHCP, Smiling Sun Franchise Figure 4.3 shows the number of different obstetric
Program, other NGOs, and stakeholders. care encounters and clients served by the
emergency obstetric facilities in Bangladesh in 2015.
Maternal healthcare
Figure 4.3 reveals that 1,212,963 institutional
The Bangladesh Ministry of Health and Family deliveries were reported in 2015, of which normal
Welfare, in collaboration with UNICEF, is deliveries accounted for 61.5%, cesarean section
undertaking facility-based Emergency Obstetric accounted for 37.9%, and vaginal breech and
Care (EOC) Program in all districts of Bangladesh forceps delivery collectively accounted for 0.6%.
to improve the maternal health situation.. All the
government medical college hospitals, district Figure 4.4 shows distribution of the types of
hospitals, upazila hospitals, and maternal and institutional deliveries conducted in 2015.
child welfare centers (MCWCs) provide obstetric
care services, inclusive of emergency obstetric Figure 4.5 shows the distribution of deliveries by
care. A number of private clinics or hospitals type between government and non-government
and health-related NGOs are also partners in (private, NGO) health facilities in 2015.
this program. Obstetric care is classified into two Table 4.3 shows the distribution of obstetric care
categories in this program, viz. Comprehensive services provided by the government and non-
Emergency Obstetric Care (CEmOC) and Basic government emergency obstetric care facilities.
Emergency Obstetric Care (BEOC). Currently, all
medical college hospitals, 59 district hospitals, 3 Table 4.4 shows the distribution of normal,
general hospitals, 132 upazila health complexes, assisted, cesarean and total deliveries within
and 63 MCWCs provide CEmOC, and rest of the government and non-government emergency
upazila health complexes provide BEOC. The list obstetric care facilities in 2015. Of the total
also includes NGOs and private care providers 449,609 deliveries in the government health
from a number of districts. Under a program, facilities, 2.3% took place in medical college
jointly operated by the Management Information hospitals, 7.7% in district hospitals, and the
System (MIS) of the DGHS and UNICEF, data largest proportion (90.0%) took place in upazila
are collected from the EOC facilities. For this health complexes;
publication, data from 621 sources, including
14 medical college hospitals, 62 district/general Of the total 219,487 deliveries in the non-
hospitals, 411 upazila health complexes, 53 government facilities (NGO, private), 19.2%
maternal and child welfare centers, private were done at NGO facilities and 80.8% at
hospitals from 45 districts, NGOs from 33 private clinics/hospitals. Table 4.4 also reveals
districts, and 3 other types of hospitals have been that there were 219,185 cesarean sections in
used for analysis to translate into a format called the public health facilities and 150,523 in
United Nations Process Indicators. Table 4.2 the non-government health facilities. Of the
summarizes the sources of data. total cesarean sections at the public facilities,
2.9% were done in medical college hospitals
Table 4.2. Number of sources of data used for this (n=6,311), 8.3% in district hospitals (n=18,232),
publication on emergency obstetric care (2015) and 88.8% in upazila health complexes
(n=194,642). Of the total cesarean sections done
Type of hospital No. Percentage
in non-government health facilities, 11.6% were
Medical college hospital 14 2.3 done at NGO facilities (n=17,480) and 88.4% at
District and general hospital 62 10.0 private clinics/hospitals (n=133,043).
Upazila health complex 411 66.2 Voucher scheme for maternal health
MCWC 53 8.5
The Ministry of Health and Family Welfare, in
Districts from where private 45 7.2 collaboration with WHO, introduced in 2007
care providers sent data an innovative maternal health voucher scheme,
Districts from where NGO 33 5.3 a demand-side financing (DSF) initiative, to
care providers sent data improve access to and use of quality maternal
Other health facilities 3 0.5 health services. Currently, the program is being
implemented in 53 upazilas of 41 districts.
Total 621 100.0
Poor women are defined by specific criteria

Figure 4.3. Number of different obstetric care encounters and maternal death in the healthcare
facilities in Bangladesh, 2015
Reg. pregnant women 1,987,881

ANC at least 1 2,294,958
ANCs 4+ 1,034,547
Normal delivery 782,421
Cesarean section 482,613
Other assisted delivery 7,929
Maternal death 2,032
Total delivery 1,272,963
PNC within 2 days 1,221,213
Figure 4.4. Distribution of the types of institutional deliveries (n=1,272,963) in2015
0.6%
Other assisted
deliveries
37.9% 61.5%
Cesarean Normal
section delivery
Figure 4.5. Distribution of deliveries by type between government and non-government (private,
NGO) health facilities, 2015
79.8
70.3 Government facility
63.6 Non-government facility
58
42
36.4
29.7
20.2
Normal delivery Cesarean section Other assisted Total delivery

delivery

Table 4.3. Obstetric care services provided by the government and non-government emergency
obstetric care facilities, 2015
Government Non-government
Other
Type of govt. NGO Private
delivery DH/
PGIH MCH UHC facilities Total facili- facili- Total
GH
at upazila ties ties
level
Normal
1,918 45,676 71,574 204,586 226,082 549,836 99,645 132,940 232,585
delivery
(%) 0.3 8.3 13.0 37.2 41.1 100 42.8 57.2 100
Cesarean
3,403 53,137 41,751 19,561 58,036 175,888 21,081 285,644 306,725
section
(%) 1.9 30.2 23.7 11.1 33.0 100 6.9 93.1 100
Other
assisted 9 1,849 1,856 1,618 998 6,330 293 1,306 1,599
deliveries
(%) 0.1 29.2 29.3 25.6 15.8 100 18.3 81.7 100
Total
5,330 100,662 115,181 225,765 285,116 732,054 121,019 419,890 540,909
deliveries
(%) 0.7 13.8 15.7 30.8 38.9 100 22.4 77.6 100
(approximately 40% of the pregnant women of delivery is attended by skilled staff, voucher-
an upazila) and validated by a body consisting holders get unconditional cash benefits for
of local government representatives, health nutritious food. Safe delivery rate is now 80%
managers, and other stakeholders. The total amongst the voucher recipients. Both public
number of cumulative beneficiaries reached and non-public healthcare providers (NGO and
1,174,868 (Figure 4.6). Figure 4.7 shows the private facilities) participate in the DSF scheme.
There is a target to scale the program for more
beneficiaries for quality services; .the maternal
The Ministry of Health and mortality rate among the voucher-holder women
Family Welfare, in collaboration is 12 per 100,000 livebirths, in sharp contrast to
the national rate of 170 per 100,000 livebirths.
with WHO, introduced in 2007
Maternal and Newborn Health Initiative
an innovative maternal health
The Maternal and Newborn Health Initiative
voucher scheme, a demand- (MNHI) is being implemented by the Director
side financing (DSF) initiative, of Primary Healthcare of the DGHS in eleven
districts of Bangladesh, with the assistance of
to improve access to and use UNFPA, UNICEF, and WHO and funded by
of quality maternal health DFATD Canada. The districts are Thakurgaon,
Jamalpur, Narail, Maulvibazar, Panchagarh,
services. Sirajganj, Patuakhali, Barguna, Rangamati,
Sunamganj, and Bagerhat. The program focuses
percentages over the years. In 20142015, a on saving maternal and newborn lives through
total of 145,900 pregnant women received the creating need-based demand and priority-based
benefit. A voucher entitles its holder for specific actions. The broad principle of this program is
health services free of charge, viz. antenatal to find the bottlenecks through data analysis.
and postnatal care, safe delivery, and treatment Finally, the health managers develop Evidence-
for complications, including cesarean section, based Planning and Budgeting (DEPB) for every
transportation cost, and laboratory tests. If

upazila and hospital. Around 25 districts have
100.0
100.0
100.0
100.0
Table 4.4. Distribution of normal, assisted, cesarean and total deliveries within the government and non-government emergency obstetric care been covered under DEPB by UNICEF. The
%
civil surgeon and deputy directors of family
planning of the respective districts serve as the
Total
local focal points for the program. UNICEF has
219,487
150,523
67,271
1,693
designed a comprehensive model to improve
No.
Non-government facilities
health of neonates, mothers, and young

children (IH&NHMYC) in hard-to-reach areas
of Bandarban, Coxs Bazar, and Netrakona
80.8
63.8
76.0
88.4
%
district, which introduced a default tracking

system to track every mother and child. Under
Private
health system strengthening, 10 consultants
177,281
133,043
42,952
1,286 are working to improve information system

No.
by using the data for planning. Innovative

dashboard has been created for all health
managers. As a part of improving quality,
19.2
36.2
24.0
11.6
Maternal and Perinatal Death Surveillance and

%
Response (MPDSR) program has been introduced

NGO
in 10 districts, which has shown good impact in

42,206
24,319
17,480
reducing maternal and neonatal deaths.

407
No.
Tetanus toxoid (TT) for women of

childbearing age
100.0
100.0
100.0
100.0
%
Table 4.5 shows the tetanus toxoid coverage

among the women of childbearing age in
Total
Bangladesh in 2015. The country is maintaining

449,609
226,022
219,185
the maternal and neonatal tetanus-free status

4,402
No.
since 2008. The immunization program of

Bangladesh aims to immunize the women of
childbearing age by administering TT before the
90.0
91.0
94.7
88.8
age of 18 years. A period of 2 years and 7 months

%
is required to complete all the 5 doses of TT

Government facilities
UHC
vaccines. If a woman starts TT vaccination at the

404,525
205,713
194,642
age of 15 years and maintains the exact interval,

4,170
No.
she would be able to complete all the doses

before she reaches the age of marriage, ensuring
protection for her entire reproductive life.
7.7
7.3
4.1
8.3
%
The data shown in Table 4.5 have been

excerpted from EPI Coverage Evaluation Survey
DH
34,839
16,427
18,232
2015. However, the coverage gradually falls

180
No.
for the subsequent TT doses and is remarkably

lower for the fourth and final doses. This aspect
needs attention to ensure effective coverage.
2.3
1.7
1.2
2.9
%
Community-based skilled birth attendants

MCH
and midwives
10,245
3,882
6,311
No.
52
Shortage of skilled manpower in the remote

areas to extend obstetric care is one of the
facilities, 2015
major barriers to improving maternal health.

deliveries
The Ministry of Health and Family Welfare

Cesarean
delivery
delivery
delivery
Assisted
Type of
Normal
undertook a short-term measure to tackle the

section
Total
problem by producing trained manpower

for fulfilling the gap in the interim period.

Figure 4.6. Number of DSF (demand-side financing) beneficiary pregnant women by year
(total1,174,868)
180,000
152,267 148,806 158,545
160,000
140,000
148,807 152,401 145,900
120,000 109,689 146,287
100,000
80,000
60,000
40,000
20,000 12,166
0
07
08
09
10
11
12
13
14
15
6-
7-
8-
9-
0-
1-
2-
3-
4-
00
00
00
00
01
01
01
01
01
:2
:2
:2
:2
:2
:2
:2
:2
:2
FY
FY
FY
FY
FY
FY
FY
FY
FY
Figure 4.7. Percentage distribution of different services provided under DSF during 2013-2014 and
20142015
Jul 2014-June 2015 Jul 2013-Jun 2014
93
89
86 84
79
75 75 76
69 72
11 9
ANC 1 ANC 2 ANC 3 Normal delivery C-section PNC
Young medical doctors were given 6 months organized in 465 upazilas of 64 districts. The
training on obstetrics and anesthesiology. Government introduced midwifery course
The Directorate General of Health Services is and created posts for 2,994 midwives.
also implementing community-based skilled
birth attendant (CSBA) training program Obstetric fistula program
since 2003, with the goal to train and educate In Bangladesh, obstetric fistula and other
the family welfare assistants/female health maternal morbidities affect thousands of
assistants, community healthcare providers, women. It is estimated that approximately
and similar health workers in NGOs and 71,000 women in the country are currently
private sector, on midwifery skills. The CSBAs living with fistula (1.69 per 1,000 ever-
are trained to conduct normal safe deliveries married women). The UNFPA has been
at home and to identify the risks and assisting the Government of Bangladesh in
complicated cases so that they can motivate strengthening quality service delivery and
the women and their family members to capacity development of service providers
refer to the nearby health facilities where at 10 medical college hospitals and 4 private
comprehensive EOC services are available.
hospitals. Since 2003, twenty-four doctors
The CSBA training program is now
and 253 nurses have been trained; 3,050

complicated obstetric fistula surgeries were of the screening tests is increasing every year. In
performed. National Fistula Center has 2015, a total of 270,542 VIA screening tests were
been established in Dhaka Medical College done, with 4.2% showing VIA-positive result.
Hospital. All VIA+ve cases were referred to colposcopy
clinic at BSMMU and different medical college
Cervical and breast cancer screening program hospitals. It is reported that 9,695 women with
VIA+ve result attended the colposcopy clinics
The cervical and breast cancers are the most
at BSMMU and medical college hospitals during
common cancers in women and contribute
2015 (Table 4.7).
to a significant disease burden in Bangladesh.
Routine screening and early detection of cervical
and breast cancer can reduce death rates and can Routine screening and early
improve life-expectancy of cancer patients. The detection of cervical and breast
Government of Bangladesh (GOB) has developed
cervical and breast cancer screening program cancer can reduce death
in all districts of Bangladesh through technical
assistance of Bangabandhu Sheikh Mujib
rates and can improve life-
Medical University (BSMMU) and UNFPA. Since expectancy of cancer patients.
2005, a total of 373 centers (Table 4.6) have been
established throughout the country, and about Figure 4.9 shows that a total of 1,054,723
1,500 service providers from 64 districts were screening tests for CBE were done from 2007
to 2015 throughout the country, using the
trained on cervical and breast cancer screening,
screening centers and, on average, 1.5% yielded
based on visual inspection with acetic acid
positive results. The coverage of CBE screening
(VIA) and clinical breast examination (CBE);
is increasing every year. In 2015, a total of
14 government medical college hospitals,
246,681 screening tests were done, with 1.4%
along with BSMMU, have been developed
CBE-positive results.
as referral centers through development
of colposcopy clinics with facilities for Universal routine child immunization
colposcopy, histopathology, and management of
precancerous condition of the cervix. Child vaccination coverage data presented in
this section were taken from the EPI Coverage
Figure 4.8 shows that 1,157,032 VIA tests were Evaluation Survey 2015 (CES 2015) Report. The
performed from 2005 to 2015 at different service EPI-CES validated the vaccination coverage rates
centers and, among the tested women, 56,592 by cross-checking vaccination cards with history
(4.9%) were found VIA-positive. The coverage taken from mothers/caregivers.
Table 4.5. Tetanus toxoid coverage (%) in Bangladesh among women of childbearing age (2015)
Area TT1 TT2 TT3 TT4 TT5
National 96.0 94.0 83.6 66.7 46.1
Rural 96.6 94.6 84.8 67.7 46.5
Urban 93.8 91.6 78.5 62.9 44.6
Table 4.6. Total number of VIA and CBE centers (2005 to 2015)
Name of locations Number of centers
District hospitals 57
BSMMU and medical college hospitals 15
MCHTI, MFSTC, mother and child welfare centers 61
Upazila health complexes 180
Union health & family welfare centers 40
Urban Primary Healthcare Project and NGOs 20
Total 373

Figure 4.10 shows the trend in vaccination Bangladesh showed a success story on polio
coverage from 2002 to 2015 by the age of 12 eradication. The country is maintaining
months. The Figure indicates that there is gradual polio-free status for the last 10 years. The last
improvement in BCG, Penta, and MCV coverage, polio case was identified on 22 November
which contributed in continual improvement in 2006. Under routine childhood immunization
the full valid vaccination coverage. schedule, Bangladesh is providing OPV to all
the target children to prevent poliomyelitis.
Figure 4.11 shows the trend in full vaccination The current valid national OPV3 coverage
coverage from 2005 to 2015 among 12 and 23 rate is 93.6%, with each district having
months old children. coverage of more than 80%. The polio
eradication program in Bangladesh illustrates
Table 4.8 shows the valid vaccination coverage
Governments commitment in providing 100%
of 12 and 23 months old children as found
cost of routine polio immunization and 95%
in EPI-CES 2015. Measles vaccine coverage was cost of supplementary polio immunization
87.4% and 91.7% among 12 and 23 months activities. Among the SEAR countries, the
old children respectively. Full vaccination last polio case was detected in India in 2011.
coverage among these two groups of children After India was polio-free for more than 36
were 82.5% and 86.5% respectively. months, Bangladesh, along with other 10
Figure 4.8. Number of VIA tests and VIA+ve results (2005 to 2015)
270,542
Total VIA VIA +ve
195,067
152,085
112,091
109,547
97,539
84,426
61,648
40,785
21,609
11,693
11,239
10,214
8,361
5,971
5,698
4,885
3,181
3,652
1,918
548
925
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Figure 4.9. Number of CBE tests done, with results, 2007 to 2015
300,000 Total CBE CBE +ve
246,681
250,000
200,000 194,565
152,684
150,000
109,305 110,733 Total CBE=1,054,723
100,000 93,884
81,701 CBE+ve=14,840
45,933
50,000
19,237
202 1,460 1,770 1,221 1,275 1,165 2,211 2,057 3,479
-
CBE +ve 2007 2008 2009 2010 2011 2012 2013 2014 2015
(%) 1.05% 3.18% 2.17% 1.3% 1.17% 1.05% 1.45% 1.06% 1.41%

member countries of the South Asia Region, switched from trivalent oral polio vaccine
obtained the polio-free certification in March (tOPV) to bivalent oral polio vaccine (bOPV)
2014. As per the global polio eradication end- in the month of April 2016 for prevention of
game strategic plan 2013 to 2018, Bangladesh outbreak due to type 2 component of OPV.
introduced inactivated poliovirus vaccine The country is also satisfactorily progressing
(IPV) in March 2015 for prevention of vaccine- toward achieving the measles elimination
derived polio viruses due to polio vaccine goal of the WHOs South-East Asia Region
type 2 component. As planned, Bangladesh by 2020. National measles control activities
Table 4.7. Total number of colposcopy tests done in 2015 at different institutions
Name of institution Number (%) of colposcopy tests
Bangabandhu Sheikh Mujib Medical University 2,860 (25.00)
Rajshahi Medical College Hospital 1,442 (12.80)
Chittagong Medical College Hospital 1438 (12.80)
Khulna Medical College Hospital 653 (5.80)
Sher-e-Bangla Medical College Hospital, Barisal 518 (4.60)
Faridpur Medical College Hospital 470 (4.10)
MAG Osmani Medical College Hospital, Sylhet 440 (4.00)
Mymensingh Medical College Hospital 388 (3.40)
Dhaka Medical College Hospital 365 (3.50)
Dinajpur Medical College Hospital 322 (2.80)
Comilla Medical College Hospital 247 (2.20)
Rangpur Medical College Hospital 224 (2.00)
Shaheed Suhwardy Medical College Hospital 150 (1.30)
Sir Salimullah Medical College & Mitford Hospital 135 (1.20)
Shaheed Ziaur Rahman Medical College Hospital 43 (0.40)
Failure to attend 1,544 (14.00)
Total 11,239 (100)
Figure 4.10. Trend in vaccination coverage (%) by the age of 12 months from card plus history
BCG Penta3 MCV1 Fully vaccinated
75.2 79.4 80.2 80.7 81.6 82.5

71.0 75.0
64.0
84.8 85.5 85.5 86.6 87.4

78.0 80.6 82.8
63.0 71.0
56.0
69.0 84.0 86.6 85.5 88.7 89.6 92.0 93.0 93.6

65.0 77.0
95.0 95.0 95.0 98.0 98.2 99.0 98.6 99.0 95.1 99.2 99.3
2002 2003 2005 2006 2007 2009 2010 2011 2013 2014 2015

Figure 4.11. Trend in national full vaccination coverage among children aged 12 months and 23
months (EPI-CES 2015)
12 months 23 months
83.0 83.0 83.6 84.7 86.5

79.0 80.0
77.0
69.0
79.4 80.2 80.7 81.6 82.5

71.0 75.0 75.2
64.0
2005 2006 2007 2009 2010 2011 2013 2014 2015
Table 4.8. Valid vaccination coverage of 23 and 12 months old children as found in EPI-CES 2015
Full
Age-group BCG OPV1 OPV2 OPV3 Penta1 Penta2 Penta3 Measles
vaccination
12 months 99.3% 93.9% 94.5% 93.6% 93.9% 94.5% 93.6% 87.4% 82.5%
23 months 99.4% 94.0% 94.7% 94.1% 94.0% 94.7% 94.1% 91.7% 86.5%
Table 4.9. Valid full vaccination coverage differentials by sex, area of residence, and division as
found in EPI CES 2015
Sex Residence Division

Age-group
Male Female Rural Urban Barisal Chittagong Dhaka Khulna Rajshahi Rangpur Sylhet
12 months 83.8% 81.1% 83.5% 78.4% 86.0% 81.6% 81.1% 83.6% 86.1% 84.9% 76.9%
23 months 87.5% 85.4% 87.1% 83.9% 89.3% 85.6% 86.6% 88.0% 89.4% 89.1% 82.8%
Table 4.10. Coverage of vitamin A capsule among under-five children and postpartum women (EPI-
CES 2015)
Vitamin A capsule
Residence
Infant Children Postpartum
(6-11 months) (12-59 months) women
Rural 80.6 88.7 37.7
Urban 75.6 81.7 37.5
National 79.6 87.3 37.6

measles elimination and rubella/congenital
National measles control rubella syndrome control. Coverage of the first
dose (MCV1) of measles vaccine was estimated
activities have been to increase from 71% in 2005 to 87.4% in
accelerated since 2004 and 2015.
already implemented all Table 4.9 shows the valid full vaccination
coverage differentials by sex, area of
recommended strategies residence, and division as found in EPI-CES
2015.
for measles elimination and
rubella/congenital rubella In the vitamin A campaign, high-potency
vitamin A was distributed among the infants
syndrome control. aged 6-11 months and the children aged 12-59
months. Table 4.10 shows the vitamin A capsule
have been accelerated since 2004 and already coverage among the under-five children and
implemented all recommended strategies for postpartum women.

Chapter Number of beds increasing steadily
5 SECONDARY AND TERTIARY

HEALTHCARE
The numbers of functional beds in the
secondary and tertiary-care facilities have
increased in 2016
Compared to the primary healthcare facilities at the ward, union and upazila levels, the secondary
and tertiary healthcare facilities provide more advanced or specialty care to the patients. The district
hospitals are usually termed secondary hospitals as these have fewer facilities for specialty care compared
to many in the medical college hospitals. There are also different types of specialty-care centers, such
as infectious disease hospitals, tuberculosis hospitals, leprosy hospitals that fall under the category of
secondary-care health facilities. The medical college hospitals are located at the regional level, one for
a few districts and provide specialty care in many disciplines. These hospitals are called tertiary-care
hospitals. Also, super-specialty hospitals at the national level or centers that provide high-end medical
services in a specific field are considered tertiary hospitals. The numbers of functional beds in some of
the secondary and tertiary-care facilities have increased in 2016.
The numbers and bed-capacity in different types Of the total 14 medical college hospitals, 4
of secondary and tertiary hospitals/health centers are in Dhaka division (28.57%), 2 in each of
under the DGHS are shown in Table 5.1 (Annex 5 Chittagong, Rajshahi and Rangpur division
shows relevant data of some private hospitals). (14.29% in each of the divisions), and 1 in
each of Barisal, Khulna, Mymensingh and
Bangabandhu Sheikh Mujib Medical University
Sylhet division (7.14% in each division). The
Bangabandhu Sheikh Mujib Medical University distribution is shown in Table 5.2. However,
(BSMMU) is the only medical university in this distribution will be changed once the
Bangladesh. The BSMMU and its affiliated new public medical college hospitals start
hospital receive financial assistance from the functioning. In terms of the number of other
Ministry of Health and Family Welfare and 117 secondary and tertiary-level facilities, Dhaka
Ministry of Education. Both university and its division is placed at the top, with 41 facilities
affiliated hospital are autonomous bodies. The (35.04%). This year, numbers of medical college
hospital has 1,551 beds, including 791 free beds. and other secondary and tertiary hospitals are
Distribution of public hospitals and hospital reduced than those of the previous year in
beds by administrative division Dhaka division. However, this is not due to
actual reduction of the number of facilities. One
The distribution of secondary and tertiary medical college hospital and 4 other hospitals,
hospitals by administrative division is shown which were in Dhaka division in the previous
in Figure 5.1. Dhaka division has the highest years, are now being counted under the newly-
number of secondary and tertiary-level health formed administrative division Mymensingh.
facilities (45), followed by Chittagong, Khulna
and Rajshahi division, with 22, 16, and 15 Available number of beds is one of the good
hospitals respectively. proxies for measuring the strength of healthcare

Table 5.1. Secondary and tertiary hospitals/health centers under the DGHS, with the numbers of
functional beds (as of June 2016)
Hospitals
Type No. of facilities No. of functional beds
50-bed hospital 2 100
Chest disease hospital 13 866
Dental college hospital 1 200
District and general hospital 65 10,328
Hospital of alternative medicine 2 200
Infectious disease hospital 5 180
Leprosy hospital 3 130
Medical college hospital 14 12,963
Other hospitals 4 325
Specialized hospital 3 850
Specialty postgraduate institute and hospital 11 3,184
Trauma center 5 100
Total (hospitals) 128 29,426
Other facilities (Specialized health centers)
Name No. of facilities No. of functional beds
Chittagong Skin & Hygiene Treatment Center 1 Not applicable
National Asthma Center 1 Not applicable
National Center For Control of Rheumatic Fever
1 Not applicable
& Heart Disease
Total hospitals and other facilities 131 29,426
Figure 5.1. Distribution (number and percentage) the administrative control of the DGHS. It
of government-owned secondary and tertiary is not surprising that about 40% (11,834 out
facilities under the DGHS by administrative of the total 29,306) of beds in the secondary
division of Bangladesh (2016) (Total 131) and tertiary hospitals under the DGHS are
concentrated in Dhaka division. Chittagong
Sylhet
8 Barisal division is in the second position, having
6% 8
6% 14.38% of beds in these hospitals.
Rangpur Chittagong
12 22
9% 17% Figure 5.3 shows the number of beds in
secondary and tertiary hospitals per 10.000
Rajshahi
15 people by administrative division of Bangladesh.
12% Health facilities in the newly-formed
Mymensingh division suffer the most for the
Mymensingh paucity of beds (1.19 beds for 10,000 people). The
5
4% ratio is higher than the country average of 1.83
Khulna in Dhaka and Barisal divisions, having 2.95 and
Dhaka
16 45 1.94 respectively. The population estimates used
12% 34%
here are taken from a publication of Bangladesh
Bureau of Statistics titled Population Projection
infrastructure in different geographic areas. of Bangladesh, Dynamics and Trends: 2011-2061
Figure 5.2 shows the distribution of beds (available at www.bbs.gov.bd).
in the government-owned secondary and
tertiary-level hospital by administrative We get a slightly different order of divisional
division of Bangladesh. These are run under ranking in terms of the availability of

CHAPTER 5: SECONDARY AND TERTIARY HEALTHCARE
Table 5.2 Distribution of secondary and tertiary public hospitals under the DGHS by division (June 2016)
Number
Type of
and Barisal Chittagong Dhaka Khulna Mymensingh Rajshahi Rangpur Sylhet Total
hospital
percentage
Medical college Number 1 2 4 1 1 2 2 1 14

hospitals Percentage 7.14 14.29 28.57 7.14 7.14 14.29 14.29 7.14 100.00
Other Number 7 20 41 15 4 13 10 7 117

secondary &
tertiary facilities Percentage 5.98 17.09 35.04 12.82 3.42 11.11 8.55 5.98 100.00
Figure 5.2. Distribution of the number of beds (total 29,306) in the secondary and tertiary hospitals
by administrative division of Bangladesh (June 2016)
5.02%
Mymensingh 1,470
5.99%
Sylhet 1,756
6.04%
Barisal 1,770
7.82%
Khulna 2,293
8.50%
Rangpur 2,490
11.87%
Rajshahi 3,480
14.38%
Chittagong 4,213
40.38%
Dhaka 11,834
Figure 5.3. Population per bed in government-run secondary and tertiary hospitals by
administrative division of Bangladesh (June 2016)
Mymensingh 1.19
Chittagong 1.32
Khulna 1.33
Rangpur 1.41
Sylhet 1.56
Rajshahi 1.70
Barisal 1.94
Dhaka 2.95
Bangladesh average 1.83

Figure 5.4. Beds in secondary and tertiary hospitals, population in 2016 and bed-population ratio
by administrative division of Bangladesh (June 2016)
45,000,000
40,000,000
35,000,000
Dhaka
Mymensingh
30,000,000 Chittagong
Population
Khulna
in 2016
25,000,000
20,000,000 Rajshahi
15,000,000 Rangpur
Sylhet
10,000,000
5,000,000 Barisal
0
1,000 3,000 5,000 7,000 9,000 11,000 13,000
Number of beds
hospital beds when weighted against Private hospitals, clinics, and diagnostic centers
population (Figure 5.3). The whole scenario is
The DGHS provided license to 14,337 private
depicted in Figure 5.4. In this bubble chart,
hospitals, clinics, and diagnostic centers in
the horizontal and vertical axes plot the Bangladesh (as of October 2016). The number of
number of beds and population respectively registered private hospitals and clinics is 4,596,
in each division while the bubble sizes and that of registered private diagnostic centers
indicate the bed-population ratio. Dhaka is 9,741. The total number of beds in these
division has the highest bed-population ratio. registered private hospitals and clinics is 78,426.

Chapter Patients satisfaction is of prime concern
6 UTILIZATION OF PUBLIC
HEALTH FACILITIES
Healthcare-seeking from the public facilities has
been continuing to rise over the past few years,
indicating improvements in the management
of patients and their increasing satisfaction.
All health bulletins published in the recent past reported utilization of health services from public,
private and NGO facilities. Since it was difficult to have data from all private and NGO facilities, those
reports had portrayed only a part of the whole scenario in the private and NGO sectors. This year we
present data from public health facilities only. Healthcare-seeking from the public facilities has been
continuing to rise over the past few years, indicating improvements in the management of patients and
their increasing satisfaction.
For 2015 (January to December), we received available numbers of each type of facilities are
data from almost all public hospitals and health used as denominators against the numbers of
centers under the DGHS. Table 6.1 shows the daily patient-attendance.
sources of data used in the analyses of the
service utilization. The analyses are done by Figure 6.2 shows the daily average attendance
grouping similar types of hospitals together. per facility in selected types of facilities. In this
Individual facility-level data are presented in the analysis, the number of working days in 2015
Annex. was considered to be 290 (by deducting 23
government holidays and 52 weekly holidays
Outpatient attendance from the number of days in 2015).
In 2015, a total of 178,697,958 patient-visits The graph clearly shows that the higher the
took place at the outpatient departments (OPD) hierarchical level of institution, the higher is the
of 16,167 public health facilities. Figure 6.1 daily patient-load. The medical college hospitals
shows the distribution of the visits among 3 are facing the highest load. On an average,
different levels of care. each of the hospitals is serving more than 1,700
patients daily. The secondary hospitals, situated
Table 6.2 shows the breakdown of patient- at the district level, stand next in handling
attendance among different facilities. patientsaround 600 cases per day per hospital,
From Figure 6.1 and Table 6.2, it is evident that and the upazila health complexes treating about
most patient-attendance (89%) occurred in the 200 patients per day per hospital are in the third
primary-level facilities, and the community position in terms of the daily outdoor patient-
clinics alone handled more than 100 million load.
visits. Only 5% of the OPD visits took place Gender and age distribution of outpatient
at the tertiary-level facilities. Thus, it can be attendees
assumed that care-seeking from the primary
healthcare facilities is lowering the patient-load About 60% of attendees at the outpatient
at the higher levels. However, the load is still departments of all facilities were female.
very high in most of the secondary and tertiary- Figure 6.3 shows the overall gender
level facilities, and this will be evident if the distribution.

Table 6.1. Sources of data on the utilization of health services (2015)
Level of care Type of facility No.
Sadar upazila health offices (UHO) 60
Upazila health complexes (UHC) 421

Primary*
Tejgaon Thana Health Complex 1
Total 483
District hospitals/general hospitals 65

Secondary
Total 65
Bangladesh Institute of Tropical and Infectious Diseases, Chittagong 1
Dhaka Dental College Hospital 1
Hospitals of alternative medical colleges 2
Medical college hospitals 14
Tertiary Other tertiary hospitals

(Mental Hospital, Pabna and Sheikh Abu Naser Specialized Hospital, 2
Khulna)
Specialty institute hospitals 11
TB Hospitals (Rajshahi and Khulna) 2
Total 34
Grand total 582
*The UHCs and UHOs provide data of the lower level facilities
Figure 6.1. Distribution of patient-visits there is predominance of female attendees but,

(N=178,697,958) in 2015 in different tiers of as the level goes up, the female predominance
public health facilities (total facilities=16,186) reduces in a linear fashion. At the medical
college hospitals, the male:female ratio is almost
Secondary Tertiary 1 (49.19% versus 50.81%) and, in the next level,
facilities facilities which contains the super specialized institute
11,431,032 8,741,849 hospitals, the scenario is reversed, having a male
6% 5% predominance. Discussion on the significance
or reason of this gender distribution pattern is
beyond the scope of this report but it can be
assumed that some socioeconomic factors are
involved.
Primary-care
facilities
158,525,077 At the lower-level facilities,
89% there is predominance of
There are interesting differences in the gender female attendees but, as the
distribution patterns among different types
of facilities. Figure 6.4 shows the percentage level goes up, the female
distribution of the male and female attendees
in different types of facilities selected from each
predominance reduces in a
of the three tiers. At the lower-level facilities, linear fashion.
CHAPTER 6: UTILIZATION OF PUBLIC HEALTH FACILITIES
Table 6.2. Distribution of the outdoor patient-visits among different facilities

Level of Number of Total visits in
Type of facility
care facilities OPD
10-bed hospitals 17 260,840
20-bed hospitals 26 285,542
Community clinics (CC) 11,165 103,342,733
Maternal and child welfare centers (MCWC) (under
33 680,946
DGFP)
Rural/urban/thana health centers 37 462,296
Sadar upazila health offices (UHO) 60 20,425
Tejgaon Thana Health Complex 1 38,447
Primary
Trauma centers (TC) 5 21,791
Union health and family welfare centers (UHFWC)
2,380 10,309,203
(under DGFP)
Union health and family welfare centers (UHFWC)
714 3,839,318
(under DGHS)
Union subcenters (USC) 1,228 15,248,109
Upazila health complexes (UHC) 421 24,015,427
Total: primary 16,087 158,525,077
District hospitals/general hospitals 65 11,431,032
Secondary
Total: secondary 65 11,431,032
Bangladesh Institute of Tropical and Infectious
1 29,911
Diseases, Chittagong
Dhaka Dental College Hospital 1 89,522
Hospitals of alternative medical colleges 2 131,996
Medical college hospitals 14 6,976,954
Tertiary Other tertiary facilities

(National Center for Control of Rheumatic Fever and
3 211,991
Heart Disease, Dhaka; Mental Hospital, Pabna; and
Sheikh Abu Naser Specialized Hospital, Khulna)
Specialty institute hospitals 11 1,295,704
TB hospitals (Rajshahi and Khulna) 2 5,771
Total: tertiary 34 8,741,849
Grand total 16,186 178,697,958
Table 6.3 gives the age and sex-wise of the facilities. The gender and age distribution
breakdowns of the OPD-attendance in 2015. It patterns were similar to those of the OPD-
shows that about one-fourth (24.79%) of the attendance.
visitors at the OPD were children aged 5 years
or less. The number of OPD and emergency-
attendance, when combined, at these public
Emergency attendance hospitals in 2015 becomes more than 186
In addition to the OPD-attendances discussed million (Table 6.5). It is worth noting that
above, 7,425,541 emergency visits were reported most of these services were provided free
from the public health facilities of different of charge; in some of the facilities, only
categories. Table 6.4 shows the age- and sex-wise a nominal fee (BDT 5 to 10 per visit) was
breakdowns of the attendance among each type charged.

Figure 6.2. Average daily patient-attendance per facility at outpatient departments of selected types
of facilities in 2015
Secondary Tertiary
Medical college hospitals 1,718
District hospitals/
606
General hospitals

Primary
Union subcenters (USC) 43
Community clinic (CC) 32
Figure 6.3. Gender distribution among Admission and death

attendees (total visits: 178,697,958) at the Last year (2015), 5,711,641 admissions were
outpatient departments of all facilities in 2015 registered in 567 public hospitals; 105,856
107,978,480 patients died, giving an overall death rate of
1.85%, Table 6.6 shows the distribution of
70,719,478 admissions as well as inpatient deaths among
different types of hospitals. The Table also
presents the sex and age distributions.
Efficiency in utilization of hospital resources

39.58% 60.42%
Conventionally, the utilization efficiency of
hospitals is assessed in terms of average length
Male Female of stay (ALOS), bed turnover rate (BTOR), and
Figure 6.4. Gender distribution among attendees at the outpatient departments of selected facilities in 2015
63.01% 58.88%
54.06% 53.95%
50.81%
49.19% 46.05%
45.94%
41.12%
36.99%
Male
Female
Community Upazila District Medical Specialty

clinic health hospital college institute
complex hospital hospital
Primary Secondary Tertiary

Table 6.3. Age and sex distribution of the OPD-attendance in 2015

OPD attendance in 2015
Age/Sex
Male Female Total
<5 Year 21,653,630 22,638,110 44,291,740
% 12.12 12.67 24.79
>5 Year 49,065,848 85,340,370 134,406,218
% 27.46 47.76 75.21
Total 70,719,478 107,978,480 178,697,958
% 39.57 60.43 100
Table 6.4. Age and sex distribution of the emergency-attendance among all hospitals in 2015
Male Female
Level Type of facility Total
<5 years >5 years <5 years >5 years
10-bed hospitals 2,805 4,777 1,767 4,442 13,791
20-bed hospital 1,782 8,923 1,721 19,718 32,144
Primary
Trauma centers (TC) 3,133 6,019 2,481 8,024 19,657
Upazila health complex 394,807 1,263,128 449,529 1,237,005 3,344,469
Secondary District hospitals 252,245 824,848 250,035 807,004 2,134,132
Bangladesh Institute Of
Tropical and Infectious 106 2,972 68 2,790 5,936
Disease, Chittagong
Hospitals of alternative
1,288 4,081 1,173 4,558 11,100
medical colleges
Medical college hospitals 119,635 624,750 89,309 567,066 1,400,760
Tertiary
Other tertiary facilities
(Mental Hospital, Pabna
and Shaheed Sheikh 0 4,223 0 3,711 7,934
Abu Naser Specialized
Hospital, Khulna)
Specialty institute
23,393 118,991 19,280 66,145 227,809
hospitals
Total 822,587 2,981,703 834,643 2,786,608 7,425,541
Table 6.5. Total number of OPD and emergency-attendances at selected public hospitals in 2015
Place of attendance Male Female Total
Outpatient department 70,719,478 107,978,480 178,697,958
Emergency department 3,804,290 3,621,251 7,425,541
Total 74,523,768 111,599,731 186,123,499
bed-occupancy rate (BOR). We analyzed the (DH/GH), medical college hospitals (MCH), and
utilization efficiencies of hospitals by grouping specialty institute hospitals (SIH). The analyses
them into 4 categories, viz. upazila health are based on hospital statistics available from
complexes (UHC), district and general hospitals the local health bulletins of 2015.

Table 6.6. Admissions and inpatient deaths with age and sex distribution in all types of hospitals in
2015
Number Male Female
Admission
Level Type of facility of Total
and death <5 yrs >5 yrs <5 yrs >5 yrs
facilities
Admission 6,838 335 1,922 426 4,155
10-bed hospitals 17
Death 13 3 6 2 2
Admission 14,931 2,942 4,663 1,366 5,960
20-bed hospitals 26
Death 39 6 20 2 11
Primary
Trauma centers Admission 279 55 95 44 85
5
(TC) Death 0 0 0 0 0
Upazila health Admission 2,376,809 265,377 753,563 284,065 1,073,804

421
complexes (UHCs) Death 7,242 984 3,014 1,017 2,227
District hospitals/ Admission 1,767,201 223,460 600,947 208,802 733,992

Secondary 65
General hospitals Death 24,988 4,137 9,955 3,473 7,423
Bangladesh Admission 5,986 124 2,965 73 2,824
Institute of
Tropical and
1
Infectious Death 30 1 23 1 5
Diseases,
Chittagong
Dhaka Dental Admission 1,868 28 858 26 956
1
College Hospital Death 2 0 1 0 1
Hospitals of Admission 1,499 50 645 62 742
alternative 2
Death 1 0 1 0 0
medical colleges
Medical college Admission 1,382,585 141,214 603,544 124,711 513,116
Tertiary 14
hospitals Death 66,661 8,381 29,804 6,401 22,075
Mental Hospital, Admission 1,570 0 1234 0 336

1
Pabna Death 14 0 8 0 6
Shaheed Sheikh Admission 2,775 0 1743 0 1032
Abu Naser
1
Specialized Death 232 0 125 0 107
Hospital, Khulna
Specialty institute Admission 148,554 6,358 86,616 4,618 50,962
11
hospitals Death 6,603 312 4,343 245 1,703
TB hospitals Admission 746 0 506 0 240
(Rajshahi and 2
Death 30 0 23 0 7
Khulna)
Admissions 5,711,641 639,943 2,059,301 624,193 2,388,204
Total 567
Deaths 105,856 13,824 47,323 11,141 33,568
Bed turnover rate BTOR indicates the speed with which patients
on a hospital bed are rotated. Obviously, the
Bed turnover rate (BTOR) is a measure of the
more complicated the case dealt with by the
productivity of hospital beds. It is calculated by
hospitals, the smaller the BTOR. A large BTOR
the following formula:
indicates that only simple type of treatment
BTOR=No. of admissions/No. of beds is being provided. On the other hand, a BTOR

Figure 6.5. Bed turnover rates by hospital type in 2015
District/general hospitals 171.11
Upazila health complexes 141.83
Medical college hospitals 106.66
Specialty institute hospitals 48.17
Figure 6.6. Average length of stay (days) by hospital type in 2015
Specialty institute hospitals 9.69
that is very small would indicate that fewer hospitals in 2015. It shows that the Specialty
people are utilizing the hospital and, probably, institute hospitals had the smallest TOR, which
patients are being unnecessarily retained in the is expected. The secondary-level district and
hospitals. Thus, both of the extreme values are general hospitals had the largest TOR that
undesirable. However, in the case of hospitals placed them above the primary-level upazila
dealing with chronic diseases or conditions hospitals. This may indicate that the number of
requiring long stay, a low TOR is inevitable. simple cases attending the secondary hospitals is
Given these facts, it is obvious that the TOR of more than expected.
higher-level hospitals should be ideally smaller Average length of stay
than those of the lower-level hospitals.
Average length of stay (ALOS) in the hospital is
Figure 6.5 shows the BTOR in different types of calculated by the following formula:

Figure 6.7. Bed-occupancy ratio (%) by hospital type in 2015
ALOS=Cumulative inpatient days/No. of showing the BOR in different types of hospitals,

admissions. it is evident that the highest-level hospitals,
namely the specialty institute hospitals do
The average length of stay, as the name suggests, not have the highest BOR, rather these rank
represents the time a patient stays in the 3rd, to remain ahead of only the primary-level
hospital. A longer average length of stay is to be
upazila hospitals. However, the medical college
expected in the case of hospitals having better
hospitals, in this regard, are placed at the top,
facilities, such as the medical college hospital
followed by district-level secondary hospitals,
or specialty institutes. In the case of primary
both having BOR of more than 100%. This
healthcare centers where the level of treatment
means that these hospitals are handling patients
in general is lower, the average length of stay is
in excess in terms of their bed-capacities.
likely to be less.
Upazila health complexes have comparatively
Figure 6.6 shows the ALOS in different types of
lower bed-occupancy rates, indicating
hospitals in 2015. Expectedly, the longest ALOS
underutilization of hospital resources. As these
is observed at the highest-level tertiary hospitals
hospitals lack adequate facilities, patients prefer
(specialty institutes) and the lowest at the
the higher-level hospitals whenever possible.
primary-level upazila hospitals. The secondary-
level hospitals are situated in the middle of the While the indicators described above (TOR,
two extremes. BOR, and ALOS) are the most acceptable
parameters for judging hospital efficiencies,
Bed-occupancy ratio
evaluating a hospital by considering only one of
Bed-occupancy ratio (BOR) is calculated by the these may be inadequate or even deceptive. So,
following formula: for capturing a more accurate scenario, Hiplito
Cumulative inpatient days x100 Pabn Lasso, a Colombian scholar, developed
BOR (%)= --------------------------------------------------------------- a graphical model by combining all of these
Number of beds x days
three indicators back in 1986. This model,
BOR is a measure of the utilization of available named after its inventor, is now widely used for
bed-capacity. It reflects the popularity of the evaluation of hospital performance. Hospitals
hospitals among the admitted patients. The under evaluation will occupy one of the four
level of bed-occupancy varies with the type of zones constructed by two perpendicular lines
facilities available in the hospital. It is normally in the graphical model. One line is drawn from
expected that the bed-occupancy ratio in average BOR point on horizontal (X) axis and
higher-level hospitals will be higher than that the other from average TOR on the vertical (Y)
in the primary-level hospitals. From Figure 6.7 axis. Either standard values of the parameters

Figure 6.8. Pabon-Lasso model for evaluation of hospital performance (Pabn Lasso, 1986)
Average length of stay (ALOS)

Quadrant II Quadrant III
Low Occupancy High Occupancy
Bed turnover (TOR) High Turnover High Turnover

Short Stay Short Stay
(Efficient)
Average
Quadrant I
Low Occupancy Quadrant IV
Low Turnover High Occupancy
Long Stay Low Turnover
(Not Efficient) Long Stay
Bed-occupancy rate (BOR)
or the average values of the parameters from efficient zone of the model from the group-wise
all hospitals under evaluation can be used for comparison done. However, the comparisons
making the subdivisions. The graphical model is should be ideally done among hospitals of
shown in Figure 6.8. similar categories. Interested readers can
compare the efficiencies of selected hospitals
In general, district-level hospitals as well as using this model and taking data presented in
the medical college hospitals both fall in the the Annexes to Chapter 6 and 7.

Chapter Morbidity profile of inpatients and other parameters
7 HEALTHCARE FOR ADMITTED

PATIENTS IN PUBLIC HOSPITALS
The pattern of reporting is changed this year,
with an added summary that can help media
personnel and other instrumental readers to
pick important data.
The chapter presents information relating to healthcare for the admitted patients in public hospitals
given in 2015. The information portrays an overall scenario of the illnesses that people in Bangladesh
suffer from as well as the types of services that the public hospitals offer. For several years, the Health
Bulletin has reported these information under a chapter titled Morbidity Profile. Since more topics
are analyzed and reported this year, morbidity profile became only a part of the subtitle. The pattern
of reporting is changed this year, with an added summary that can help media personnel and other
instrumental readers to pick important data.
Summary the respiratory systems were the next prominent

group of diseases causing 34.68% of admissions
Source of data: Data were obtained from the in the said age-group.
2015 editions of online local health bulletins
published by the public health facilities Injuries, poisoning, and other external causes
of morbidity together constituted 27.96%
Number of admissions: In 2015, a total of of admissions in the age-group of 30 plus
5,711,641 admissions were reported from 567 years. Although the infectious diseases were
public hospitals under the DGHS. The number responsible for more than 24% of admissions
could have been higher if data from all public in this age-group, non-communicable diseases,
hospitals were included but all hospitals did not like myocardial infarction (heart attack) and
publish the local health bulletins. cerebrovascular diseases (stroke), were also
prominent causes for hospitalization.
Recipients of service: About 53% of the
patients admitted in 2015 were male, and Number of procedures performed: A total of
47% were female. Among the admitted 498,748 major and 1,221,848 minor surgeries
patients, around 22% were children aged 5 were reported during 2015.
years or less.
Source of data and limitations
Geographical distribution: In terms of the
number of admissions, Dhaka division was As already said, data were obtained from
at the top, with almost 23% of all admissions the 2015 editions of the online local health
while Barisal division was at the lowest position bulletins published by the public health
with slightly more than 6% of all admissions. facilities. In the local health bulletins, only top
causes for admission are reported to provide a
Reasons of admissions: Among children glimpse of the morbidity profile of patients in
in the age-group of 5 years or less, the highest the hospitals. In 2015, each hospital compiled
percentage (43.15%) of admissions was due two separate lists of top 5 causes for admissions
to infectious diseases, and diarrheal diseases in the facility; one is for children aged 5 years or
outnumbered the other conditions. Diseases of less and the other for persons aged 30 plus years.

CHAPTER 7: HEALTHCARE FOR ADMITTED PATIENTS IN PUBLIC HOSPITALS
Table 7.1. Type and number of public hospitals reporting indoor morbidity data for 2015
Level of care Type of facility No.
10-bed hospitals 17
20-bed hospitals 26
Primary Trauma centers 5
Subtotal: Primary 469
District hospitals/general hospitals 65
Secondary
Subtotal: Secondary 65
Tertiary Other tertiary hospitals

(Mental Hospital, Pabna and Shaheed Sheikh Abu Naser Specialized 2
Hospital, Khulna)
TB hospitals (Rajshahi and Khulna) 2
Subtotal: Tertiary 33
Total 567
Table 7.2. Age and sex distribution of the admitted patients in public hospitals in 2015
Age/sex category Number Percentage of total
Male children aged 5 years or less 639,943 11.20
Male aged more than 5 years 2,059,301 36.05
Female children aged 5 years or less 624,193 10.93
Female aged more than 5 years 2,388,204 41.81
Total male (all ages) 2,699,244 47.26
Total female (all ages) 3,012,397 52.74
Total children aged 5 years or less 1,264,136 22.13
Total patients aged more than 5 years 4,447,505 77.87
Grand total 5,711,641 100
Table 7.3. Number and percent distributions of hospitalization among 8 divisions in 2015
Division No. of admissions Percentage of total
Dhaka 1,300,462 22.77
Chittagong 933,975 16.35
Rajshahi 826,607 14.47
Rangpur 758,586 13.28
Khulna 689,976 12.08
Sylhet 425,969 7.46
Mymensingh 414,330 7.25
Barisal 361,736 6.33
Total 5,711,641 100

For the reporting, ICD-10 codes were assigned denominator against the number of admissions.
against the conditions/diseases which appeared Figure 7.1 shows the admission per 1,000
at the top 5 in the lists. Hence, the analyses population in each of the divisions as well as the
presented here are not based on all causes for country average.
hospitalization, rather on the top causes for
admissions reported by the relevant hospitals. It shows that the Rangpur division was at
the top position in terms of the number of
Various types of institutions from which morbidity admissions in the public hospitals per 1,000
data were received are shown in Table 7.1. population, followed by Rajshahi, Khulna,
Barisal, and Sylhet division, all having more
Data of the individual facilities can be seen and
than the country average of 35.65 admissions
raw data, aggregated by type of facilities, can
per 1,000 population. Surprisingly, Dhaka
be exported from the Local Health Bulletin
and Chittagong were in the last two places,
section under Publication tab of our official
although these two divisions occupied the first
website (www.dghs.gov.bd).
and second positions respectively in terms of
Recipients of service the number of admissions. This might be due to
the fact that the private hospitals are absorbing
Of the 5,711,641 admissions in 567 public more patients in Dhaka and Chittagong
hospitals during January-December 2015, female divisions as these two areas have more private
patients constituted 47.26%. Children aged hospitals than those in other divisions.
5 years or less comprised 22.13% of the total Nonetheless, the higher admission rates in some
admissions. Table 7.2 shows the breakdown of of the divisions deserve a closer review to detect
the age and sex distributions. other causes, if any.
Geographical distribution Reasons of admissions (morbidity profile)
In terms of the number of admissions, Dhaka For analyses presented in this section, two
division was at the top position with almost age-groups were considered, one is the group
23% of all admissions while Barisal division was of children aged 5 years or less, and the other
at the lowest position with slightly more than group comprises patients aged 30 years or more.
6% of all admissions which took place in the In each of the groups, data are aggregated by
public hospitals in 2015. Table 7.3 shows the type of hospitals. Data from upazila health
division-wise distribution.
complexes, district and general hospitals,
The order of the positions is completely and the medical colleges were grouped and
different once population is added as presented separately. In addition, a summary
Figure 7.1. Admissions per 1,000 populations in the public hospitals of 8 divisions in 2015
Rangpur 43.10
Rajshahi 40.50
Khulna 39.99
Barisal 39.56
Sylhet 37.73
Bangladesh average 35.65
Mymensingh 33.50
Dhaka 32.37
Chittagong 29.20

of each of the age-groups is provided, which upazila health complexes. As in the previous
contains aggregated data from all types of years, unspecified infectious diarrheal diseases,
hospitals, including upazila health complexes, causing almost 12% of all admissions, are at the
district and general hospitals, medical college top of the list. The list also contains typhoid
hospitals, and other specialized tertiary hospitals and paratyphoid fevers and cholera, all of
as shown in Table 7.1. The WHO-prescribed which are mainly waterborne diseases. Why
ICD-10 codes are shown against the conditions waterborne infections are still persisting at this
and, in the summary tables, the causes for high rate despite more than 97% households
admissions are grouped according to the in Bangladesh now having access to tap and
chapters in the ICD-10 coding system. tubewell water, should be a matter of concern
for the public health authorities.
Morbidity profile of children aged 5 years or less
Different types of pneumonias together
Upazila health complexes
occupied the second place in the list. A non-
Table 7.4 shows the top 5 causes for admissions specific condition, termed fever of unknown
in the age-group of 5 years or less at the origin occupied the third position; this may be
Table 7.4. Top causes for admissions among children aged 5 years or less in upazila health complexes
in 2015
Percentage of total
Condition/Disease No. admissions reported from
UHCs
Diarrhea and gastroenteritis of infectious origin (A09) 125,930 11.73
Pneumonia (J12-J18) 95,092 8.86
Fever (unknown origin) (R50) 13,539 1.26
Typhoid and paratyphoid fever (A01) 11,381 1.06
Cholera (A00) 8,798 0.82
Table 7.5. Top causes for admissions among children aged 5 years or less at the district-level secondary
hospitals in 2015
Percentage of total
admissions reported
Condition/Disease No.
from district and general
hospitals
Pneumonia (J12-J18) 9,679 1.32
Bacterial sepsis of the newborn, Other septicemia ( P36, A41) 4,277 0.58
Acute bronchiolitis (J21) 2,249 0.31
Birth asphyxia (P21) 2,229 0.30
Table 7.6. Top causes for admissions among children aged 5 years or less at medical college hospitals
in 2015
Percentage of total
Condition/Disease No. admissions reported from
MCH
Pneumonia (J12-J18) 27,813 5.42
Low birthweight and prematurity (P05-P08) 17,662 3.44
Bacterial sepsis of the newborn, Other septicemia ( P36, A41) 9,412 1.83

Table 7.7. Causes for admissions among children aged 5 years or less in all types of hospitals in
2015
Percentage of cases
ICD-10 chapter No. of admissions reported in the top 5
causes for admission
Chapter I-Certain infectious and parasitic diseases
287,238 43.15
(A00-B99)
Chapter II-Neoplasms (C00-D48) 322 0.05
Chapter III-Diseases of blood and blood-forming
organs and certain disorders involving the immune 9,097 1.37
mechanisms (D50-D89)
Chapter IV-Endocrine, nutritional and metabolic
3,983 0.60
diseases (E00-E90)
Chapter V-Mental, behavioral disorders (F00-F99) 19 0.00
Chapter VI-Diseases of the nervous system (G00-G99) 2,348 0.35
Chapter VII-Diseases of the eye and adnexa (H00-H59) 121 0.02
Chapter VIII-Diseases of the ear and mastoid process
672 0.10
(H60-H95)
Chapter IX-Diseases of the circulatory system (I00-I99) 67 0.01
Chapter X-Diseases of the respiratory system (J00-J99) 230,907 34.68
Chapter XI-Diseases of the digestive system (K00-K93) 6,310 0.95
Chapter XII-Diseases of the skin and subcutaneous

54 0.01
tissue (L00-L99)
Chapter XIII-Diseases of the musculoskeletal system
55 0.01
and connective tissue (M00-M99)
Chapter XIV-Diseases of the genitourinary system
1,139 0.17
(N00-N99)
Chapter XV-Pregnancy, childbirth and the Not applicable in Not applicable in the
puerperium (O00-O99) the age-group age group
Chapter XVI-Certain conditions originating in the
89,253 13.41
perinatal period (P00-P96)
Chapter XVII-Congenital malformations,
deformations and chromosomal abnormalities 1,288 0.19
(Q00-Q99)
Chapter XVIII-Symptoms, signs and abnormal clinical
and laboratory findings, not elsewhere classified 22,335 3.35
(R00-R99)
Chapter XIX-Injury, poisoning and certain other
5,936 0.89
consequences of external causes (S00-T98)
Chapter XX-External causes of morbidity and
4,604 0.69
mortality (V01-Y98)
Total (reported in top-5 morbidity list) 665,748 100

due to the fact that the primary-level upazila contributed most in the group. Although
hospitals are less capable of making precise accidents, assaults, and pesticide poisoning
diagnoses. are not the primary concern of the health
department, these are consuming enormous
District-level secondary hospitals resource from health department. Multisectoral
Table 7.5 shows the top 5 causes for admissions collaborations are essential to reduce the effects
among the children aged 5 years or less in the of these preventable conditions imposing
district-level secondary hospitals. Diseases of the burden on the health system.
respiratory systems consisting of pneumonia The group containing diarrheal diseases was
and bronchiolitis are very prominent in this list. at the second position. A group of diseases
Diarrheal diseases are at the second position at of the digestive system, comprising peptic
this level. ulcers, gastritis, dyspepsia, etc., was at the third
Medical college hospitals position while diseases of the respiratory system,
such as asthma and COPD occupied the 4th and
Table 7.6 presents the top causes for admission 5th positions respectively.
in the medical college hospitals. Birth asphyxia,
a condition affecting the newborn babies, was District and general hospitals
the leading cause for admission at this level. Table 7.9 presents the top causes for admissions
Diarrheal diseases occupied the second position among the patients of the stated age-group
while pneumonia, illnesses relating to low in the district-level secondary hospitals. The
birthweight and prematurity, and bacterial group of conditions containing diarrheal
sepsis of the newborn was the other prominent diseases was at the top position, causing
causes for admission. 13.51% of admissions. Here also, the group
Summary of all hospitals containing injury, poisoning, and other external
causes was responsible for a large number of
Table 7.7 shows the summarized picture of the hospitalizations. Asthma, peptic ulcer diseases,
causes for admissions among children aged 5 and COPD occupied the 3rd to 5th positions.
years or less in 567 public hospitals. Types of Cerebrovascular diseases (commonly known as
hospitals included in the analysis are listed stroke) and acute myocardial infarction (widely
in Table 7.1. The percentages shown here are known as heart attack) were also significant
calculated on the basis of cases reported in the causes for admissions at this level.
top 5 causes for admissions.
Medical college hospitals
Infectious and parasitic diseases were responsible
for 43.15% of causes for admissions reported in Table 7.10 shows the top causes for admission
the list of the top 5 causes for admissions in this among persons aged 30 plus years at the
age-group. Admissions due to diseases of the medical college hospitals in 2015. The group
respiratory systems were 34.68%. Conditions of conditions relating to injury, poisoning,
affecting perinatal period, consisting mainly of and other external causes appeared at the top,
birth asphyxia, low birthweight, prematurity, causing 18.75% of all admissions at the medical
and sepsis of the newborn together accounted college hospitals. Cerebrovascular diseases,
for 13.41% of such admissions. COPD, acute myocardial infarction occupied the
next three positions. Thus, non-communicable
Morbidity profile of persons aged 30 plus years diseases (NCDs) occupied all of the top 4 groups
of conditions leading to hospitalizations of
Upazila health complex persons aged 30 plus years at the medical college
Table 7.8 shows the top 5 groups of conditions hospitals. Diarrheal diseases, tuberculosis, and
among persons aged 30 plus years in the upazila peptic ulcer diseases were the other significant
health complexes. The group containing causes for hospitalization among this age-group.
injury, poisoning, and other external causes, Summary from all hospitals
being responsible for a stunning 19.49% of all
admissions, was at the top position. Road-traffic Table 7.11 presents summary of the causes for
accidents, assaults, and pesticide poisoning admissions among persons aged 30 plus years

Table 7.8. Top causes for admissions among patients aged 30 plus years at upazila health complexes
in 2015
Percentage of total
Condition/Disease No. admissions reported
from UHCs
Injury, poisoning, and certain other consequences of
external causes (S00-T98) 209,319 19.49
External causes of morbidity and mortality (V01-Y98)
Diarrhea and gastroenteritis of infectious origin (A09),
197,580 18.40
Cholera (A00)
Peptic ulcers, gastrojejunal ulcer, gastritis and duodenitis,
107,780 10.04
dyspepsia (K25-K30)
Asthma, Severe acute asthma (J45, J46) 53,374 4.97
Chronic obstructive pulmonary diseases (COPD) (J43-J44) 29,432 2.74
Table 7.9. Top causes for admissions among persons aged 30 plus years in the district-level secondary
hospitals in 2015
Percentage of total
Condition/Disease No. admissions reported
from DH & GH
Diarrhea and gastroenteritis of infectious origin (A09),
99,136 13.51
Cholera (A00)
Asthma, Severe acute asthma (J45, J46) 34,603 4.71
27,522 3.75
dyspepsia (K25-K30)
Chronic obstructive pulmonary diseases (COPD) (J43- J44) 25,739 3.51
Cerebrovascular diseases (I60-I69) 13,965 1.90
Acute myocardial infarction (I21) 11,867 1.62
Table 7.10. Top causes for admissions among persons aged 30 plus years at medical college hospitals
in 2015
Percentage of total
admissions reported
Condition/Disease No.
from medical college
hospitals
Chronic obstructive pulmonary diseases (COPD) (J43-J44) 15,792 3.08
Tuberculosis (A15-A19) 4,661 0.91
4,199 0.82
dyspepsia (K25-K30)

Table 7.11. Causes for admissions among persons aged 30 plus years in all hospitals in 2015
Percentage of cases reported
ICD-10 chapter No. in the top 5 causes for
admission
386,598 24.90
(A00-B99)
Chapter II-Neoplasms (C00-D48) 4,815 0.31
organs and certain disorders involving the immune 11,317 0.73
6,877 0.44
diseases (E00-E90)
Chapter V-Mental, behavioral disorders (F00-F99) 39,232 2.53
Chapter VI-Diseases of the nervous system (G00-G99) 10,326 0.67
Chapter VII-Diseases of the eye and adnexa
15,333 0.99
(H00-H59)
Chapter VIII-Diseases of the ear and mastoid process
0 0.00
(H60-H95)
Chapter IX-Diseases of the circulatory system
192,629 12.41
(I00-I99)
Chapter X-Diseases of the respiratory system (J00-J99) 190,389 12.26
Chapter XI-Diseases of the digestive system (K00-K93) 155,763 10.03
Chapter XII-Diseases of the skin and subcutaneous
6,490 0.42
tissue (L00-L99)
Chapter XIII-Diseases of the musculoskeletal system
425 0.03
and connective tissue (M00-M99)
Chapter XIV-Diseases of the genitourinary system
15,896 1.02
(N00-N99)
Chapter XV-Pregnancy, childbirth and the puerperium
21,109 1.36
(O00-O99)
Not
Chapter XVI-Certain conditions originating in the applicable Not applicable in this age-
perinatal period (P00-P96) in this age- group
group
Chapter XVII-Congenital malformations, deformations,
0 0.00
and chromosomal abnormalities (Q00-Q99)
Chapter XVIII-Symptoms, signs, and abnormal
clinical and laboratory findings, not elsewhere 61,347 3.95
classified (R00-R99)
Chapter XIX-Injury, poisoning, and certain other
87,756 5.65
consequences of external causes (S00-T98)
Chapter XX-External causes of morbidity and mortality
346,317 22.31
(V01-Y98)
Chapter XXI-Factors influencing health status and
420 0.03
contact with health services (Z00-Z99)
Total (reported in the list of top 5 causes of
1,552,619 100
morbidity)

Figure 7.2. Distribution of major surgeries Figure 7.3. Distribution of minor surgeries
among different types of hospitals in 2015 among different types of hospitals in 2015
(n=498,748) (n=1,221,848)
In UHC*
In other
62,563 In UHC*
facilities
12% 471,611
259,431
In other 39%
21%
facilities
In DH & GH
193,826
84,096
39%
17% In MCH
194,805
16%
In DH & GH
In MCH 296,001
158,263 24%
32%
*Include the private and NGO hospital data in the catchment areas under respective UHCs
in 567 public hospitals. The percentages shown group of patients as reflected by 12.41% of
here are calculated on the basis of cases reported admissions due to diseases of the circulatory
in the top 5 causes for admissions among this systems. Respiratory system diseases were also
age-group. notable contributors causing 12.26% of all
hospitalizations among persons aged 30 plus
Infectious and parasitic diseases were responsible
years.
for 24.90% of causes for admissions reported
in the list of the top 5 causes for admissions Number of procedures performed
in this age-group. Injuries, poisoning, and
other external causes of morbidity together A total of 498,748 major and 1,221,848 minor
caused 27.96% of admissions in the age-group. surgeries were performed in all hospitals
Non-communicable diseases, like myocardial combined in 2015. Figure 7.2 and 7.3 show
infarction and cerebrovascular diseases, made the distribution of major and minor surgeries
very prominent appearances among this respectively in different types of hospitals.

Chapter Changing pattern of the causes of death
8 MORTALITY IN PUBLIC
HOSPITALS
Measures are being taken jointly by the newly-
formed Civil Registration and Vital Statistics
(CRVS) Secretariat of the Cabinet Division and
the DGHS to ensure death notifications from
the community and all health facilities.
The chapter presents mortality profile of inpatients in public hospitals of Bangladesh in 2015. As estimated
from the crude death rate, around 880,000 persons died in the country during the said year. From the
selected public hospitals 105,856 deaths were reported. Deaths that occur in residents and private health
facilities are largely remaining unreported. Recently, measures are being taken jointly by the newly-formed
Civil Registration and Vital Statistics (CRVS) Secretariat of the Cabinet Division and the DGHS to ensure
death notifications from the community and all health facilities. As in the previous chapter, the pattern of
reporting is changed this year, with the addition of a summary at the beginning to facilitate a quick look
into the overall scenario of the causes of death in public hospitals of the country.
Summary Leading causes of death: Among children

in the age-group of 5 years or less, certain
Source of data: Data were obtained from the conditions of the perinatal periods, like birth
online local health bulletins published by the asphyxia, low birthweight and prematurity, and
public health facilities in 2015. neonatal sepsis were the leading causes of death.
Numbers and rates of deaths in public Diseases of the respiratory systems, mainly in
hospitals: In 2015, a total of 105,856 deaths the forms of pneumonia and bronchiolitis, were
were reported against 5,711,641 admissions in among the other top causes of death in this age-
567 public hospitals under the DGHS, and, thus, group.
the overall death rate against admission was In the 30 to 70 years age-group, non-
1.85% (see Annex 8 for details). communicable diseases were the main killers.
Age and sex distribution: About 58% of the Diseases of the circulatory system caused
patients who died in hospitals were male, and almost 18% of all deaths reported. The
42% were female. Among the deceased, around principal causes of death in this age-group
24% were children aged 5 years or less. were acute myocardial infarction (heart attack),
other heart diseases, and cerebrovascular
Places of death: The medical college hospitals diseases (stroke). Injuries and poisoning from
(total 14) in the public sector reported 66,661 various external causes together constituted
deaths contributing almost 63% of all deaths 6.23% of all deaths in hospitals. Assault and
among admitted patients. Other tertiary transport accidents were the main causes of
hospitals reported 6% of the total deaths..From injuries while accidental or intentional misuse
65 district and general hospitals, 24,998 (around of pesticides were the main causes of death
24% of the total) deaths were reported; 421 due to poisoning. Diseases of the respiratory
upazila health complexes reported 7,242 deaths systems, mainly COPD and asthma caused
showing around 7% of the total deaths. 4.3% of all deaths reported.

The principal causes of maternal deaths Data of the individual facilities can be seen and
included prolonged labor, various types raw data, aggregated by type of facilities, can
of abortions, eclampsia, and postpartum be exported from the Local Health Bulletin
hemorrhage. section under Publication tab of our official
website (www.dghs.gov.bd).
Source of data and limitations
Age and sex distribution
As in the case of drawing the morbidity profile,
mortality data were also obtained from the Of the 105,856 deaths in 567 public hospitals
online local health bulletins published in 2015 during January-December 2015, female constituted
by the public health facilities. In those bulletins, 42.24%, although they were 52.74% of the total
only top causes of deaths are reported to provide admitted patients. Thus, hospital death rate of
a hint of the mortality profile among inpatients female patients was lower compared to that of the
in the hospitals. In 2015, each hospital male. Children aged 5 years or less constituted
compiled three separate lists of top 5 causes of 23.58% of the hospital deaths. Table 8.2 shows the
death in the facility: one is for children aged age and sex distributions of hospital admissions,
5 years or less, one for persons aged between total deaths, and percentage of death against
30 and 70 years, and the other is for maternal admissions in the respective age and sex categories.
deaths. In this reporting, ICD-10 codes were
Places of death
assigned against the conditions/diseases, which
appeared at the top 5 in each of the groups. Table 8.3 shows the distribution of the total
Hence, the causal analyses presented here are reported deaths by type of hospital. The death
not based on all causes of death, rather on the rates are shown as percentages of death against
top causes of deaths among inpatients broken admission in the respective types of hospitals.
down into the abovementioned groups.
Figure 8.1 shows the percentage distribution
Types of institutions from which mortality data of the deaths among three tiers (primary,
were received are shown in Table 8.1. secondary and tertiary) of hospitals.
Table 8.1. Type and number of public hospitals reporting indoor mortality data for 2015
Level of
Type of facility No.
care
10-bed hospitals 17
20-bed hospitals 26
Primary Trauma centers 5
Subtotal: Primary 469
District hospitals/General hospitals 65
Secondary
Subtotal: Secondary 65
Other tertiary hospitals
Tertiary
(Mental Hospital, Pabna and Shaheed Sheikh Abu Naser Specialized 2
Hospital, Khulna)
TB hospitals (Rajshahi and Khulna) 2
Subtotal: Tertiary 33
Total 567

CHAPTER 8: MORTALITY IN PUBLIC HOSPITALS
Table 8.2. Age and sex distribution of the deaths against admissions among inpatients in public
hospitals in 2015
% of total admissions Number Death rate (%)
Age/sex category of against admission in
(n=5,711,641) deaths respective categories
Male children aged 5 years or less 11.20 13,824 13.06
Males aged more than 5 years 36.05 47,323 44.71
Female children aged 5 years or less 10.93 11,141 10.52
Females aged more than 5 years 41.81 33,568 31.71
100 100
Total males (all ages) 47.26 61,147 57.76
Total females (all ages) 52.74 44,709 42.24
100 100
Total children aged 5 years or less 22.13 24,965 23.58
Total patients aged more than 5 years 77.87 80,891 76.42
Grand total 100 105,856 100
Most of the deaths (69%) took place in the tertiary- complexes. Pneumonia, causing slightly above
level hospitals. District-level secondary hospitals 10% of all deaths reported from these hospitals
had 24% of all deaths while the primary-care was at the top position. Birth asphyxia, injury
hospitals reported the remaining 7%. The order of and poisoning, sepsis, and low birthweight
ranking among three tiers of hospitals in terms of and prematurity occupied the 2nd through 5th
number of deaths is opposite to that of the ranking positions respectively.
of admission. However, this is quite expected
District-level secondary hospitals (DLH)
because the higher-level hospitals have to handle
more complicated patients nearing death. Table 8.5 shows the top 5 causes of death in
this age-group in the district-level secondary
Leading causes of death
hospitals. Birth asphyxia was the leading cause
For analyses presented in this section, data of death.
from upazila health complexes, district and
Medical college hospitals (MCH)
general hospitals, and the medical colleges
were aggregated and presented separately Table 8.6 presents the top causes of death
for each of the two age-groups (<5 years and in the medical college hospitals. Here also,
30-70 years). A summary for each of the birth asphyxia was the leading cause of
age-groups is also provided. It contains data death.
aggregated from all three types of hospitals, viz.
upazila health complexes, district and general Summary from all hospitals
hospitals, medical college hospitals. The WHO- Table 8.7 shows the summarized picture of the
prescribed ICD-10 codes are shown against the causes of death among children aged 5 years
conditions and, in the summary tables, the or less in all of the three types of hospitals as
causes for admissions are grouped according described above. The percentages shown here
to the chapters in the ICD-10 coding system. are based on all deaths reported from these
The causes of maternal deaths are separately hospitals.
presented in a summarized form.
Conditions affecting perinatal period, consisting
Mortality profile of children aged 5 years or less mainly of birth asphyxia, low birthweight,
Upazila health complexes (UHC) prematurity, and sepsis of the newborn together
accounted for 13.41% of all deaths. Diseases of
Table 8.4 shows the top 5 causes of death in the the respiratory system accounted for 3.53% of
age-group of 5 years or less at the upazila health all deaths.

Table 8.3. Distributions of deaths among inpatients in hospitals in 2015
Death rate
Level of No. of % of total deaths
Type of facility (%) against
care deaths in hospitals
admission
10-bed hospitals 13 0.01 0.19
20-bed hospitals 39 0.04 0.26
Primary Trauma centers 0 0.00 0.00
Upazila health complexes (UHC) 7,242 6.84 0.30
Subtotal: Primary 7,294 6.89 0.30
District hospitals/General hospitals 24,988 23.61 1.41
Secondary
Subtotal: Secondary 24,988 23.61 1.41
Bangladesh Institute of Tropical and
30 0.03 0.50
Infectious Diseases, Chittagong
Dhaka Dental College Hospital 2 0.00 0.11
Hospitals of alternative medical
1 0.00% 0.07
colleges
Institute of Child and Mother
412 0.39 2.84
Health (ICMH)
Medical college hospitals 66,661 62.97 4.82
Mental Hospital, Pabna 14 0.01 0.89
National Institute of Cancer
168 0.16 2.31
Research and Hospital (NICRH)
National Institute of Cardiovascular
4,018 3.80 6.34
Diseases (NICVD)
National Institute of Chest Disease
972 0.92 7.06
and Hospital (NIDCH)
Tertiary National Institute of ENT - - -
National Institute of Kidney
189 0.18 3.29
Diseases and Urology (NIKDU)
National Institute of Mental Health
4 0.004 0.13
& Research (NIMHR)
National Institute of Neurosciences
696 0.66 9.53
and Hospital (NINH)
National Institute of
0 0.00 0.00
Ophthalmology (NIO)
National Institute of Traumatology
and Orthopaedic Rehabilitation 144 0.14 0.77
(NITOR)
Shaheed Sheikh Abu Naser
232 0.22 8.36
Specialized Hospital, Khulna
TB hospitals (Rajshahi and Khulna) 30 0.03 4.02
Subtotal: Tertiary 7,3573 69.50 4.76
Grand total 105,856 100 1.85

Figure 8.1. Percentage distribution of the deaths among three tiers of hospitals in 2015
Primary
7,294
7%
Secondary
24,988
24%
Tertiary
73,573
69%
Table 8.4. Top 5 causes of death among children aged 5 years or less in upazila health complexes in
2015
Percentage of total
Cause of death No. deaths (N=7,242)
reported from UHCs
Pneumonia (J12-J18) 729 10.07
Birth asphyxia (P21) 449 6.20
External causes (injury, poisoning and other external causes) of
222 3.07
mortality (V01-Y98)
Bacterial sepsis of the newborn, Other septicemia ( P36, A41) 221 3.05
Low birthweight and prematurity (P05-P08) 90 1.24
Table 8.5. Top causes for admissions among children aged 5 years or less at the district-level
secondary hospitals in 2015
Percentage of total
Cause of death No. deaths (N=24,988)
reported from DLHs
Pneumonia (J12-J18) 853 3.41
Bacterial sepsis of the newborn, Other septicemia ( P36, A41) 978 3.91
Acute bronchiolitis and unspecified acute lower respiratory
141 0.56
infection (J22)
Child mortality: position of Bangladesh in the prematurity, sepsis of the newborns, respiratory
global and regional contexts infections, and injuries. The findings are in
As revealed from the above analyses, the agreement with the statistics and information
principal causes of child death in Bangladesh published by WHO. We are presenting an extract
include birth asphyxia, low birthweight and from the cause-specific mortality estimates for

Table 8.6. Top causes of death among children aged 5 years or less at medical college hospitals in
2015
Percentage of total deaths
Cause of death No.
(N=66,661) reported from MCH
Bacterial sepsis of the newborn, Other
2,204 3.31
septicemia ( P36, A41)
Pneumonia (J12-J18) 1,505 2.26
Meningitis/encephalitis (G00, G03, G04) 448 0.67
selected causes of under-five child death for together contributed more than 11% of deaths
the year 2015. The original report was jointly in these hospitals. Assaults, transport accidents,
prepared by the Department of Evidence, and pesticide poisoning contributed most for
Information and Research (WHO, Geneva) and deaths in this group. They were also the leading
the Maternal Child Epidemiology Estimation causes of admissions at this level, as described in
(MCEE) group. The readers can assess the Chapter 7.
position of Bangladesh in terms of the causes of
child death in the global and regional contexts As Bangladesh could
by the graphs presented in Figure 8.2. These
show the rates of death (no. of deaths per 1,000 significantly reduce her child
livebirths) from selected diseases in the countries
under the WHO South-East Asian Region (SEAR).
mortality to achieve the
The global averages are also shown. related MDG, it can be safely
From comparisons of the disease burdens assumed that, with some
among WHO-SEAR countries, we see that
Bangladesh is in better situation for some of fine-tuning, mortality due to
the cases, like malaria. We could successfully these conditions will also be
reduce the burden of malaria having only
0.08 cases per 1,000 livebirths, the global reduced in the near future.
average of which is above 2. In neighboring
The group containing cerebrovascular diseases,
India, the rate is more than three times of
collectively known as stroke was at the
that in Bangladesh. Our positions are around
second position causing more than 10% of all
the middle portions in terms of the burden of
deaths at this level. A group of diseases of the
conditions, like respiratory infections, injury,
respiratory system, known as COPD occupied
and prematurity. However, from two of the
the 3rd position. Various heart diseases and
cases, viz. neonatal sepsis, and birth asphyxia,
acute myocardial infarction took the 4th and 5th
we are suffering the most. As Bangladesh
positions respectively while asthma, another
could significantly reduce her child mortality
disease from the respiratory system appeared in
to achieve the related MDG, it can be safely
the next position.
assumed that, with some fine-tuning,
mortality due to these conditions will also be District and general hospitals (DLH)
reduced in the near future.
Table 8.9 presents the top causes of death
Causes of death among persons aged between among the patients of the stated age-group
30 and 70 years in the district-level secondary hospitals. At
Upazila health complex this level, acute myocardial infarction was
at the top position, causing 7.3% of deaths.
Table 8.8 shows the leading causes of death Cerebrovascular diseases, another major
among persons aged between 30 and 70 years NCD, appeared at the very next position. The
in the upazila health complexes. Various types third position was occupied by other heart
of injury, poisoning and other external causes diseases.

Table 8.7. Causes for admissions among children aged 5 years or less in all types of hospitals in 2015
Percentage of all deaths
ICD-10 chapter No. of deaths (N=98,891) in UHC,
DLH, and MCH
2,131 2.15
(A00-B99)
organs and certain disorders involving the immune 72 0.07
180 0.18
diseases (E00-E90)
Did not appear
Did not appear in the
in the top 5
Chapter V-Mental, behavioral disorders (F00-F99) top 5 causes of death in
causes of death
any hospital
in any hospital
Chapter VI-Diseases of the nervous system (G00-G99) 605 0.61
Did not appear Did not appear in the
Chapter VII-Diseases of the eye and adnexa in the top 5
top 5 causes of death in
(H00-H59) causes of death
in any hospital any hospital
Did not appear Did not appear in the

Chapter VIII-Diseases of the ear and mastoid process in the top 5
(H60-H95) causes of death
in any hospital any hospital
Chapter IX-Diseases of the circulatory system (I00-I99) 40 0.04%

Chapter X-Diseases of the respiratory system (J00-J99) 3,486 3.53%
Chapter XI-Diseases of the digestive system (K00-K93) 7 0.01%
Did not appear
Chapter XII-Diseases of the skin and subcutaneous in the top 5
tissue (L00-L99) causes of death
any hospital
in any hospital
Did not appear
Chapter XIII-Diseases of the musculoskeletal system in the top 5
and connective tissue (M00-M99) causes of death
any hospital
in any hospital
Chapter XIV-Diseases of the genitourinary system (N00-N99) 16 0.02
Chapter XV-Pregnancy, childbirth, and the
Not applicable Not applicable
puerperium (O00-O99)
Chapter XVI-Certain conditions originating in the
11,239 11.37
perinatal period (P00-P96)
Chapter XVII-Congenital malformations, deformations,
156 0.16
and chromosomal abnormalities (Q00-Q99)
clinical and laboratory findings, not elsewhere 62 0.06
235 0.24
mortality (V01-Y98)
Total (reported in the list of top 5 causes of death) 18,251 18.46

Figure 8.2. Deaths per 1,000 livebirths from selected diseases in WHO-SEAR countries with global
average in 2015
Acute respiratory infections Birth asphyxia and birth trauma
Sri Lanka 0.62
Maldives 0.62
Thailand 1.14 Maldives 0.75
DPR Korea 3.67 Sri Lanka 0.80
Indonesia Thailand 0.91
4.57
DPR Korea 2.90
Bhutan 4.88
Indonesia 3.24
Nepal 5.34
Bhutan 4.01
Bangladesh 5.44 Global 4.95
WHO SEARO 6.39 WHO SEARO 5.04
Global 6.59 India 5.48
India 7.13 Nepal 5.51
Myanmar 8.16 Bangladesh 5.57
Timor-Leste 10.56 Myanmar 7.14
Injuries Malaria
Maldives 0.42
Sri Lanka 0.64 Bhutan 0.000
Thailand 0.80 DPR Korea 0.000
DPR Korea 1.78 Maldives 0.000
Sri Lanka 0.000
India 1.79 Nepal 0.004
Indonesia 1.82 Thailand 0.008
WHO SEARO 1.85 Bangladesh 0.081
Bangladesh 2.24 WHO SEARO 0.260
Nepal 2.25 India 0.264
Indonesia 0.382
Bhutan 2.49 Myanmar 0.573
Global 2.61 Timor-Leste 0.809
Myanmar 3.42 Global 2.193
Prematurity Sepsis and other infectious conditions of the newborn

Maldives 2.08 Sri Lanka 0.21
Sri Lanka 2.14 Maldives 0.33
Thailand 3.00 Thailand 0.41
Indonesia 5.08 DPR Korea 1.59
DPR Korea 5.39
Indonesia 1.76
Timor-Leste 5.53
Global 2.89
Nepal 7.21
Bhutan 3.00
Bhutan 7.33
Bangladesh WHO SEARO 3.42
7.39
Global 7.57 Myanmar 3.53
Myanmar 9.94 India 3.77
WHO SEARO 10.87 Nepal 4.08
India 13.13 Bangladesh 4.63
Table 8.8. Top causes for death among patients aged between 30 and 70 years at upazila health
complexes in 2015
Cause of death No. (N=7,242) reported from
UHCs
External causes (injury, poisoning, and other external
798 11.02
causes) of mortality (V01-Y98)
Cerebrovascular diseases (I60-I69) 759 10.48
Chronic obstructive pulmonary diseases (COPD) (J40-J44) 645 8.91
Other forms of heart diseases (I20, I22-25, I27, I40, 142,
611 8.44
I46, I50, I51)
Acute myocardial infarction (I21) 608 8.40
Asthma, Severe acute asthma (J45, J46) 548 7.57
Medical college hospitals the only difference being the order of their
positions. Here, cerebrovascular diseases
Table 8.10 shows the top causes of death took the first place. Injury and poisoning,
among persons aged between 30 and 70 years acute myocardial infarction, COPD, other
at the medical college hospitals in 2015. forms of heart diseases, and chronic kidney
The usual suspects, all belonging to NCDs diseases appeared in the 2nd through 6th places
occupied the top positions at this level also, respectively.

Table 8.9. Top causes for death among persons aged between 30 and 70 years in the district-level
secondary hospitals in 2015
DLHs
Other forms of heart diseases (I20, I23-25, I40, I46, I50, I51) 1,385 5.54
External causes (injury, poisoning and other external
1,007 4.03
Chronic obstructive pulmonary diseases (COPD) (J40-J44) 739 2.96
Asthma, Severe acute asthma (J45, J46) 384 1.54
Chronic kidney disease (N18) 345 1.38
Table 8.10. Top causes of death among persons aged between 30 and 70 years at medical college
hospitals in 2015
MCHs
External causes (injury, poisoning, and other external
4,360 6.54
Chronic obstructive pulmonary diseases (J44) 1,089 1.63
Other forms of heart diseases (I20, I46, I50, I51) 1,043 1.56
Chronic kidney disease (N18) 523 0.78
Summary from UHCs, DLHs, and MCHs causes of death due to poisoning. Diseases of the
respiratory systems, mainly COPD and asthma,
Table 8.11 presents a summary of the causes caused 4.3% of all deaths reported, placing the
of death among persons aged between 30 and group in the 3rd position.
70 years in 500 public hospitals (421 UHCs, 65
DLHs, and 14 MCHs). The aggregated number Causes of maternal death
of all deaths reported from the abovementioned
hospitals was used as the denominator to Each of the hospitals (UHCs, DLHs, and
calculate the percentage shown in Table 8.11. MCHs) reported top 5 causes of maternal death
separately. Figure 8.3 shows the leading causes
Non-communicable diseases were the main of maternal death sorted out from all of these
killers in this age-group. While aggregated, tree types of hospitals. Of the 4,089 maternal
the diseases of the circulatory system took deaths reported in the top 5 lists, 23.26%
the top position, causing almost 18% of all were due to prolonged labor. Various types of
deaths reported. The principal causes of deaths abortions (20.13%), eclampsia (19.91%), and
under this group of diseases included acute postpartum hemorrhage (17.71%) were other
myocardial infarction, other heart diseases, and notable causes.
cerebrovascular diseases. Injuries and poisoning
Mortality profile at the specialty institute
from various external causes as a group occupied
hospitals
the 2nd position, leading to 6.23% of all hospital
deaths. Assault and transport accidents were The mortality profiles of selected age-groups at
the main causes of injuries while accidental or the specialty institute hospitals are presented in
intentional misuse of pesticides were the major the following section.

Table 8.11. Causes of death among persons aged between 30 and 70 years in different hospitals
in 2015
Percentage of all deaths
ICD-10 chapter No. of deaths (N=98,891) in UHCs, DLHs
and MCHs
Chapter I-Certain infectious and parasitic
663 0.67
diseases (A00-B99)
Chapter III-Diseases of blood and blood-
forming organs and certain disorders involving 51 0.05
the immune mechanisms (D50-D89)
Chapter IV-Endocrine, nutritional and
492 0.50
metabolic diseases (E00-E90)
Chapter V-Mental, behavioral disorders
3 0.00
(F00-F99)
Chapter VI-Diseases of the nervous system (G00-G99) 682 0.69
Did not appear in Did not appear in the top
Chapter VII-Diseases of the eye and adnexa
the top 5 causes of 5 causes of death in any
(H00-H59)
death in any hospital hospital
Chapter VIII-Diseases of the ear and mastoid
process (H60-H95)
Chapter IX-Diseases of the circulatory system (I00-I99) 17,495 17.69
Chapter X-Diseases of the respiratory system
4,257 4.30
(J00-J99)
Chapter XI-Diseases of the digestive system
160 0.16
(K00-K93)
Chapter XII-Diseases of the skin and
1 0.00
subcutaneous tissue (L00-L99)
Chapter XIII-Diseases of the musculoskeletal
system and connective tissue (M00-M99)
Chapter XIV-Diseases of the genitourinary
933 0.94%
system (N00-N99)
Chapter XV-Pregnancy, childbirth, and the Reported under causes Reported under causes of
puerperium (O00-O99) of maternal death maternal death
Reported under
Chapter XVI-Certain conditions originating in Reported under mortality of
mortality of <5
the perinatal period (P00-P96) <5 years age-group
years age-group
Chapter XVII-Congenital malformations,
deformations, and chromosomal abnormalities 16 0.02%
(Q00-Q99)
clinical and laboratory findings, not elsewhere 301 0.30%
6,165 6.23%
mortality (V01-Y98)
Total (reported in the list of top 5 causes of death) 31,668 32.02%

Figure 8.3. Percentage distribution of the top causes of maternal death (N=4,089) in 2015
Prolapse of gravid

uterus
(O35.5), 7.34%
Long labour
(O63), 23.26%
Postpartum
hemorrhage
(O72), 17.71%
Pregnancy with
Eclampsia abortive outcome
(O15), 19.91% (O00-O08), 20.13%
Institute of Child and Mother Health (ICMH), shows the number and percentage of the top 5
Dhaka causes of death in the group of persons between
30 and 70 years of age; different anatomical sites
A total of 381 children aged 5 years or less were primarily affected by the cancers. Cancers
died at ICMH in 2015. The causes of death affecting the lungs or bronchus (C34.9) were at
at this hospital are listed in Table 8.12. Birth the top position, causing 32.14% of all deaths
asphyxia was at the top of the list, causing more in this hospital. It is worth mentioning that
than one-fourth (25.5%) of the deaths in this smoking is strongly associated with this type
age-group. Prematurity and low birthweight of cancer. Both breast and liver cancers caused
together constituted 21.3% of deaths. Other 7.75% of deaths.
causes included sepsis and malnutrition.
In the age-group of 5 years or below, 6 patients
Table 8.12. Mortality profile of children aged died from cancers. Non-Hodgkins lymphoma
5 years or less at ICMH in 2015 and acute lymphoblastic leukemia were reported
ICD-10 code with name of No. of to be the causes (not shown in Table).
%
disease cases
Table 8.13. Mortality profile of patients aged
P21 Birth asphyxia 97 25.5
between 30 and 70 years at NICRH in 2015
P07 Disorders related to short
81 21.3 ICD-10 code with site of No. of
gestation and low birthweight %
cancer cases
P36 Bacterial sepsis of newborn 76 19.9 C34.9 Bronchus or lung,
54 32.14
A41.9 Septicemia, unspecified 25 6.6 unspecified
E43 Unspecified severe protein- C50.9 Breast, unspecified 13 7.74
24 6.3
energy malnutrition C22.9 Liver, unspecified 13 7.74
Total deaths (<5 years)=381 C16.9 Stomach, unspecified 9 5.36
In 2015, only 2 maternal deaths were reported C20 Malignant neoplasm of
8 4.76
from this hospital; both of them died of rectum
eclampsia in the puerperium (O15.2). Total deaths=168
National Institute of Cancer Research and National Institute of Cardiovascular Diseases

Hospital (NICRH), Dhaka (NICVD), Dhaka
One hundred and sixty-eight cancer-affected Table 8.14 shows the top causes of death among
patients died at NICRH in 2015. Table 8.13 the group of persons aged between 30 and 70

years at NICVD in 2015. Acute myocardial Table 8.16. Mortality profile of patients aged
infarction was responsible for 27.45% of the between 30 and 70 years at NIDCH in 2015
4,018 deaths that occurred in this hospital in
ICD-10 code with name of No. of
2015. Other notable causes included unstable %
disease cases
angina, left ventricular failure, and old
myocardial infarction. J44 Chronic obstructive
195 20.06
pulmonary disease
Table 8.15 shows the top causes of death
A15 Respiratory tuberculosis,
among children aged 5 years or less at the same
bacteriologically- and 130 13.37
institute in 2015. Different types of congenital
histologically-confirmed
heart diseases were responsible for the deaths.
J47 Bronchiectasis 104 10.70
Table 8.14. Mortality profile of patients aged J12-18 Pneumonia 91 9.36
between 30 and 70 years at NICVD in 2015 C34 Malignant neoplasm of
79 8.14
ICD-10 code with name of Number bronchus and lung
%
disease of cases Total deaths=972
I21 Acute myocardial
1,103 27.45 National Institute of Kidney Disease and Urology
infarction
(NIKDU), Dhaka
I20.0 Unstable angina 311 7.74
I50.1 Left ventricular failure 166 4.13 Table 8.17 enlists the top causes of death among
patients of the group of persons aged between
I25.2 Old myocardial
160 4.38 30 and 70 years at NIKDU in 2015. In total,
infarction
189 patients died at the hospital during 2015.
Total deaths=4,018 Chronic kidney disease of stage 5 and acute renal
failure occupied the top two positions, causing
38.86 % and 27.51% of deaths respectively.
Table 8.15. Mortality profile of patients aged 5
years or less at NICVD in 2015 Only four patients of the age-group of 5 years
ICD-10 code with name of Number and below died in this institute during the period
% (not shown in Table). The causes were rapidly-
disease of cases
progressive nephritic syndrome (N01), nephrotic
Q21.3 Tetralogy of Fallot 31 0.77
syndrome (N04), acute renal failure (N17), and
Q21.0 Ventricular septal chronic renal failure (N18).
26 0.65
defect
Table 8.17. Mortality profile of patients aged
Q21.1 Atrial septal defect 15 0.37
between 30 and 70 years at NIKDU in 2015
Q25.0 Patent ductus
12 0.30 ICD-10 code with name of No. of
arteriosus %
disease cases
I42.0 Dilated
10 0.25 N18.5 Chronic kidney
cardiomyopathy 64 33.86
disease, stage 5
Total deaths=4,018 N17 Acute renal failure 52 27.51
National Institute of Diseases of the Chest & E87 Disorders of fluid,
23 12.17
Hospital (NIDCH), Dhaka electrolyte, and acid-base balance
N01 Rapidly-progressive
Table 8.16 shows the top 5 causes of death 14 7.41
nephritic syndrome
among the group of persons aged between 30
and 70 years at NIDCH in 2015. Total number of Total deaths=189
deaths was 972, and none of them belonged to National Institute of Mental Health and
the age-group of 5 years or less. COPD (20.06%) Research (NIMHR), Dhaka
and respiratory tuberculosis (13.37%) were the
two leading causes of death in this hospital. Table 8.18 summarizes the causes of death at
Lung cancer also appeared as the top causes of NIMHR in 2015. Four patients died in the hospital
death in this institute, causing more than 8% of during this period. Schizophrenia, drug-abuse, and
deaths. manic episode were reported as the causes.

Table 8.18. Mortality profile at NIMHR in

National Institute of Traumatology and
Orthopaedic Rehabilitation (NITOR), Dhaka
2015
ICD-10 code with name of No. of During 2015, a total of 144 patients died in
% NITOR. Various types of injuries were the causes
disease cases
of death. Most of the underlying causes of the
F20 Schizophrenia 2 50
injuries were transport accidents and assaults.
F19 Mental and behavioral
disorders due to multiple Pabna Mental Hospital
1 25
drug-use and use of other
In total, 14 patients died in Pabna Mental
psychoactive substances
Hospital in 2015, out of whom, 12 were in the
F30 Manic episode 1 25 age-group of 30 to 70 years. Schizophrenia (F20)
Total deaths=4 was reported as the cause of all these deaths.
National Institute of Neuroscience (NINH), Shaheed Sheikh Abu Naser Specialized Hospital,
Dhaka Khulna
Table 8.19 shows the leading causes of death Table 8.21 summarizes the causes of death
among the patients aged between 30 and 70 among persons aged between 30 and 70 years at
years at NINH in 2015. Stroke was at the top Shaheed Sheikh Abu Naser Specialized Hospital
position in the list, accounting for 18.97% of in 2015. In total, 232 patients died at this
the total 696 deaths. Cancer involving brain had hospital, and none of them belonged to the
the 2nd place, causing 14.22% of deaths. age-group of 5 years or less. Cerebrovascular
diseases, chronic renal failure, acute myocardial
Table 8.20 displays the top causes of death infarction, and heart failure were the top causes
among children aged 5 years or less in the of death among patients in the said age-group.
institute during the same period. Encephalitis,
hydrocephalus, and meningitis were included in Table 8.21. Mortality profile of patients aged
the list as causes of death. between 30 and 70 years at Shaheed Sheikh
Abu Naser Specialized Hospital in 2015
Table 8.19. Mortality profile of the patients No.
aged between 30 and 70 years at NINH in 2015 ICD-10 code with name of
of %
disease
ICD-10 code with name of No. of cases
%
disease cases Cerebrovascular diseases
72 31.03
I64 Stroke, not specified as (I60-I69)
132 18.97
hemorrhage or infarction N18 Chronic renal failure 65 28.02
C71 Cancer involving brain 99 14.22 I21 Acute myocardial
55 23.71
infarction
S09 Injuries of head 29 8.48
I50 Heart failure 38 16.38
G03 Meningitis 35 5.03
Total deaths=232
Total deaths=696
Mortality profile at other tertiary hospitals
Table 8.20. Mortality profile of patients among Dhaka Dental College Hospital (DDCH), Dhaka
children aged 5 years or less at NINH in 2015
Two patients died in DDCH during 2015, and
ICD-10 code with name of No. of both of them belonged to the age-group of 30-
%
disease cases 70 years. Osteomyelitis (M86) and carcinoma of
G04 Encephalitis, myelitis the oral cavity (D00) were reported as the causes
14 2.01
and encephalomyelitis of death.
G91 Hydrocephalus 11 1.58 Hospitals of alternative medical colleges
G03 Meningitis 6 0.86
Among the two of this type of hospitals, only
Total deaths=696 Govt. Homeopathic Medical College Hospital,

Dhaka, reported 1 death. Unspecified respiratory (GHE). The original data, methods, and cause
failure (J96.9) was mentioned as the cause. categories are described in a technical paper
available on the WHO website. The preparation
Overall scenario of mortality: position of of these statistics was undertaken by the WHO
Bangladesh in the global and regional contexts Department of Health Statistics and Information
The findings on the causes of mortality among Systems in collaboration with WHO technical
adults in Bangladesh as presented here match programs.
the global mortality scenario which is marked From the Table, it is evident that conditions,
by the dominance of NCDs. For the interested like ischemic heart disease, COPD, respiratory
readers, we are presenting (in Table 8.22) the infections, road injury, and hypertensive heart
summary estimates of mortality for the year diseases, are included as the leading causes of
2012 in the world and the WHO South-East death around the globe and, for these cases,
Asia region; These are extracted from the second Bangladesh is no exception. Interestingly,
round of the WHO Global Health Estimates diarrheal diseases appeared in both the lists as
Table 8.22. Leading causes of death in 2012 estimated by WHO

Global WHO South-East Asia Region
No. of Deaths per No. of Deaths per
% %
Rank Cause deaths 100,000 Rank Cause deaths 100,000
deaths deaths
(000s) population (000s) population
- All causes 55,859 100.0 789.5 - All causes 13,759 100.0 750.5
Ischemic Ischemic
1 heart 7,356 13.2 104.0 1 heart 1,580 11.5 86.2
disease disease
2 Stroke 6,671 11.9 94.3 2 Stroke 1,443 10.5 78.7
Chronic Chronic
obstructive obstructive
3 3,104 5.6 43.9 3 1,271 9.2 69.3
pulmonary pulmonary
disease disease
Lower Lower
4 respiratory 3,052 5.5 43.1 4 respiratory 753 5.5 41.1
infections infections
Trachea,
bronchus, Diarrheal
5 1,600 2.9 22.6 5 651 4.7 35.5
lung diseases
cancers
Preterm
6 HIV/AIDS 1,534 2.8 21.7 6 birth com- 456 3.3 24.9
plications
Diarrheal Tubercu-
7 1,498 2.7 21.2 7 449 3.3 24.5
diseases losis
Diabetes Diabetes
8 1,497 2.7 21.2 8 410 3.0 22.4
mellitus mellitus
Road Road
9 1,255 2.3 17.7 9 337 2.5 18.4
injury injury
Hyperten-
Cirrhosis
10 sive heart 1,141 2.0 16.1 10 326 2.4 17.8
of the liver
disease

important causes of death but mortality due to Bangladesh in 2015, it did not appear in any of
diarrheal diseases in Bangladesh over the past the lists as top causes of death in any hospital
years were negligible. Although diarrhea was of the country. Cirrhosis of liver and HIV/AIDS,
one of the leading causes of hospitalization in appearing in the WHO-SEAR and global top-
Figure 8.4. Life-expectancy (age in years) of the people in Bangladesh (both sexes) at birth from
2000 to 2015
71.80
71.39
74.00
71.01
70.67
70.31
69.94
69.53
72.00
69.12
68.61
68.24
67.77
Age in years
70.00
67.28
66.81
66.34
65.82
68.00
65.27
66.00
64.00
62.00
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Years
Figure 8.5. Life-expectancy (age in years) at birth (both sexes) in different countries in 2015
Japan 83.7
Australia 82.8
USA 79.3
Maldives 78.5
Iran 75.5
Sri Lanka 74.9
Thailand 74.9
Saudi Arabia 74.5
Bangladesh 71.8
Global average 71.4
Ukraine 71.3
Egypt 70.9
DPR Korea 70.6
Russian Federation 70.5
Kazakhstan 70.2
Bhutan 69.8
Uzbekistan 69.4
Nepal 69.2
Indonesia 69.1
Iraq 68.9
Philippines 68.5
India 68.3
Myanmar 66.6
Pakistan 66.4
South Africa 62.9
Afghanistan 60.5
Nigeria 54.5

10 lists respectively, also did not impose any the country, be it in households or private and
significant threat to Bangladesh yet. However, public hospitals.
the absence of cancers in the list of top causes
of death in Bangladesh probably does not The Management Information System (MIS)
reflect the accurate picture. Even in the NICRH, under the DGHS is closely working with the
the specialty hospital primarily dealing with CRVS Secretariat of the Cabinet Division
cancer patients, did show a much lower death to bring both qualitative and quantitative
rate compared to other tertiary hospitals. This improvements in the pattern of mortality
apparently-paradoxical phenomenon might be reporting in the country, with support from
explained by our social culture of taking care of Bloomberg Philanthropies through their
dying persons at home and, as a result, most of program titled Data for Health Initiatives. A
the deaths from cancers are not being reported. pilot project has been started in the Kaliganj
upazila of Gazipur district. One of the objectives
Successes and further improvement of this project is to institutionalize the practice
of verbal autopsies so that causes of all deaths
For hard work of the health workforce in the
occurring in the community can be captured.
country, Bangladesh is steadily making its
The domiciliary health workforce of the
progress in the health sector. The single-most
MOHFW will be engaged in the activities. To
convincing evidence of this might be the 71
implement the WHO-suggested conventions in
plus years of life-expectancy of the people in
capturing the underlying causes of deaths that
this country. The figure is better than many
occur in hospitals, four hospitals: Sir Salimullah
of the countries in the region as well as of
Medical College Hospital, Dhaka; Shaheed
higher-income groups. Figure 8.4 shows the life-
Suhrawardy Medical College Hospital, Dhaka;
expectancy in Bangladesh from 2000 through
Shaheed Tajuddin Ahmed Medical College
2015, and Figure 8.5 shows a comparison of life-
Hospital, Gazipur; and Kaliganj Upazila Health
expectancy at birth in different countries.
Complex, Gazipur are included in the project.
For making further improvements in reducing Both local and foreign training courses are
preventable deaths, more accurate and complete being arranged for capacity-building of health
information relating to the mortality profile personnel in quality reporting. Besides, other
of the country is needed. As mentioned at the development partners, like WHO, UNICEF, etc.,
beginning of this chapter, several initiatives are also contributing to improve the quality of
are being taken to count all of the deaths in morality reporting in the country.

Chapter Improved management protocols sustaining low mortality
9 COMMUNICABLE DISEASE
CONTROL IN BANGLADESH
For awareness-building among mass people
about the transmission mechanism of
communicable diseases and prevention and
treatment, the supporting role of the media is
to be patronized.
Comprehensive prevention measures and improved treatment protocols are constantly keeping the
spread of communicable diseases under good control. We have a strong signal for policy-makers and
implementing bodies to note the changing patterns and put special emphasis on emerging and re-
emerging communicable diseases. Due attention to trans-boundary and international migration of
people is needed to contain novel emerging diseases at the spots of origin. Core capacity development
at the point of entries is to be considered a multisectoral action of national priority. Early detection of
infectious diseases, novel pathogens as well as antimicrobial resistance must be prioritized, escalating
budget, capacity-building, strengthening infrastructure, providing logistic support, and other related
measures. Viral hepatitis, as an important public-health issue, needs due attention of the policy-makers
and civil society organizations. For awareness-building among mass people about the transmission
mechanism of communicable diseases and prevention and treatment, the supporting role of the media
is to be patronized.
Malaria Healthcare (PHC) and converted into Malaria

Control Program in 1977. Bangladesh adopted
Malaria, as one of the major public-health
the Revised Malaria Control Strategies (RMCS)
problems in Bangladesh, is endemic in 13 eastern
in the 1990s and, later on, in 1998, the Roll
and north-eastern border districts, with variable
Back Malaria (RBM) Initiative of WHO. Since
transmission potentials (high, moderate, and
2007, the activities of the National Malaria
low). A total of 13.25 million people living in
Control Program have been strengthened and
these areas are at risk of malaria. Historically, over
accelerated with funding support from Round
90% of the total cases are reported from three
districts in the Chittagong Hill Tracts (Rangamati, 6 and 9 of the Global Fund New Funding
Khagrachhari, and Bandarban) and the coastal Model (NFM), and the partnership established
district Coxs Bazar. The endemicity of malaria is with BRAC-led 21-member NGO Consortium,
shown in Map 9.1. academic and research institutions, and the
private sector.
The National Malaria Control Program (NMCP)
is responsible for implementing malaria control Increased access to diagnosis and treatment
interventions under the Communicable Disease through an initiative called Early Diagnosis
Control unit of the DGHS. It is one of the oldest and Prompt Treatment (EDPT), prevention
programs in the health sector of the country. by using long-lasting insecticide-treated nets
In 1960s, Malaria Eradication Program was (LLINs), strengthened surveillance, monitoring
started under the Malaria Eradication Board in and evaluation, capacity-building of the
former East Pakistan. After the Liberation, the health personnel in malaria management and
Eradication Program was merged with Primary reporting through effective training, increased

Map 9.1. Thirteen malaria-endemic districts of Bangladesh (Source: National Malaria Control Program)
Malaria Situation in 2015
xRisk population: 13.25 million
xEndemic districts: 13
iHigh endemic: 3
iModerate endemic: 1
iLow endemic: 9
xTotal cases: 39,719
xDeath: 9
xAPI: 3.00/1,000 population
xMortality: 0.068/100,000 population
xLLIN distributed: 2,380,759
API 2015
00.0000 - 00.9999
00.9999 - 05.9999
05.9999 - 22.9999
22.9999 - 37.6211
37.6211 - 47.0264
awareness of the population at risk through 2. Have 100% malaria patients receiving early
effective behavior change communication and quality diagnosis (RDT or microscopy)
(BCC), and enhanced collaboration with and effective treatment by 2018
NGOs and private sector are the main
components of the program. Due to effective 3. Continue strengthening of program
implementation of the activities, both cases management towards elimination of malaria
and deaths have been reduced to such a level by 2020
that the program is now aiming at malaria
4. Continue strengthening of disease and
elimination from the country. The new
vector surveillance, monitoring and
Strategic Plan 2015-2020 has been developed
evaluation towards malaria elimination
with the vision of Malaria-free Bangladesh.
The goal of the National Strategic Plan 5. Intensify advocacy, communication, and social
(NSP) is: to have achieved zero indigenous mobilization (ACSM) for malaria elimination.
transmission and zero death by 2020, aiming
at malaria elimination in Bangladesh. The However, the program is in the process of
strategic objectives of the NSP 2015-2020 are updating the National Strategic Plan to align
as follows: with the Global Technical Strategy for Malaria
2016-2030 developed by WHO.
1. Achieve 100% coverage of at-risk population
with appropriate preventive interventions The monsoon (JuneSeptember) is the peak
by 2018 period for malaria transmission. The following

CHAPTER 9: COMMUNICABLE DISEASE CONTROL IN BANGLADESH
groups of people are considered high-risk achieved a huge success in terms of reducing
population for malaria infection: morbidity and mortality, and a steady decline
is noted. However, there was a regional upsurge
Jhum cultivators, wood-cutters, and in 2014, and Bangladesh was not immune o
forest-goers that principally for favorable meteorological
Settlers, refugees, and mobile population conditions during the monsoon period that
year Due to that sudden upsurge, the numbers
Members of Armed Forces, Border Guard, of both cases and deaths increased in 2014
and Police from non-endemic areas working compared to 2013, mostly in 3 hill districts.
in the Hill Tracts The program took various initiatives for the
containment of the upsurge. As a result, both
Travelers from non-endemic areas number of cases and deaths decreased in 2015,
People residing in non-endemic areas for a long especially the substantial reduction in the
time and returning home in endemic areas number of deaths was remarkable. Therefore,
53% and 94% reduction in morbidity and
Young children, particularly under-5 mortality respectively occurred in 2015
children compared to 2008.
Pregnant women. Table 9.1 summarizes year-wise epidemiological

data (20002015) on malaria from the endemic
Malaria control efforts have been augmented
districts.
since the implementation GFATM grants since
2007, in collaboration with NGO Consortium. With the exception of 2014, when the numbers
Initially, it was possible to detect an increased of both cases and deaths increased due to a
number of cases in 2008 due to scaling up sudden upsurge, significant progress in malaria
of interventions; introduction of RDT for control has been achieved in Bangladesh
diagnosis, and ACT for treatment of P. falciparum during the period from 2007 to 2013, showing
cases. Since 2008 till 2013, the program has a progressive decline in total cases and deaths.
Table 9.1. Summary of year-wise epidemiological data (2000-2015) from the malaria-endemic districts
Positive cases P. falciparum P. vivax Death
Year Per 1,000 Per 1,000
No. No. % No. % No.
population population
2000 54,223 5.63 39,272 72.4 14,951 27.6 478 0.049
2001 54,216 5.55 39,274 72.4 14,942 27.6 490 0.049
2002 62,269 6.23 46,418 74.5 15,851 25.5 588 0.058
2003 54,654 5.40 41,356 75.7 13,298 24.3 577 0.056
2004 58,894 5.67 46,402 78.8 12,492 21.2 535 0.052
2005 48,121 4.56 37,679 78.3 10,442 21.7 501 0.047
2006 32,857 3.06 24,828 75.6 8,029 24.4 307 0.029
2007 59,857 5.46 46,791 78.2 13,066 21.8 228 0.021
2008 84,690 7.73 70,281 83.0 14,409 17.0 154 0.014
2009 63,873 5.83 57,020 89.3 6,853 10.7 47 0.004
2010 55,873 5.10 52,049 93.2 3,824 6.8 37 0.003
2011 51,773 3.91 49,194 95.0 2,579 5.0 36 0.003
2012 29,518 2.23 27,819 94.2 1,699 5.8 11 0.001
2013 26,891 2.03 25,908 96.3 983 5.8 15 0.001
2014 57,480 4.34 54,132 94.2 3,348 5.8 45 0.003
2015 39,719 3.00 35,708 89.9 4,011 10.1 9 0.0007

Figure 9.1 shows the epidemiological trend in districts constitutes only around 12% of the total
the cases and deaths during 2007-2015. population at risk. The incidence rates in these
districts in 2015 are illustrated in Figure 9.3.
Out of 13 malaria-endemic districts, four
highly-endemic and moderately-endemic Challenges
districts (Bandarban, Khagrachhari, and
Geographical inaccessibility and population
Rangamati of Chittagong Hill Tracts) and Coxs
movement
Bazar have reported ~98% of the malaria cases
and ~56% of malarial deaths in 2015. Malaria High endemicity in border areas consisting
caused by both P. falciparum and P. vivax of forests and hills
is prevalent in the country; the number of
reported falciparum cases accounts for 90% of Difficulty in implementing EDPT and vector
the total cases. control
Figure 9.2 gives an idea about the share of total Shortage of human resources at the
malaria burdens by endemic districts in 2015. community level
Although three districts in the Hill Tracts report Inadequate cooperation and collaboration
majority of cases, the population of those among the neighboring countries
Figure 9.1. Epidemiological trend in malaria cases and deaths during 2007-2015
90,000 250
84,690
80,000 228
Total +ve Death
70,000 200
63,873
60,000 59,857
154 55,873 57,480
150
50,000 51,775
40,000
39,719 100
30,000 29,518
26,891
20,000 50
47 45
36
10,000 37
11 15 9
- -
2007 2008 2009 2010 2011 2012 2013 2014 2015
Figure 9.2. Distribution of malaria burden among 13 endemic districts in 2015
Khagrachhari, 3,874 Sunamganj, 59
Netrakona, 140 Maulvibazar, 50

Sylhet, 44
Cox's Bazar, 2,923
Mymensingh, 33
Habiganj, 22
Rangamati, 13,832
Other, 828 Sherpur, 17
Kurigram, 3
Chittagong, 460
Bandarban, 18,262

Increasing drug resistance, particularly Finding vector density and mapping out the
resistance to Artemisinin Combination insecticide resistance
Therapies (ACT) in the neighboring
countries Adoption of new interventions for vector control,
piperonyl butoxide (PBO) nets, for instance
Insufficient preparedness for and response
Establishing an early warning system
to epidemics
Net retention surveys, including telephonic
Minimum monitoring and supervision from
survey, can be done to expedite
the central level due to insufficient budget
allocation. Recruiting health workers/volunteers in
highly-endemic areas, communicating hill
Recommendations
district councils
Develop a formal communication strategy
Increasing coordination between GOB and
or standard operating procedure (SOP) and
NGOs
inclusion of communication experts in the
process to address the linguistic barriers Ensuring data-sharing among neighboring
countries through political commitment at
Preparing travelers guideline
the highest levels
Arranging mobile camps in hard-to-reach
Conducting vector management activities
areas
simultaneously in both parts of bordering areas
Increase active participation of Armed
Taking technical assistance from Global
Forces (Army, BGB, Police, etc.) in the
Health Security through IEDCR
malaria management in the border-belt and
geographically-inaccessible areas Developing a combined rapid response
system to control all outbreaks
Conducting comprehensive analyses of all
fatal cases to find out the factors influencing Increasing supervision and monitoring from
case fatalities the central level and ensuring adequate
budget for this purpose.
Strengthening community clinics and the
referral system Dengue
Increasing community participation in The re-emergence of dengue viruses has been

malaria prevention by vector management very dreadful and created a new threat in
Figure 9.3. Malaria incidence in 13 endemic districts in 2015

47.03
23.21
0.14 6.31
0.04 0.07 0.28 0.01 0.05 0.04 0.04 0.03 1.59
Sherpur
Mymensingh
Netrakona
Kurigram
Sylhet
Habiganj
Sunamganj
Maulvibazar
Chittagong
Khagrachhari
Rangamati
Bandarban
Coxs Bazar

recent times in Bangladesh. The country has and 58 deaths. The prevalent serotypes of
experienced this viral infection in the most dengue until 2000 in Bangladesh were: DENV1,
horrific manner in 2000 after an earlier outbreak DENV2, and DENV3, with the highest number
as Dhaka Fever in the 1960s. The re-emergence of reported cases attributed to DENV3. A similar
resulted in huge number of cases, along with situation can be seen in other countries, such
morbidity and mortality of public-health as India and Sri Lanka, where DENV3 has been
concern. It is not yet possible to address the reported most of the time in DF/DHF-related
dengue situation in the country as a separate illnesses. Over the last 10-15 years, dengue
entity. So far, only sporadic cases of dengue fever and dengue hemorrhagic fever have
were diagnosed in Bangladesh through small- become leading causes of hospitalization and
scale surveys that actually failed to unearth the deaths among children in South-East Asian
real situation in the country. In 1996-1997, regions, followed by diarrheal diseases and acute
dengue infections were confirmed in 13.7% respiratory infections.
of 255 febrile patients screened at Chittagong
Medical College Hospital. The first epidemic of The reporting of dengue cases is based upon
dengue hemorrhagic fever occurred in mid-2000 information collected from the Control Room
when 5,551 dengue infections were reported at the DGHS. The source of information is
from Dhaka, Chittagong, and Khulna cities, mainly the private sector: private clinics and
occurring mainly among adults. Among the some selected urban NGOs. Moreover, the
reported cases, 4,385 (62.4%) were dengue fever information sources at present are based in
(DF) infections, and 1,186 (37.6%) cases were Dhaka city. Information from other parts of
dengue hemorrhagic fever (DHF). The case- the country is lacking. So, it is very difficult to
fatality rate (CFR) was 1.7%, with 93 reported come to a definitive conclusion regarding the
deaths. Aedes aegypti was identified as the main program perspective. Still, some assessment can
vector responsible for the epidemic, and Aedes be possible by analyzing the currently available
albopictus was identified as a potential vector information. Table 9.2 shows the distribution of
in Chittagong. According to WHO, the worst dengue cases, deaths, and case-fatality rates in
outbreak occurred in 2002, with 6,104 cases Dhaka by year beginning from 2000.
Table 9.2. Distribution of dengue cases, deaths, and case-fatality rates by year in Dhaka city
Year Cases Deaths Case-fatality rate (%)

2000 5,551 93 1.68
2001 2,430 44 1.81
2002 6,132 58 0.93
2003 486 10 2.06
2004 3,934 13 0.38
2005 1,048 04 0.38
2006 2,200 11 0.50
2007 466 0 0
2008 1,153 0 0
2009 474 0 0
2010 409 0 0
2011 1,362 06 0.44
2012 671 01 0.15
2013 1,749 02 0.11
2014 375 00 0
2015 3,162 6 0.19

these problems, moreover, have a cumulative

So far, only sporadic cases of adverse effect at the individual, household,
community and national levels.
dengue were diagnosed in
Bangladesh is known to be surrounded by
Bangladesh through small- endemic areas for filariasis, particularly the
scale surveys that actually northeast border areas of India that are adjacent
to Assam, Bihar, and West Bengal, In Bangladesh,
failed to unearth the real the disease is prevalent all over the country,
with the highest endemicity in the northern
situation in the country. part. Out of the total 147 million population of
Figure 9.4 shows the month-wise distribution of Bangladesh (as estimated in 2011 census), about
20 million in the area have been suffering from
3,162 dengue cases reported in 2015. The graph
the disease, most of whom are children. The
clearly identifies the peak season of dengue.
More than 82% of the cases were reported
during the months of August through October, The consequences of filarial
and 30% of the total cases were reported in
September alone.
infection are many. A large
Filariasis
number of afflicted persons
Lymphatic filariasis (LF) is a vectorborne
exhibit physical and mental
parasitic disease caused by tissue nematodes. disabilities, an impaired ability
Wuchereria bancrofti is the most common
parasite, and Culex mosquitoes are the main
to work, and a compromised
vectors for transmission in Bangladesh. It is quality of life.
one of the neglected tropical diseases (NTDs) in
Bangladesh. exact figures of filariasis cases in Bangladesh are
not known but it is endemic in 33 districts out of
The consequences of filarial infection are many. 64 districts as revealed from ICT by LQAS done
A large number of afflicted persons exhibit in 2002 and 2004. There was high endemicity
physical and mental disabilities, an impaired of filariasis in Nilphamari, Thakurgaon,
ability to work, and a compromised quality of Dinajpur, Rangpur, Panchagarh, Kurigram,
life. These problems arise not only from the Chapainowabganj, Rajshahi, and Lalmonirhat. It
disease process but also from social stigma is estimated that about 70 million are at risk of
directed towards the afflicted persons. All of infection while one million people have various
Figure 9.4. Month-wise distribution of dengue cases (total: 3,162) in Dhaka city, 2015
965
869
765
271
171
75
10 28
0 0 2 6
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

forms of clinical deformity, and another 10 (MDA) among at-risk population once a year
million people are microfilaremics. Microfilaria for successive five years through door-to-door
survey done in March-May 2006 revealed that household registration, except for pregnant
it is present in 34 districts, and clinical cases are women, children aged <2 years, and severely-
reported from 49 districts. ill patients and alleviation of sufferings of
lymphedema patients by community-based
Mass Drug Administration (MDA) was launched morbidity control.
in November 2001 (Round I) at Panchagarh
district and, thereafter, it was scaled up in Table 9.3 shows data of MDA rounds from 2001
19 districts by 2008 following the baseline through 2015.
survey of the area. The 19 endemic districts
are: Panchagarh, Thakurgaon, Nilphamari, Transmission Assessment Survey (TAS) is
Kurigram, Rangpur, Lalmonirhat, Dinajpur, the WHO-recommended survey protocol to
Rajshahi, Chapainowabganj, Sirajganj, Pabna, assess the status of elimination to stop MDA.
Meherpur, Kushtia, Chuadanga, Barisal, Based on microfilaria (Mf) survey report,
Patuakhali, Jhalokathi, Pirojpur, and Barguna. Bangladeshs Elimination of Lymphatic
Filariasis (ELF) Program conducted TAS in
Goal, objectives, and strategies 18 out of 19 districts where MDA started.
The preconditions for conducting TAS are:
Goal of the program is elimination of filariasis
completion of at least five to six successive
by 2020, and the objectives are to reduce
rounds of MDA, Mf result <1%, and MDA
microfilaria prevalence to <1% and to give
coverage >65%. Results of TAS indicate
relief to the patients of lymphedema caused by
that Bangladesh has achieved preliminary
filariasis.
elimination goal in 18 districts. As per WHO
Strategies adopted to achieve this goal and protocol, MDA has been stopped in 18 out of
objectives are: Mass Drug Administration 19 districts (except Rangpur).
Table 9.3. Year-wise MDA round (20012015) with coverage

District/ Total Coverage (%) Coverage (%) Actual coverage
Year Implementation population reported by observed in (%) among the
unit (IU) (Million) civil surgeons survey eligible
2001 1 0.81 95.5 93.0 ND
2002 4 5.18 93.6 83.2 87.3
2003 6 8.73 93.3 77.9 81.9
2004 10 11.75 98.6 ND ND
2005 12 20.16 90.3 78.0 82.2
2006 13 23.92 92.2 78.2 82.2
2007 17 31.0 91.5 82.4 84.3
2008 20 42.0 90.53 79.38 83.06
2009 19 35.0 96.87 83.33 85.76
2010 19 35.0 92.47 60.23 62.98
2011 14 29.70 97.14 92.35 94.90
2012 09 16.67 98.11 89.76 92.78
2013 04 8.66 98.86 88.9 93.26
2014 01 3.01 81.72 69.5 90.33
2015 01 3.40 79.83 67.3 93.93
ND=Not done

The outstanding question for the Bangladeshs Assembly resolution 54.19 of 2001). The first
LF Program was how to assess the 15 endemic National Deworming Day was observed on 1
districts that were found to have low prevalence November 2008. Subsequently, the program
(<1%) and not eligible for MDA. Night blood was implemented every six monthsApril and
microfilaria and community clinical surveys October. From 2010, deworming is conducted
undertaken in 2008-2010 in selected areas of for a week, instead of the National Deworming
these districts found little or no evidence of Day, and the age-group of 5 years (baby class) is
infection and disease, such as lymphedema and included as the target. Single-dose Albendazole
hydrocele. Currently, there is no recommended (400 mg) has been replaced by Mebendazole
strategy for assessing less-endemic districts; (500 mg) and is being administered at school
therefore, the TAS method was used as the by little doctors, with the help of teachers
primary assessment tool in surveys done in as guide. About 25.5 million children who
2014-2015. are studying in Class I-V, or are 5-12 years old
are targeted. All types of schools, including
The results of the TAS conducted to date government, non-government, NGO, private,
show promising signs that the National LF English medium ones, madrasahs, etc., are
Program will be able to shrink the LF map by included in the program.
approximately 38 million people and can start
move one step closer to the elimination goal, Goal of the program is to control intestinal
with an increased focus on the new priorities helminthes among children, with the objective
of surveillance and morbidity management. It of deworming school-age children of 5-12 years
will be important to follow up the children who twice a year (April and October)
tested ICT-positive to determine if there is some
focality of transmission in these areas. Achievements
Soil-transmitted helminthes control: a nationwide School-based deworming program covered

deworming program every primary-level institutions in the country
to deworm all school-age children of 5-12 years
Soil-transmitted helminthes (STH) control twice a year. The reports of treatment coverage,
is an important component of the Filariasis as sent by the civil surgeons offices of the
Elimination Program of CDC. The STH Control concerned districts, are shown in Table 9.4.
Program has been integrated with Filariasis
Elimination Program, with the aim to minimize Overall, the STH prevalence among school
its operation cost. children has been reduced to 8.5 %, according
to a survey conducted by STH Control Program
In 2005, it was started in 3 districts, in 16 till in 2015. Similar findings are also observed in the
2006 to June 2007, in 24 till May 2008 and, study by other organizations. Figure 9.5 shows
finally, it was extended up to 64 districts by the trend of the infection rates based on surveys
November 2008. done in the 2007, 2010, 2013, and 2015. If we
strengthen the hygiene status of the schools and
The Little Doctor Program (involving school
maintain this accordingly, the country will be
students) is another initiative under STH
able to control the soil-transmitted helminthes
Control Program. It has been introduced
in near future.
nationwide through all primary-level
institutions for peer-education in STH control Kala-azar
and developing health-related wellbeing,
followed by regular and proper hygiene Kala-azar (KA) or visceral leishmaniasis (VL)
practices. It is estimated that there will be a total is a neglected tropical disease affecting the
of 1,650,000 little doctors each year from more poor and marginalized rural population. It is
than 100,000 primary-level institutions in the prevalent in about 90 countries and threatens
country. 350 million people, especially in South Asian
Region and East Africa. Approximately 0.2
The nationwide school-based deworming to 0.4 million visceral leishmaniasis cases
program has been started in 2008, with occur worldwide and, among them, 90% of
an aim of regular deworming among 75- the disease burden is borne by 6 countries:
100% school-age children (World Health India, Bangladesh, Sudan, South Sudan, Brazil,

Table 9.4. Reported coverage of school-based deworming program (20082015)
No. of No. of children
Reported
Year Round districts
Targeted Treated coverage (%)
covered
2008 November 64 15,743,159 15,482,778 94
May 64 19,303,404 19,101,496 98
2009
November 64 19,303,404 18,782,212 97
May 64 19,837,612 19,440,860 98
2010
November 64 2,19,71,611 2,17,45,757 98.97
May 64 2,20,70,512 2,17,35,040 98.48
2011
November 64 2,20,82,923 2,19,92,383 99.59
May 64 2,22,63,213 2,20,40,581 99
2012
November 64 2,22,63,192 2,20,38,334 98.99
April 64 2,49,86,323 2,47,99,113 99.25
2013
October 64 2,50,89,864 2,48,98,332 99.23
April 64 2,48,86,323 2,46,98,576 99.25
2014
October 64 2,50,90,960 2,49,93,205 99.61
April 64 3,12,81,837 2,67,04,597 85.37
2015
October 64 3,13,46,057 2,66,00,439 84.86
Figure 9.5. STH prevalence among school children in different years
27.20%
23.95%
15.70%
8.50%
2007 2010 2013 2015

and Ethiopia. It is estimated that around 147 The Kala-azar Elimination Program (NKEP) in
million people are at risk in three countries: Bangladesh has set the target of elimination
Bangladesh, India, and Nepal. Around 31 of kala-azar by 2017. The goal is to reduce the
million people are at risk in Bangladesh. The annualincidence of kala-azar to less than 1
people at risk are residing in 26 districts of patient per 10,000 population. The strategic
Bangladesh where kala-azar is endemic. In objectives are to: (i) ensure early diagnosis and
these 26 districts, 100 upazilas are mostly complete management of the cases, (ii) implement
endemic. integrated vector management, (iii) conduct

patient and vector surveillance, (iv) conduct Moreover, operational researches, like
operational research, and (v) develop social pharmaco-vigilence, vector bioassay test, clinical
mobilization and building partnerships. trial of combination therapy for the treatment
of new kala-azar, etc., were conducted.
At the beginning of 2014, a new activity No
kala-azar transmission has been adopted and Capacity-building training is regularly being
implemented in moderately- and hyper-endemic arranged for the key field-level personnel. In
upazilas. Besides the 26 kala-azar-endemic 2015, a total of 3,605 persons were provided
districts, a few sporadic cases are being reported training. The numbers of trainees in different
from 15 districts that are mostly concentrated categories are shown in Table 9.5.
in 19 upazilas. The endemicity is arbitrarily
defined as: (a) hyper-endemic: 2.5 cases/10,000 Table 9.5. Number of participants in capacity-
population, (b) moderately-endemic: 1 to 2.49 building training conducted in 2015
cases/10,000 population, and (c) less-endemic:
Number
<1 case/10,000 population. Kala-azar patients are Category
of trainees
detected and treated mainly through primary
healthcare centers (upazila health complexes) Medical officer 423
and referral centers, especially at Surya Kanta
Kala-azar Research Center (SKKRC) and some Senior staff nurse 298
medical college hospitals. The ICT-based rK39 is Lab technician 13
being used for the diagnosis of kala-azar both in
the field (UHC) and hospitals. Injection Sodium Health inspector, assistant health
191
Stibogluconate (SSG) had long been used in inspector, and health assistant
the treatment of kala-azar and post-kala-azar Community healthcare provider
2,080
dermal leishmaniasis (PKDL) cases, which have (CHCP)
been phased out. In the WHO-supported VL Graduate and non-graduate
Elimination Program in Bangladesh, single-dose 600
private doctor
AmBisome (amphotericin B) has been introduced
Total 3,605
in the treatment for kala-azar since 2013.
Initially, it was focused on eight hyper-endemic
NKEP is now about to reach its elimination
upazilas but now it is being introduced in the
target. By means of successful implementation
remaining 91 endemic upazilas (Annual Report, of planed activities, NKEP has converted the
KEP, Bangladesh). WHO Bangladesh has been hyper-endemic upazilas to moderately-endemic
providing technical assistance to increase the upazilas in Bangladesh by 2015.
capacity of the program to implement the single-
dose Inj. AmBisome in all the endemic upazilas. Figure 9.6 and 9.7 show the year-wise kala-azar
cases and related deaths respectively, each from
Monthly reporting of kala-azar cases and case 2000 to 2015. The numbers of cases are steadily
search are running regularly under active and decreasing from 2007. In 2006, the highest number
passive surveillance of KA cases. In 2015, the of cases was reported to be 9,379 while, in the last
Active case detection (ACD) activities were year (2015), the number came down to 862.
continued in 20 upazilas to strengthen disease
surveillance strategy for Kala-azar Elimination Diarrhea
Program by house-to-house searching. A In 2015, a total of 2,560,598 diarrhea cases and
total of 140 camps were arranged to conduct 24 related deaths were reported. The death rate
the said case-detection activities. In total, due to diarrhea thus remains at around 0.001%
8,576 suspected cases of kala-azar were found as in the previous years. Figure 9.8 shows the
throughout 2015. Out of them, 57 were detected total diarrhea cases in 2015 by month.
as new kala-azar (NKA) cases while 15 cases
were diagnosed as PKDL. Figure 9.9 shows that the deaths due to diarrhea
decreased almost each year but drastically
In addition, a program is doing pre- and post- from 2007 to 2015. The amazing reduction
impact of indoor residual spraying (IRS) on in diarrhea-related mortality over the last few
malaria vector bionomics and susceptibility test years proves the effectiveness of the strategies
on regular basis as part of vector surveillance. adopted. The strategies include the provision

Figure 9.6. Year-wise number of kala azar cases from 2000 through 2015
9,379
8,110
7,640
6,892
6,113 5,920
Cases
4,824
4,932
4,283 3,806
4,293
3,376 2,060
1,068
1,428
862
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Figure 9.7. Year-wise number of reported deaths from kala-azar during 2000 through 2015
36
27
24
23 23
17 17
16
14
6
4
3
2 2
0 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
of early oral rehydration at the household best addressed through reliance on rapid
level. Cases that cannot be managed at detection, diagnosis, and containment.
the community level are usually referred to The Disease Control Unit of the DGHS
the treatment centers where more efficient has separate programs on emerging
therapy, including intravenous rehydration and and re-emerging diseases, including
antibiotics, can be used. hepatitis, rabies, anthrax, chikungunya,
and antimicrobial resistance. Different
Emerging and Re-emerging Diseases Control
comprehensive action plans have been
Program
taken to combat these diseases. Some
A growing and globalizing threat of important steps, which already have been
emerging and re-emerging diseases is taken in 2015, are as follows: Training of

Figure 9.8. Numbers of diarrhea cases in Bangladesh in 2015 [Source: Control Room (DGHS)]
0 50,000 100,000 150,000 200,000 250,000
Ja nua ry 194,090
Fe brua ry 184,060
M a rch 213,567
April 234,608
May 236,611
June 226,309
July 201,168
August 206,486
Se pte mbe r 214,731
Octobe r 219,432
Nove mbe r 217,513
De ce mbe r 212,023
Figure 9.9. Numbers of diarrhea-related deaths in Bangladesh during 1998-2015 [Source: Control
Room (DGHS)]
2,327
1,282
1,165
977 1,022
929
521 537
475 393 345
239
128 70 43 19 24
24
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
trainers (TOT) was conducted for doctors, Seminar and training on viral hepatitis
nurses, and store-keepers of District Rabies
Measures taken on the prevention of Ebola virus
Prevention & Control Center (DRPCC)
in 64 districts of the country in order to Training of health assistants and sanitary
improve and centralize modern treatment inspectors on the prevention and control of
and management of dog- and animal- communicable diseases
bites
Meeting of the core working committee on
Nationwide training on rabies prevention, antimicrobial resistance
disease surveillance, and technical aspects of National symposium on antimicrobial
vaccine resistance for UH&FPOs in the whole

country held in Dhaka Medical College established at the district level where dog-bite
auditorium victims are receiving modern management.
These district centers also distribute antirabies
Training of MT lab on communicable vaccines and rabies immunoglobulin free
disease prevention and control of charge. Mass dog vaccination, launched
in 2011 in Coxs Bazar Sadar Municipality
Orientation meeting on emerging diseases
as a pilot, is a unique idea to make the dog
(Nipah, MERS-CoV), and re-emerging
population immune from rabies so that any
diseases (dengue, chikungunya fever)
dog-bite does not transmit rabies to humans.
conducted for district health education
If 70% of the existing dog population can be
officers of the country
vaccinated, there will be herd immunity among
Approval of National Strategy of the dog population, keeping them protected
Antimicrobial Resistance from rabies. Large-scale mass dog vaccination
activities have been scaled to 37 districts of
Establishment of thermal scanner in four divisions (Dhaka, Rajshahi, Sylhet, and
different ports of entry. Rangpur).
Rabies Intra-dermal tissue culture-based rabies vaccines
are now being used replacing the locally-
Rabies was a neglected tropical zoonotic produced nerve tissue vaccines for dog-bites.
disease. It claims more than 2,000 lives For all these measures, the case-fatality rates are
annually in the country. This is the highest declining.
for any single infectious disease. Rabies, if
manifested, is nearly 100% fatal but is 100% Anthrax
preventable as well if appropriate preventive
measures are taken. Annual number of dog- Anthrax is caused by Bacillus anthracis, a
bites in Bangladesh varies between 200,000 bacterium that can form spores. Spores allow it
and 300,000, and 95% of rabies occur due to survive in the soil for long periods. Anthrax
to dog-bites. Only suspected rabid dogs are is primarily a disease of herbivorous mammals,
such as cattle, sheep, goats, and buffaloes,
thought to be responsible for rabies as dogs
which may have chance to ingest anthrax
rarely can remain healthy. Other animals that
spores while grazing. Humans generally acquire
occasionally transmit rabies in Bangladesh
the disease directly or indirectly from infected
are cat, fox, monkey, jackal, and mongoose.
animals or from occupational exposure to
Other than humans, an estimated 25,000 or
infected or contaminated animal products.
more cattle succumb to rabies every year. In
Control in livestock is, therefore, the key to
the national rabies elimination goal by 2020,
reducing incidence. There is no documented
a number of activities are being conducted,
evidence of person-to-person transmission. The
such as national rabies survey, setting up of
impact of the disease on animal and human
national and district rabies prevention and
health can be devastating. The disease exists
control centers, mass dog vaccination, and
in animals and humans in most countries
management of dog population. To estimate
of the world. Prevalence of anthrax in
the total dog population and annual events Bangladesh was not well-documented earlier.
of dog-bites and rabies, a national rabies However, since August 2009, the Institute of
survey was conducted in 600 clusters all over Epidemiology, Disease Control and Research
the country, each cluster comprising 300 (IEDCR) investigated 14 outbreaks of cutaneous
households, altogether covering a total of anthrax in three districts of Bangladesh
180,000 households. (Pabna, Sirajganj, and Tangail). Recently, more
A national rabies prevention and control center outbreaks are being reported. In 2015, a total
has been established at the Infectious Diseases of 189 cases of anthrax were reported from
4 districts: Meherpur, Kushtia, Rajshahi, and
Hospital, Mohakhali, Dhaka, where about 350
Narayanganj.
to 450 dog-bite victims receive the service daily.
Antirabies vaccines and rabies immunoglobulin Nipah virus infection
are distributed free of charge from this center.
In addition to the national center, 65 rabies Nipah virus infection in humans is an emerging
prevention and control centers have also been zoonotic disease in Bangladesh. First recognized

in a large outbreak with 276 reported cases in Rotavirus and intussusceptions

Malaysia and Singapore (between September
1998 and May 1999), Bangladesh identified the IEDCR, in collaboration with icddr,b, has started
first cases in 2001. Encephalitis and respiratory hospital-based rotavirus and intussusception
distress are common presenting symptoms and surveillance in three selected hospitals across the
signs of Nipah infections. country from July 2012. The objectives of this
surveillance are to estimate the proportion of
In 2015, 18 nipah cases were identified by diarrhea-related hospitalization among children
IECDR (Table 9.6); out of them 11 died. These aged less than 5 years (which are attributable to
cases were from 6 different districts: Nilphamari, rotavirus), to describe the predominant strain of
Panchagarh, Faridpur, Magura, Naogaon, and rotavirus throughout Bangladesh, to determine
Rajbari. One cluster was identified in Naogaon, the age, region and seasonal distribution of
which consisted of three Nipah encephalitis hospitalizations associated with rotavirus in the
cases. Of these, two were laboratory-confirmed population under surveillance, and to estimate
cases. the frequency of hospitalization associated with
intussusceptions among children aged less than
MERS-CoV and A/H7N9 2 years in the surveillance hospitals.
In recent times, newly-emerged MERS-CoV Chikungunya
outbreak in the Middle East and novel influenza
A/H7N9 outbreak in China have been of Chikungunya fever, a dengue-like disease, is
growing public-health concern in our country. emerging alarmingly in the country in recent
The IEDCR has started surveillance for those two years. Chikungunya is also transmitted by
newly-emerging diseases, using the platform of mosquito-bites. In 2011 (August to October),
nationwide influenza surveillance in selected suspected chikungunya fever outbreaks were
hospitals. The laboratories at IEDCR have the detected in Dohar upazila of Dhaka district and
capability to detect these two viruses. Shibganj upazila of Chapainowabganj district.
Recently, two other outbreaks in Rajshahi and
Table 9.6. Yearly distribution of Nipah cases in Bangladesh, 2001-2015
Total number of cases Total number of

Year % deaths in a year
in a year deaths in a year
2001 13 9 69
2002 0 0
2003 12 8 67
2004 67 50 75
2005 13 11 85
2006 0 0
2007 18 9 50
2008 11 9 82
2009 4 0 0
2010 18 16 89
2011 42 36 86
2012 18 13 72
2013 26 22 85
2014 38 15 39
2015 18 11 61
Total 298 209 70

Pabna districts were identified. No case fatality (iii) regular movements of companion animals
was reported from the outbreaks. Diagnosis of with expatriates from overseas.
chikungunya is important to distinguish it from
dengue. An enhanced vector control program is Bangladesh developed modern diagnostic
an essential component to control and contain laboratories for pandemic influenza, with
the spread of the disease. real-time polymerized chain reaction (RT-PCR)
and biosafety level 3 (BSL,3) facilities. The
Avian and pandemic influenza country reports to the WHO on any event of
avian influenza following the guidelines of
Background International Health Regulation 2005 (IHR
Influenza pandemics are unpredictable but 2005).
recurring events can have consequences Bangladesh situation
worldwide. Since the 16th century, influenza
pandemics have been described at intervals About 244 species of migratory birds visit
ranging between 10 and 50 years with varying Bangladesh during the winter season (October
severity and impact. Characteristics of the four to March), of which approximately 21 species
influenza pandemics are summarized in Table 9.7. may carry the HPAI/N5N1 virus. In Bangladesh,
the first outbreak of this in poultry was declared
The risk of avian influenza and other zoonotic on 22 March 2007. The first report of human
diseases increases due to (i) high population case of avian influenza in Bangladesh was made
density of humans and animals; (ii) high on 22 May 2008. Subsequently, the country was
number of backyard farms and live poultry declared to have pandemic alert situation.
markets; (iii) mixed farming practice with
low biosecurity; (iv) limited control over After that report, two more human cases of
poultry movements; (v) inadequate regulation H9N2 were detected in 2011 in Bangladesh. The
of slaughtering and processing of products; swine flu virus first struck in Mexico six years
and (vi) suboptimal veterinary public health ago, with panic gripping even in Bangladesh
infrastructure, surveillance system, and about 11,000 kilometers away from this Latin
laboratory facilities. External risk factors American country. Within a couple of months,
include: (i) long porous border (with significant the World Health Organization declared H1N1
cross-border movements of people and a lack of a global pandemic, and Bangladesh recorded
animal quarantine stations); (ii) importation of the first case of swine flu attack, triggering
avian species, particularly breeder chickens; and the panic further. At least eight people died
Table 9.7. Characteristics of the past four influenza pandemics

Influenza
virus subtype Estimated
Year of
(type of Estimated Estimated attributable Age-groups
emergence of Area of
animal genetic reproductive case excess most
pandemic and origin
introduction/ number fatality mortality affected
common name
recombination worldwide
events)
1918 Unclear H1N1 1.2-3.0 2.3% 20-50 Young
(unknown) million adults
Spanish flu
1957-1958 Southern H2N2 (avian) 1.5 <0.2% 1-4 million All age-
China groups
Asian flu
1968-1969 Southern H3N2 (avian) 1.3-1.6 <0.2% 1-4 million All age-
China groups
Hong Kong flu
2009-2010 North H1N1 (swine) 1.1-1.8 <0.2% 100,000- Children
influenza America 400,000 and young
A(H1N1) 2009 adults

among an estimated 10,000 cases. As part of Table-top and field exercises

the Governments measures, incoming persons,
imported foods, and some goods are checked Purchase, storage, and distribution of
at landports, airports, and other entry-points antiviral, supportive medication and
for swine flu. After the 2009 outbreak, swine disinfectants
flu became a seasonal influenza in Bangladesh, Acquisition, storage, and distribution of
like other two viruses: influenza B and H3. A personal protective equipment (PPE) sets
combined vaccine against these three viruses is
available. Technical assistance for pandemic planning
Prevention and control activities for avian and Equipment and materials for quarantine
pandemic influenza operations and mortality issues
Avian influenza is handled under a new A technical committee is formed, and drugs
program reflected in the operational plan of have been stockpiled with the Government
CDC from 2007-2008. Formerly, it was included and the World Health Organization (WHO)
in emerging and re-emerging diseases. Since
July 2007, it has been a separate program with Twenty-five infrared thermometers have
a Deputy Program Manager (DPM) posted. After been supplied and are being used. In
Influenza A(H1N1) 2009 pandemic and chance addition, seven thermal scanners have been
of appearance of new viruses of other types set up at selected points of entry
with pandemic potential, the Avian Influenza
Pregnant women, older people, children,
(AI) Program was renamed Avian Influenza and
and those with co-morbid conditions,
Pandemic Influenza Program. The activities of
such as diabetes, heart disease, and
the Program are summarized below.
asthma, were at higher risk of infection
Implementation and review of national policy with seasonal influenza as well as swine
flu. Public awareness was increased to be
Adaptation of international protocols and cautious about influenza, suggesting the
guidelines to Bangladesh use of handkerchiefs and tissue papers
when coughing or sneezing, washing hands
Development of standard operating
regularly, and getting proper rest if suffering
procedure (SOP)
from a fever or seasonal influenza
Evaluation of health services/needs
Bangladesh has put its health offices on
assessments
high alert over H1N1 following an outbreak
Upgrading healthcare facilities of the disease in neighboring India.
Improving capacity of diagnostic Zika virus and preparedness

laboratories Zika virus is mostly transmitted through the bite
Upgrading of priority infrastructure for of an infected mosquito, primarily Aedes aegypti
health surveillances the same vector that transmits chikungunya
and dengue. Aedes albopictus can also transmit
Training of public health workers in disease the disease, and further studies are in progress
surveillance to better understand its role in the transmission
of Zika virus. This virus may also be transmitted
Reinforcement of rapid response teams for through sexual intercourse. Zika virus disease
outbreak investigations has a similar epidemiology, clinical presentation,
Providing rapid diagnostic kits to regional and transmission cycle in cities and towns as
centers for preliminary diagnosis chikungunya and dengue, although the illness is
generally milder.
Training of clinicians, healthcare workers,
and paramedics Symptoms of Zika virus disease include mild
fever, skin rash, conjunctivitis, muscle and
Implementation and review of joint pain which normally last for 2 to 7 days.
communication strategy There is no specific treatment but symptoms are

normally mild and can be treated with common 3. Develop, strengthen, and implement
medicines against fever, rest, and drinking integrated surveillance systems at all levels
plenty of fluids. for Zika disease, its complications, other
arboviral diseases, and their vectors
The current Zika virus outbreak and its
association with an increase in microcephaly, 4. Awareness-raising among gynecologists and
other congenital malformations and Guillain- pediatricians
Barr syndrome (GBS) have caused increasing
alarm in countries across the world, particularly 5. Consultation with gynecologists and
in the Americas. Brazil announced a national pediatricians, especially about reporting of
public health emergency in November 2015. microcephaly cases
Zika virus and its complications, such as 6. Consultation with Chief Health Officer/
microcephaly and Guillain-Barr syndrome, Health Departments of Municipalities/
represent a new type of public-health threat Pourosova regarding mosquito control/
with long-term consequences for families, vector control and high-level motivation
communities, and countries. The experts agreed and support needed; prevent adverse
that a causal relationship between Zika infection health outcomes associated with Zika
during pregnancy and microcephaly is strongly virus infection through integrated vector
suspected, though not yet scientifically proven. management
The International Health Regulations (IHR,
7. Surge capacity assessment and actions
2005) Emergency Committee met on 1 February
necessary to strengthen the capacity
2016, and WHO declared the recent clusters of
microcephaly and other neurological disorders 8. Lab capacity and SOPs
in Brazil (following a similar cluster in French
Polynesia in 2014) a Public Health Emergency 9. Training to the Rapid Response Team,
of International Concern. In the absence including consultants of gynecology and
of another explanation for the clusters of pediatrics
microcephaly and other neurological disorders,
10. Training of physicians of big private
the IHR Emergency Committee recommended
hospitals/clinics
enhanced surveillance and research and
aggressive measures to reduce infection with 11. Awareness-raising among general public
Zika virus, particularly amongst pregnant and preparation of mass media materials;
women and women of child-bearing age. prevent adverse health outcomes associated
with Zika virus infection through
At present, the most important protective
measures are the control of mosquito risk communication and community
populations and the prevention of mosquito- engagement.
bites among at-risk individuals, especially Tuberculosis
pregnant women.
Since long, tuberculosis (TB) has been a major
The recent outbreaks in Singapore, Malaysia, public-health problem in Bangladesh. Under the
and Thailand raised concern that the disease Mycobacterial Disease Control (MBDC) Unit of
can spread in the region. Moreover, experts the DGHS, the National Tuberculosis Control
predict that Bangladesh is one of the high-risk Program (NTP) is working with a mission of
countries for Zika virus infection. Although eliminating TB from Bangladesh. The goal of
Zika virus causes mild disease, its potential to the program is to reduce morbidity, mortality,
cause microcephaly is a concern, and country and transmission of TB until it is no longer a
capacities need to be strengthened. public-health problem while the present aim is
Planning and preparation of MOHFW against to achieve universal access to high-quality care
Zika disease for all TB patients.
1. National strategy developed The NTP introduced DOTS strategy in November

1993. The program was progressively expanded
2. Develop clinical management guideline of Zika to cover all upazilas by mid-1998. By 2007, the
virus infection with microcephaly and GBS DOTS services were made available throughout

the country, including the metropolitan cities. positive TB cases reduced from 0.40/100,000
The NTP started implementing Stop TB Strategy people in 2011 to 0.36/100,000 in 2014. The
in 2006 giving emphasis on all types of TB proportion of multidrug-resistant tuberculosis
cases, including clinically-diagnosed cases, (MDR-TB) among new TB cases was 1.4%, and
drug-resistant TB, childhood TB, and TB/HIV that among re-treatment cases was 29% (Table
co-infected cases to ensure quality care for all 9.9).
people with TB.
Progress in TB control
Now Bangladesh is in the stage of adopting
WHOs End TB Strategy that is the Global Remarkable progress in TB control has been
strategy with its ambitious targets for made in terms of DOTS coverage, detection
tuberculosis prevention, care, and control after of TB cases, and treatment success since the
2015. The strategy aims to end the global TB introduction of DOTS in Bangladesh in 1993.
epidemic, with targets to reduce TB-related
In all upazilas, DOTS coverage was achieved by
deaths by 95% and to cut new cases by 90%
June 1998 and, by 2007, NTP reached the 100%
between 2015 and 2035, and to ensure that no
DOTS coverage.
family is burdened with catastrophic expenses
due to TB. It sets interim milestones for 2020, In total, 209,438 cases (including 2,523
2025, and 2030 as shown in Table 9.8. combined cases of return after failure, return
after loss to follow-up, and others) have
Tuberculosis situation
been reported to NTP in 2015. So, the overall
The incidence and prevalence rates of all forms case notification rate of all forms of TB cases
of tuberculosis in 2014 were 227 and 404 (excluding 2,523 returning cases) was 130 per
per 100000 people respectively according to 100000 population. The case notification rate
the revised estimates by WHO. It is further for bacteriologically-confirmed pulmonary (new
estimated that about 51 per 100 000 people smear-positive) cases in 2015 was 72 per 100000
died of TB in the same year. Although the HIV people (Figure 9.10 and 9.11; Table 9.10, and
prevalence is still low, HIV poses a threat to TB 9.11). The projected population for 2015 based
control. The estimated incidence rate of HIV- on 2011 census is 158,917,106.
Table 9.8. Global strategy and targets for TB prevention, care, and control
Targets
Milestones
Indicator SDG End TB
2020 2025 2030 2035

Reduction in number of TB-related deaths
35% 75% 90% 95%
compared to 2015 (%)
Reduction in number of TB incidence
20% 50% 80% 90%
compared to 2015 (%)
TB-affected families facing catastrophic costs
Zero Zero Zero Zero
for treatment and management (%)
Table 9.9: Estimated population and TB burden in Bangladesh, 2014 (reported by WHO in 2015)
Population 159 million
Mortality rate 51/100000 population
Prevalence rate (all TB cases) 404/100000 population
Incidence rate (all TB cases) 227/100000 population
Incidence rate (HIV-positive TB cases) 0.36/100000 population
Proportion of new TB cases with MDR-TB 1.4%
Proportion of re-treated TB cases with MDR-TB 29%
Source: Global Tuberculosis Report, WHO, 2015

The program has successfully treated 94% of the available at: NIDCH, Dhaka; CDH, Rajshahi,
new smear-positive cases registered in 2014 as Chittagong, Khulna, and Sylhet; and 20-bedded
shown in Figure 9.12. CDH at Pabna.
Drug-resistant tuberculosis (DR-TB) Besides these, the government-run hospitals

have the treatment facilities for DR-TB
The multidrug-resistant tuberculosis (MDR-
management and are also available at three
TB) has become a significant public-health
other hospitals of Damien Foundation at
threat globally against effective TB control.
Jalchhatra under Tangail district, Onontopur
There were an estimated 480 000 (range: 350
under Netrakona district and Shambhuganj
000610 000) new cases of MDR-TB worldwide
under Mymensingh district, with a shorter
in 2014. Globally, an estimated 3.3% of new
regimen of 9 months. The Damien Foundation,
cases and 20% of previously-treated cases have
Bangladesh also conducts operational research
MDR-TB.
on drug-resistant TB.
Bangladesh is also facing the challenge of drug-
From 2008 to 2015, a total of 4,340 multidrug-
resistant TB. To combat this problem under
National TB Control Program, Bangladesh has resistant TB patients have been enrolled for
taken appreciable steps in terms of diagnosis and treatment; 2,989 under 24 months regimen
management of drug-resistant TB. The diagnostic (supported by the Global Fund) and 1,351 under
facilities are available at: National TB Reference 9 months regimen (supported by the Damien
Laboratory (NTRL) in the NIDCH, Dhaka; and Foundation, Bangladesh) (Table 9.12). The
Regional TB Reference Laboratory (RTRL) in the treatment success rates of the enrolled cases of
CDHs, Rajshahi; Chittagong, and Khulna. The cohort 2013 are 80% and 73% under 9 months
treatment facilities for drug-resistant TB are and 24 months regimen respectively (Figure 9.13).
Figure 9.10. Nationwide TB case notification; absolute number, 2001-2015

250000
New extra-pulmonary
200000
New Smear-ve
150000
100000
50000
0
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Table 9.10. Nationwide TB case notification; absolute number, 2015 (according to new classification)
Type of cases
Pulmonary Pulmonary All

Extra-
Reporting unit (Bacteriologically- (Clinically- re-treated
pulmonary
confirmed) diagnosed) cases, Total
except
New Relapse New Relapse New Relapse relapses
Upazila 102,192 2,223 36,885 3,028 31,186 807 2,053 178,374
Metropolitan
10,478 842 5,567 360 9,559 484 394 27,693
area
CDC 1,278 101 617 15 1,255 29 76 3,371
Total 113,948 3,166 43,078 3,403 42,000 1,320 2,523 209,438

Figure 9.11. Nationwide TB case notification rate (per 100000 population/year), 2001-2015
130
119 122
109 108
103 103 104 103
99
88
72
66
59 62
73 73 73 74 70 72
70 68 68
65
61
46
35 40
31
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2014
2015
2013
All cases NSP cases
Table 9.11. Year-wise (2011-2015) tuberculosis case notification by type of reporting unit, 2011-2015
Pulmonary Smear+ve/
Pulmonary Extra-
Bacteriologically-
Year Area Smear -ve pulmonary Total
confirmed
New Relapse New New
Rural/Upazila 87743 1889 16,433 20,340 126,405
Metropolitan area 9,391 698 4,442 5,648 20,179
2011
CDC 1,814 114 1,046 1,341 4,315
Total 98,948 2,701 21,921 27,329 150,899
Rural/Upazila 95,132 2,135 18,856 22,506 138,629
2012
CDC 1,640 112 955 1,194 3,901
Total 106,840 3,067 24,451 30,549 164,907
Rural/Upazila 94,668 2,024 36,036 25,081 157,809
2013
CDC 1,501 93 990 1,231 3,815
Total 105,541 2,868 42,393 33,705 184,507
Rural/Upazila 95,716 2,496 36,346 27,854 162,412
2014
CDC 1,438 51 851 1,204 3,544
Total 106,739 2,989 42,860 37,406 189,994*
Rural/Upazila 102,192 2,223 36,885 31,186 172,486
2015
CDC 1,278 101 617 1,255 3,251
Total 113,948 3,166 43,078 42,000 202,192*
*Pulmonary smear-negative relapse and extra-pulmonary relapse are not included in the total

Figure 9.12. Treatment success rate (%) of new smear-positive TB cases, 2001-2014 cohorts
89 91.5 92 92 92 92 92 92 93 94 94
84 84 85
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Table 9.12. Number of MDR-TB cases enrolled for treatment, 2008-2015

Year 24 months regimen 9 months regimen Total
2008 107 129 236
2009 179 181 360
2010 183 154 337
2011 253 137 390
2012 376 129 505
2013 495 191 686
2014 716 230 946
2015 680 200 880
Total 2,989 1,351 4,340
Figure 9.13. Treatment success rates of enrolled MDR-TB cases of 2008-2013 cohort
79
80 82
80
74 72
73
70 24 months
73
68 70 regimen
64 9 months
regimen
2008 2009 2010 2011 2012 2013
Leprosy of and treatment for leprosy. In 1943, the

sulphone drugs (dapsone monotherapy)
Leprosy is an ancient and chronic were introduced in the treatment for
infectious disease caused by Mycobacterium leprosy. In 1985, multidrug therapy was
leprae, affecting mainly the peripheral introduced in the treatment for leprosy
nerves. The disease also affects the due to emergence of dapsone-resistant
skin, mucosa of the upper respiratory strains of M. leprae.
tract, muscles, eyes, bones, testes, and
internal organs. Before 1873, the cause Bangladesh has achieved elimination of
of leprosy was not known, and no leprosy at the national level by the end of
effective treatment was available. In December 1998. It was 2 years ahead of
1873, the discovery of the pathogen M. WHO-targeted date. The elimination as
leprae (Hansens Bacillus) by Dr. Armuer defined by the WHO is to reduce registered
Hansen opened avenues to the diagnosis prevalence to less than 1 case per 10,000

people. When WHO declared elimination,

the registered prevalence was 0.87/10,000 After achieving elimination at
people, and the number of endemic districts/ the national level, the National
areas were 15. After achieving elimination
at the national level, the National Leprosy Leprosy Elimination Program
Elimination Program (NLEP) is consolidating
its effort to achieve subnational (district-
(NLEP) is consolidating its
level) elimination. At the end of December effort to achieve subnational
2004, the registered prevalence came down
to 0.51/10,000 people, and the number of
(district-level) elimination.
endemic districts/areas came down to 10. Figure 9.15 shows the number of new leprosy
The NLEP has been experiencing a very slow cases and completed MDT from 2010 to 2015.
decline of leprosy prevalence during the last Table 9.13 and 9.14 show the division-wise new
nine years, with 0.0.2/10,000 at the end of case detection and completion of MDT (cured)
December 2015 (Figure 9.14). respectively in 2015.
Figure 9.14. Registered prevalence rate of leprosy (per 10,000 people) in different years between
1991 and 2014 in Bangladesh
14
13.6
12
10
2
0.87 0.57 0.31 0.27 0.28 0.24 0.22 0.22 0.2 0.21
0 .2
0
1991 1998 2004 2007 2008 2009 2010 2011 2012 2013 2014 2015
Figure 9.15. Number of new leprosy cases detected and MDT completed (cured) under NLEP,
Bangladesh, 2010-2015
4,332
4,183
4,033
3,976
3,970
3,621
3,586
3,442
3,437
3,295
3,156
3,107
New case
Completed MDT (Cured)
2010 2011 2012 2013 2014 2015

Table 9.13. Division-wise profile of the newly-detected leprosy cases, Bangladesh, 2015
Registered
Population MB PB Total
Division prevalence/10,000
(N) (N) (N) (N)
people
Barisal 8,717,535 2 00 2 0.002
Chittagong 31,473,600 286 97 383 0.122
Dhaka 53,612,057 735 492 1,227 0.229
Khulna 16,750,368 101 9 110 0.066
Rajshahi 20,184,700 232 147 379 0.188
Rangpur 17,289,615 537 598 1,135 0.656
Sylhet 11,257,091 308 205 513 0.456
Total 159,284,966 2,201 1,548 3,749 0.235
Table 9.14. Division-wise leprosy cases (completed MDT) in Bangladesh in 2015

MB PB
Division Total
(>5 lesions) (1 to 5 lesions)
Dhaka 403 527 930
Barisal 3 0 3
Chittagong 179 152 331
Sylhet 161 184 345
Khulna 49 110 59
Rajshahi 169 160 331
Rangpur 4,530 763 1,443
Total 1,494 1,796 3,442
HIV/AIDS population), with a concentrated epidemic

among the PWID. The prevalence rate of HIV
Although Bangladesh is still considered a low- among PWID was more than 5% in Dhaka in
prevalence country for HIV/AIDS, it remains 2011. Although it is estimated that less than
vulnerable to an HIV epidemic because of the 0.1% of the total population of 160 million is
high prevalence in neighboring countries and infected with HIV, the number of HIV cases is
the high mobility of people within and beyond increasing rapidly according to a report titled
the country. Inadequacy in correct knowledge Assessment of Impact of Harm Reduction
about HIV and AIDS due to illiteracy, ignorance, Interventions among People Who Inject Drugs
and gender inequity aggravate the vulnerability. (PWID) in Dhaka City.
The most important factors that may contribute
to a potential HIV epidemic include: high rate HIV and AIDS are beyond the health issues
of needle-sharing among people who inject as the economic and social challenges for the
drugs (PWID), low rate of condom-use, and high most productive age-group are surmounted due
prevalence of sexually transmitted infections to HIV. Bangladesh has an estimated 22,178
(STIs) among the key populations. PWID, 81,605 FSW, 96,610 MSM, 22,619 MSW,
and 9,840 Hijra (according to the unpublished
As in other countries of the region, HIV Mapping Study and Size Estimation of Key
prevalence in Bangladesh is higher among key Populations in Bangladesh, 2016), counting the
populations (i.e. female and male sex workers numbers of men who have sex with men, male
(FSW and MSW), men who have sex with sex workers, and Hijra in Bangladesh to provide
men (MSM), PWID, and Hijra/transgender HIV prevention service); 23% of the total

population comprises young people. Due to whereas several other developing countries
various societal barriers, the young people have have not been that successful to keep the
limited knowledge about HIV and AIDS. AIDS epidemic from expanding beyond this
current level. The comprehensive, timely and
The most important factors strategically-viable prevention measures have
prevented the gradual spread of HIV from key
that may contribute to a populations (KPs) to the general population. To
a significant extent, this is probably attributable
potential HIV epidemic to the willingness of the Government to
include: high rate of needle- acknowledge the existence of key populations
and risk behaviors, which facilitated the start of
sharing among people who the effective interventions at early time, high-
inject drugs (PWID), low quality interventions by NGOs, strong technical
support from international and local agencies
rate of condom-use, and and communities, and a clear strategic focus by
donor agencies extending support to Bangladesh.
high prevalence of sexually
A total of 469 new HIV infections have been
transmitted infections (STIs) detected in 2015 (Figure 9.16). Further, until
among the key populations. December 2015, the total number of detected
cases was 4,143, of whom 658 people living with
Precautionary measures are being undertaken HIV (PLHIV) have died, leaving 3,485 known
by the Government of Bangladesh to limit the people living with HIV. However, the majority
spread of HIV infection since the detection of of infections are likely to remain undetected,
the first HIV-positive case in 1989. The National and the total national estimate is around 9,000
AIDS Committee (NAC) was formed in 1985 and PLHIV (source: GARRP 2014).
reconstituted in 2010. The MOHFW is playing
the leading role in the prevention of HIV and Surveillance
control of AIDS. The National AIDS/STD Control
Since 1998, the NASP introduced a surveillance
Program (NASP) is implementing HIV and AIDS
system, using facility-based data from HIV/AIDS
prevention activities in Bangladesh through
and STI/STD service providers. As in previous
a coalition of three functionaries, namely the
years, Round IX of serological surveillance
NAC, MOHFW, and the DGHS. The NASP
was conducted among the key populations,
under the DGHS is responsible for coordinating
including heroin-smokers (HS). This round was
activities of all stakeholders and development
conducted during December 2010-June 2011,
partners involved in the areas of concerns.
and 12,894 individuals were sampled from 36
Strong political history and commitment of geographical areas of Bangladesh. The overall
Bangladesh to the HIV response helped the prevalence of HIV and active syphilis was
nation attain a unique position to succeed respectively 0.7% and 3%.
Figure 9.16. New HIV-positive cases as reported and estimated by year in Bangladesh (1989-2014)
469
445
433
370
333 343 338
288
250
216
193
115
102
60
29 31 31
12 13 10 19 12 20
1 2 6 2
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015

The PWID in Dhaka have the highest rate of A cross-sectional survey was conducted in
HIV. The prevalence was 5.3% in Round VIII and 2013-2014 by icddr,b with support from Global
7% in Round IX. The decline is not statistically Fund to assess changes in risk behaviors and
significant. Fortunately, the localization of prevalence of HIV and active syphilis among
the cases among PWID to one neighborhood MSM (males having sex with males), MSW (male
of Dhaka observed in the previous years has sex workers), and Hijra population. The results
also remained static. HIV was also detected in show that, in Dhaka, the prevalence of HIV
another four groups of people who use drugs in MSM, MSW and Hijra population was <1%
(PWUD)male PWID from Narayanganj (1.5%) while, in Hili, HIV was detected only among
and Satkhira (0.4); combined female PWID two of 28 Hijra (7.1%). In the same group,
active syphilis was <1%. Over the years in
and heroin-smokers from Dhaka, Narayanganj,
Dhaka, the prevalence of active syphilis declined
Tongi (1.2%), and Benapole (1%).
significantly among the Hijra and MSW but it
Active syphilis rates at >5% was detected among has remained unchanged at <2% among MSM.
six groups of PWID, and the highest proportion In Chittagong, although HIV was not detected
was found in male PWID in Narsingdi (7.9%). in these groups, active syphilis was 2.2%
High active syphilis rates suggest practice of among MSM and MSW (combined). The overall
unsafe sex. prevalence of HIV in all three cities (Dhaka,
Chittagong, and Hili) was 0.4% among MSM,
Antibodies to hepatitis C virus (HCV), a marker 0.4% among MSW, and 1% among the Hijra.
of unsafe injecting practices, were measured in The overall prevalence of active syphilis in all
all PWID and groups of combined PWID and three cities was 1.2% among MSM, 2.4% among
heroin-smokers but not in the groups consisting MSW, and 2.8% among the Hijra.
of only heroin-smokers and, in six cities, >50%
HIV prevalence over the rounds
were HCV-positive. The higher prevalence of
HCV was found among PWID from several cities Over the rounds of surveillance, the overall HIV
of Rajshahi division, with Kanshat having the prevalence has remained at <1%, irrespective
highest prevalence (95.7%). HCV rates have of whether the total population is considered
declined significantly (p<0.05) over the rounds or when segregated for the key (most at-risk)
of surveillance in Dhaka. and bridging populations (Figure 9.17). It is to
be noted that bridging population groups (e.g.
In total, 3,568 female sex workers were sampled mainly truck-drivers, dockyard workers, etc.) were
from 13 areas of Bangladesh. Overall HIV not sampled since Round VI of surveillance.
prevalence was low (<1%) in all groups of FSW,
except in casual sex workers from Hili where Cross-border mobility in recent years (among
two in 125 samples were positive (1.6%). Active FSW, MSM, MSW, and Hijra)
syphilis rates at >5% was detected in three sites Two areas where more than one population
street-based FSW of Hili (12.5%) and Chittagong group with HIV were detected include: Benapole
(10.3%) and hotel-based FSW of Sylhet (9.3%). (female PWID and residence-based FSW) and
Figure 9.17. HIV prevalence among PWID over the rounds of surveillance in Dhaka city
8
7.0 7.0
7
6
5.3
5
4.9
4.0
4
4.0
3
2 1.4
1.7
1
0
2000 2001 2002 2004 2005 2006 2007 2011

Hili (Hijra and casual FSW); both sites have Geographical and occupational distribution
border with West Bengal of India. It is well-
recognized that mobility and migration can It is evident from regular case reporting that
enhance vulnerability to HIV, and women the highest number of PLHIV is recorded in
are particularly vulnerable (Blanchet, Biswas Dhaka but Sylhet has the highest concentration
et al. 2003). Figure 9.18 and 9.19 show the of PLHIV. Map 9.2 shows the district-wise case
percentage of FSW, MSM, MSW, and Hijra living reports.
in border areas, who crossed the border in the Estimated size of key populations
year 2011 and sold sex while abroad. It is clear
that cross-border mobility is more common A new size estimation of key populations is
in Hili. Little is known about the sex workers being planned in Bangladesh. As per existing
(male, female, and Hijra) living in these border information, the estimated sizes of the
areas. For evidence-based programming, a better different key populations are shown in Table
understanding is essential. 9.15.
Figure 9.18. Cross-border mobility of different key populations, 2011

100 87.2
90
80
70 60
60 50
50
40
30
15.6
20 6.8 8.7
5.9 4.7
10
0
Residence and hotel-based
Casual female sex workers

workers-Hilli
Street-based female sex workers

workers-Hili
Residence-based female sex workers

workers-Benapole

workers-Burimari
Hotel-based female sex workers

workers-Benapole
Hijra-Hili
MSM/MSW-Hili
FSW-Teknaf
Figure 9.19. Selling sex while abroad in the last year (by those who crossed the border in 2011)
120
100
100
79.8
80 71.4
66.7 66.7
60
60
37.5
40
22.8
20
0
Residence-based female sex workers
Hotel-based female sex workers

Residence and hotel-based
workers-Benapole
Street-based female sex workers

workers-Hili

workers-Hilli

workers-Burimari
workers-Benapole
Hijra-Hili
MSM/MSW-Hilli
FSW-Teknaf

Map 9.2. Geographical distribution of PLHIV
[Source: National AIDS/STD Control Program (NASP), Directorate General of Health Services]
Table 9.15. Estimated sizes of different key scenarios, and establishes priorities that aim to
populations make the response more effective, efficient, and
sustainable, towards the global goal of Ending
Estimated
Key population AIDS by 2030. For developing the study
size (2015)
design, the AIDS Epidemic Model (AEM) and
Total FSW 78,470 programmatic analysis were used.
Brothel-based FSW 4,417
Street-based FSW 35,749 It is clear from the AEM that the early response
Hotel- and residence-based FSW 38,304 to HIV/AIDS helped maintain a low prevalence
in the country. AEM analysis demonstrates that
PWID 22,178
the ongoing interventions have averted a total of
MSM 96,610 141,225 HIV infections up to 2014 in Bangladesh
MSW 22,619 and saved 3,841,000 DALYs and 19,545 lives till
TG [Hijra] 9,840 2014. The HIV prevalence would have exceeded
20% in most KPs within the next 20 years, and
Investment case study a generalized epidemic would have taken off if
there would be no interventions since 2000.
Bangladesh undertook an initiative from
January 2015 to conduct an investment case Care, support, and treatment services
study to explore how limited resource could be
used in maximizing impact and to help direct Under the direct supervision of NASP, the
a rapid and sustainable increase in domestic Government of Bangladesh has taken the
and donor investment. With this backdrop, initiative to provide optimum care and
the Investment Case Study in Bangladesh treatment to key populations and PLHIV
analyzes the HIV status and response, examines through care, support, and treatment (CST)
the impact and implications of various future services at GO and NGO facilities.

Figure 9.20. A screen-shot from the national reporting system for HIV/AIDS
The Government had a target to provide and advocacy, HIV testing and counseling
optimum care to 65% PLHIV by 2014 in its (HTC), and community sensitization.
Millennium Development Goal 6 (MDG 6). So,
the package of services aims to take initiative National reporting system for HIV and AIDS
on early detection of HIV through HIV testing In 2013, a unified online national reporting
and counseling (HTC) to detect more cases and system for HIV and AIDS was established. This
increase the coverage of optimum care for PLHIV. was a collaborative initiative among NASP,
GOB initiative for comprehensive care, support, icddr,b, MIS of the Directorate General of Health
and treatment to PLHIV Services, and UNAIDS. Previously, in assessing
the national progress of programs on HIV and
NASP is procuring 100% ARV drugs from AIDS, data were collected manually from each
November 2012 onwards of the organizations conducting the program,
which was time-consuming, infrequent,
ARV drugs are dispensed through 5
cumbersome, and prone to errors. Using the
government health facilities through GO-
existing web portal of MIS of the DGHS where
NGO collaboration under HPNSDP
the countrys overall health information is
Twelve government health facilities are routinely collected, a unified reporting system
providing other services relating to PLHIV for HIV and AIDS was initiated. Through this
system, data on HIV and AIDS program relating
Eight NGO facilities are providing BCC, to key populations are now being collected on
home-based care, community sensitization, output/coverage indicators every six months
drug adherence, opportunistic infections from all drop-in-centers (DICs) and service
(OIs) management and capacity-building of delivery points, including HTC centers for the
health service providers general population. This web-based reporting
Three tertiary-level health institutions are allows assessment of the national response at
supporting PMTCT among ANC attendees. a six-month interval, which facilitates NASP
to monitor and plan activities in an informed
In addition to the abovementioned treatment, manner. A screen-shot from the national online
care and support package, the Government repotting system is shown in Figure 9.20..
of Bangladesh recognized the need of the key Efforts are being made to incorporate HIV and
populations: FSW, MSM, Hijra, and PWID and AIDS program data from all agencies engaged in
is providing prevention services to them. The HIV and AIDS intervention programs into the
major services covered STI management, BCC online system since June 2013.

Chapter Quick response with real-time information
10 PREPAREDNESS AND RESPONSE

IN HEALTH EMERGENCIES
The overall disaster situation of the country
causes high burden of disaster-related
diseases, disabilities, and deaths
Natural calamities requiring medical help in mass health emergencies are common in Bangladesh but
the year 2016 experienced comparatively less disasters, with a few incidences of flood, cyclone, and
tornado of moderate intensity, and earthquake of low intensity. However, our preparedness continued
as usual. Bangladesh being the most densely-populated country in the world has more victims of road,
rail and river traffic accidents than other developing countries. Sudden onset of re-emerging and newly-
emerging diseases often requires emergency responses. The overall disaster situation of the country
causes high burden of disaster-related diseases, disabilities, and deaths. What are required for the best
public-health practices at adequate level include: skilled manpower, uninterrupted supply of logistics,
and availability of guidelines to reduce the adverse health impact of these disasters.
The health emergency preparedness and accidents. Some of the recent experiences will
response program is actively focusing on clarify its effectiveness.
adequate preparedness for and quick responses
to mass health emergencies during disasters The south-eastern and southern parts of
under the relevant operational plan of the Bangladesh (Chittagong and Barisal division)
were affected by cyclonic storm Roanu on 21
DGHS for non-communicable disease control
May 2016 causing heavy rains after crossing
(NCDC). Two programs work in collaboration
the Chittagong coastal area in Bangladesh.
with each other. One is the National Health
From the report of National Health Crisis
Crisis Management Center and Control Room
Management Center and Control Room, the
(NHCMC&CR) under NCDC program of the
DGHS could compile the casualty statistics very
DGHS supported by the Health, Population
quickly (on 22 May 2016). The district-wise
and Nutrition Sector Development Program
summarized report is shown in Figure 10. The
(HPNSDP) 2011-2016, and the other one is the
Figure shows that a total of 105 persons were
Emergency Preparedness and Response (EPR)
injured, and 26 others died during the calamity,
supported by WHO.
and Chittagong district suffered the most in
At the national level, the NHCMC&CR of the terms of the number of causalties. By virtue of
DGHS and, at subnational level, local control the agile reporting system, rescue missions and
rooms, situated at the district and upazila health other interventions were based on information
facilities, along the coastal belt, have been and could be well-targeted ensuring optimal
made functional. A central hotline number use of available resources. A total of 671
(+8801759114488) has also been activated. medical teams were engaged to manage the
post-cyclonic health issues with the following
The NHCMC&CR operates round-the-clock, district-wise allocation of teams: Chittagong:
all seven days a week, to receive reports of 242, Coxs Bazar: 90, Feni: 78, Noakhali: 102,
any health emergencies relating to disasters or Laxmipur: 67, and Bhola: 92.

CHAPTER 10: PREPAREDNESS AND RESPONSE IN HEALTH EMERGENCIES
Figure 10. Number of persons injured and dead in cyclone Roanu by district (21 May 2016)
Injured Dead
50
40
15
12
3 3 4
2 1 1
0 0
Cox's Bazar Chittagong Feni Noakhali Laxmipur Bhola
The regular activities of EPR include capacity- components of health sector are ongoing
building of the health managers and raising under NCDC program of the DGHS. House-
awareness of community people. The primary to-house active surveillance and interpersonal
goal of the program is to reduce avoidable and communication on post-disaster health
preventable morbidities, disabilities, and deaths management have been completed through
during emergencies through strengthening workshops for fieldworkers of health and family
overall capacity of the health sector to prevent planning sector at 324 upazilas in 40 districts.
and mitigate the adverse health consequences Assessment and monitoring, critical gap-filling,
of disasters. The program activities involve coordination through cluster approach, and
developing plans, policies, guidelines, capacity-building during emergencies are treated
IEC materials (viz. training modules, as strategic priority functions.
leaflets, posters, etc.), collecting disaster-
related information, and conducting other
coordination functions with the NHCMC&CR
House-to-house active
and other government and NGO stakeholders surveillance and interpersonal
during the normal periods.
communication on post-
A number of institutional capacity-building
activities, such as formation and training of disaster health management
Disaster Health Management Committees at have been completed
all levels; conducting training of trainers (TOT)/
workshops/mock drills/simulation exercises on through workshops for
search, rescue, evacuation, first-aid, psychosocial
support, risk communication, and mass casualty
fieldworkers of health and
management for health professionals and family planning sector at 324
workers; provision of emergency supplies (first-
aid kits, rain-coats, umbrellas, solar lamps, safety upazilas in 40 districts.
rubber boots, jackets, caps, whistles, etc.) for the
first-level health responders; and provision of A team is formed and sent immediately to the
emergency drugs (maintaining buffer stock) and affected areas for assessment and monitoring as
medical equipment/supplies are among the major and when an emergency situation arises after
functions of the EPR program of the DGHS. cyclones, floods, etc. The team measures the
health status of the victims and promptly makes
In addition, research on EPR program and an assessment of their needs, identifying priority
surveys of various structural and non-structural actions to address the health problems and

avert deaths. In June 2015, a team was formed were recruited. A well-developed buffer stock
with officials from EPR program of NCDC system is working for making logistics available.
and Emergency and Humanitarian Action Current buffer stock position is being reported
(EHA) program of WHO, and they successfully every month from every upazila health complex
completed an assessment and monitoring of and civil surgeons offices.
health situation, needs, vulnerabilities with
prioritization of health problems in certain flash Seven divisional health management committees
floods and landslide-affected areas of Chittagong are there, with 50 trained staff members; there
and Coxs Bazar district. are also 63 district committees, with 880 trained
staff, 9 medical college-level committees, and 407
By emergency response to a recent flood in upazila health complex-level committees having
North Bengal, some parts of Dhaka and Khulna 31,045 trained staff members.
divisions in 2016, the devastating situation was
successfully managed with the support of health Activities of the EPR program of NCDC are
cluster partners, including technical assistance from supported by the EHA program of the WHO
Management Information System (MIS) of the and other stakeholders in the health sector.
DGHS. Necessary medicines, logistics, and Injection In addition to the governmental and other
Anti-snake Venom were provided adequately organizations, the Comprehensive Disaster
throughout the country with the support of WHO Management Program (CDMP) and European
and other health cluster partners. Union Narre Consortium provide technical and
logistic support to the program for strengthening
The EPR program ensures that critical gaps in disease surveillance and emergency supplies,
health responses be rapidly identified and filled like drugs for replenishing buffer stocks,
based on the needs assessment report, with laboratory reagents, and related goods for proper
resources that are available. investigation and case management. The EPR
program is part of a strong coordinated response
The emergency situations are assessed, for to emergencies, along with the DGHS, armed
coordination through cluster approach, by forces, UN agencies, fire brigade, Red Cross,
conducting cluster meetings participated by development partners, and NGOs. Some recent
invited humanitarian actors for joint planning capacity-building activities carried out by the
and joint response and actions. The participants EPR program from January 2012 to June 2016 are
with multidisciplinary knowledge and shown in Table 10.
experiences share the observations and identify
the under-served or over-served areas. To ensure Replenishment of buffer stocks at regular
a holistic collaborative effort, all participants are intervals; full functioning of Emergency Medical
made aware about who does what and where. Services (EMS), achievement of 12 SEARO-
EHA benchmarks, and adequate coordination
The DGHS, on an urgent basis, conducts some among concerned agencies are some identified
sessions of relevant training on how to manage challenges to be met.
and overcome ongoing devastating situation for
the health managers as part of capacity-building Aims of the EPR program are to: (i) prepare
during emergency,. Providing training to staff comprehensive national disaster management
and local people in the community is helpful in plan for the health sector, (ii) operationalize
identifying a sustainable strategy to be adopted the national disaster management institute
in future emergencies both for public health in the health sector, (iii) strengthen National
interventions and related areas, such as water Health Crisis Management Center and Control
quality surveillance, mental health counseling, Room, and (iv) procure make-shift hospitals and
and other required issues. ambulances with devices to run on rivers.
The EPR program of NCDC of the DGHS has The worlds worst victim of climate change
formed the Disaster Health Management is Bangladesh, the country being the most
Committee at all levels of health facilities for densely-populated. There are obvious resource
efficient and effective management of health- constraints. However, the use of experience
related problems originated from the disasters; to guide emergency preparedness for health
2,562 trained doctors, along with paramedics, authorities to ensure better response, statistics of
28,483 other health and family planning some notable disasters of the previous year have
workers, and 5,940 volunteers at the union level been of great concern for us.

CHAPTER 10: PREPAREDNESS AND RESPONSE IN HEALTH EMERGENCIES
Activities of the National Institute of Preventive

Table 10. Training/workshop/seminar
and Social Medicine in areas of preparedness
organized by EPR program of NCDC of the and response in mass health emergencies
DGHS, with support from WHO during
January 2012-June 2016 The National Institute of Preventive and Social
Medicine (NIPSOM) performs some activities
No. of
No. of relating to mass health emergencies. The
training
Activity partici- Asian Disaster Preparedness Center (ADPC) has
sessions
pants been conducting the Hospital Preparedness
held
for Emergencies (HOPE) training course in
Workshop on several countries in Asia, including Bangladesh.
comprehensive health- HOPE is a component of the Program for
sector emergency Enhancement of Emergency Response (PEER),
preparedness 7 245 a region-based program initiated by USAID/
and response for health OFDA. HOPE is a capacity-building and
and disaster management technical assistance program for the staff of
professionals medical facilities and healthcare personnel, both
medical and non-medical, to prepare healthcare
Training on public-health facilities to respond effectively to emergencies.
risks and interventions in In collaboration with the National Institute of
6 210
emergencies for Preventive and Social Medicine, medical service
health professionals providers are trained with HOPE, and expert
Training on prevention assistance is provided on enhancing medical
and control of post-disaster facility preparedness. In Bangladesh, HOPE
4 140 has developed 24 new trainers, and, under the
communicable diseases for
health professionals 3rd phase of PEER, 64 medical professionals
have been trained on hospital mass casualty
Health cluster meetings 6 180 management.
Training on risk Efforts are being made to better prepare
communication for health 2 74 communities in Bangladesh to strengthen
professionals earthquake resilience. ADPC has been currently
TOT on emergency medical implementing USAIDs Strengthening Earthquake
3 110 Resilience in Bangladesh (SERB). So that the
services for master trainers
Government of Bangladesh can respond to and
Training on search, manage natural disasters more effectively, the
rescue, and evacuation for program is involved in capacity-building activities.
3 105
community-level health
workers
Efforts are being made to
Advanced training on
psychosocial health for 2 68 better prepare communities
health professionals in Bangladesh to strengthen
Workshop on EPR and earthquake resilience.
post-disaster health
management for doctors, 300 14,000 A resource pool of skilled trainers and facilitators
nurses, paramedics, and in Bangladesh has already been established by
fieldworkers at upazila level ADPC. They are providing technical assistance
in implementing the program. In collaboration
Training on health with the National Institute of Preventive and
emergency preparedness Social Medicine, Fire Service and Civil Defense
and response for primary Directorate (FSCD) and partners, such as
48 1350
healthcare-level physicians Department of Disaster Management (DDM)
from disaster-prone and Directorate General of Health Services,
districts ADPC is implementing the program.

Chapter Rising Burden from Enhanced Life-expectancy
11 NON-COMMUNICABLE
DISEASES
In the current Health, Population and Nutrition
Sector Development Program 2011-2016, control
of non-communicable diseases is one of the
topmost priority areas of healthcare in the country.
Non-communicable diseases (NCDs) mostly affect middle-aged persons and the elderly worldwide,
with no exception in Bangladesh, having a major share of the disease burden and mortality. Changing
dietary habits and lifestyle, rapid urbanization, growth of commuting, tobacco-use, uncontrolled growth
and consumption of processed foods and beverages, indoor air pollution, road-traffic injuries, lack of
awareness about healthful behavioral patterns, and psychological pressure are among the important
factors responsible for non-communicable diseases. For enhanced life-expectancy, the proportion of
population affected with NCDs is on the rise. In the current Health, Population and Nutrition Sector
Development Program (HPNSDP) 2011-2016, control of non-communicable diseases is one of the
topmost priority areas of healthcare in the country. The relevant operational plan under the ongoing
HPNSDP 2011-2016 categorized non-communicable diseases into two major groups, viz. conventional
and non-conventional.
The conventional group includes major NCDs, The NCDs may account for 61% of the total
like cardiovascular diseases (CVDs), peripheral disease burden
vascular diseases (PVDs), cerebrovascular disease
Among the sampled adult population (25+ years),
(stroke), cancer, diabetes, chronic obstructive
pulmonary disease (COPD), arsenicosis, renal 97% had at least one risk factor, half of whom
diseases, deafness, osteoporosis, congenital had two risk factors
anomalies, oral health, and thalassemia. The The country has 40 million adult smokers and
non-conventional group of health issues smokeless tobacco-users
constitute: road safety and traffic injury; child
injury (including drowning); sports injury; In total, 64.5 million people are not taking
snake-bite; suicide and related injury; violence adequate fruits and vegetables
against women; acid burn; occupational health
Seventeen million people are not doing adequate
and safety; and industrial and agricultural
physical activity
health hazards; climate change; air pollution;
water, sanitation and other environmental About 18% adults have hypertension
health issues; emergency preparedness and
response; post-disaster health management and About 4% have documented diabetes as reported
emergency medical services; mental health; by the patients themselves.
autism; and tobacco-, alcohol- and substance-
Summary of data gathered from different
abuse.
specialized hospitals is presented to understand
From the national NCD risk factor survey the volume of patient-loads in these hospitals
conducted in 2010, some critical issues that and the share of national disease burden
evolved include the following: contributed by NCDs.

CHAPTER 11: NON-COMMUNICABLE DISEASES
National Institute of Cardiovascular Diseases (n=3193) and 27.53% females (n=1,213).
Figure 11.1 shows the numbers of outdoor The numbers of cath-lab procedures done in NICVD
visits and admissions in the National Institute in 2015 are shown in Table 11.1.
of Cardiovascular Diseases (NICVD) in the last
seven years (2009-2015). In 2015, a total of 3,452 coronary
angiographies, 99 cardiac cath, 112 other
During 2015, a total of 4,406 exercise tolerance (peripheral/renal) angiographies and 3,423
tests (ETTs) were done in the institute; the other procedures were done.
recipients of services included 72.46% males
Figure 11.1 Numbers of outdoor visits and admissions in NICVD (2009-2015)
Admission Outdoor visit
222,186
200,533
174,366 172,269
160,008 161,958 163,813
63,390
41,554 42,779 43,275 44,559 43,341 49,283
2009 2010 2011 2012 2013 2014 2015
Table 11.1. Number of cath-lab procedures performed in NICVD during 2015

Other Other interventions
Coronary Cardiac Angio-
angiogra- EPS &
angiography cath plasty PCI PTMC TPM PPM Other Total
phies RFA
3,452 99 112 02 1,413 89 1,077 552 130 69 3,423
Table 11.2 shows the numbers of heart and National Center for Control of Rheumatic
vascular surgeries done in the NICVD in 2015. Fever and Heart Diseases
These included a total of 928 open-heart The patients suffering from rheumatic heart
surgeries, 31 closed-heart surgeries, and 1,861 diseases and related conditions are treated at the
vascular surgeries. National Center for Control of Rheumatic Fever
and Heart Diseases (NCCRFHD). There were
Table 11.2. Heart and vascular surgeries 27,247 outdoor visits in 2015; among the visitors,
performed at NICVD in 2015 61.34% (n=16,713) were female, and 38.66%
(n=10,534) were male; 50.8% (n=13,842) were
new, and 49.2% (n=13,405) were old patients
Open-heart Closed-heart Vascular (Figure 11.2 shows the monthly distribution).
surgeries surgeries surgeries
Figure 11.3 shows the monthly distribution
of the number of prophylactic antibiotic
928 31 1,861 injections (n=8,569) given, ECGs (n=2,146), and
echocardiograms (n=1,931) done on patients at
the NCCRFHD in 2015.

Figure 11.2. Monthly distribution of outdoor patients attending NCCRFHD in 2015 (total=27,247,
new=13,842, old=13,405]
Total New Old
2821
2721
2568 2518
2487
2249 2303
2113
2132
1716
1748
1871
1465
1349
1250 1222
1064 1523 1024 1159 1118
969 1356
1237 945 1296
881 1219 1198 1144
1185 1108
995
867 926
747
Jan Feb Mar Apr May June July Aug Sep Oct Nov Dec
Figure 11.3. Monthly distribution of the number of prophylactic antibiotic injections (8,569) given,
ECGs (2,146), and echocardiograms (1,931) done at the NCCRFHD in 2015
Injection ECG Echo
817
763 767
736 722
705 714
677 666 662 681
659
260
218 223 227
178 168 175 178 188
132
92 107 208 198 195 196
164 185 181 162 154
98 109
81
Jan Feb Mar Apr May June July Aug Sep Oct Nov Dec

National Institute of Kidney Diseases & Urology radiology and imaging, biochemistry,
histopathology, microbiology, immunology,
As a specialized postgraduate institute and hematology, and anesthesiology.
training center, the National Institute of
Kidney Diseases & Urology (NIKDU) offers The numbers of outdoor and indoor patients
postgraduate courses, like MD (Nephrology), treated in this institute from 2009 to 2015 are
MD (Pediatric Nephrology), and MS (Urology) shown in Figure 11.4. Outdoor visits were made
and provides postgraduate training on by 488,56 males,. 28,016 females, and 4,461
nephrology, urology, pediatric nephrology, children, the total being 81,333.
Figure 11.4. Numbers of outdoor and indoor patients (both sexes and all ages) at NIKDU from 2009
to 2015
OPD Indoor
81,333
63,756
53,198 53,708 54,112 54 ,737

50,417
4,306 4 ,084 4,224 4,439 4,741 5,553 5,744
2009 2010 2011 2012 2013 2014 2015
Among the indoor patients, 3,196 were males, the patients were from 45-54 years age-group
2,020 were females, and 528 were children, the (30.3%). The second leading age-group was 55-
total being 5,744. 64 years (16.0%).
National Institute of Cancer Research & Hospital Table 11.6 shows the distribution of admitted
cancer patients by department in 2015.
The largest cancer hospital in Bangladesh is the Majority (48.7%) of the patients were admitted
National Institute of Cancer Research & Hospital to the Medical Oncology Department, followed
(NICRH). It is the only tertiary-level cancer by Surgical Oncology (11.4%), Pediatric
institute in the public sector.
It offers a wide range of cancer-related services

at low cost or free of charge. There are 23
The largest cancer hospital
full-fledged departments at the NICRH. All in Bangladesh is the National
departments are working together in cancer
management from prevention to cure, from Institute of Cancer Research
diagnosis to research, and from surgery to
rehabilitation. In 2015, the NICRH provided
& Hospital (NICRH). It is the
services to 174,037 outdoor, 4,479 emergency, only tertiary-level cancer
and 7,285 indoor patients. Table11.3 and
11.4 show the OPD and emergency visits, institute in the public sector.
admissions and deaths at the NICRH in the last
four years. Table 11.5 presents distribution of Oncology (10.4%), Radiation Oncology (9.8%),
patients by age-group (n=17,788). Majority of and Gynecological Oncology (6.0%).

Table 11.3. Numbers of OPD and emergency visits at the NICRH in the last four years (2012-2015)
OPD Emergency
Year Child Child
Total Male Female Total Male Female
(Under-5) (Under-5)
2012 59,221 33,073 26,148 1,803 3,606 2,305 1,301 177
2013 163,029 81,753 81,276 2,425 3,720 2,220 1,500 107
2014 201,195 97,585 99,274 4,336 4,493 2,530 1,963 105
2015 174,037 86,565 84,562 2,910 4,479 2,545 1,836 98
Table 11.4. Numbers of admissions and deaths at the NICRH in the last four years (2012-2015)
Admission Death
Year Child Child
Total Male Female Total Male Female
(Under-5) (Under-5)
2012 3,020 1,731 1,289 481 60 45 15 5
2013 3,045 1,820 1,225 577 115 67 48 3
2014 4,057 2,280 1,857 212 124 86 38 4
2015 7,285 4,040 2,830 415 168 96 66 6
Table 11.5. Distribution of patients at the NICRH by age-group in 2015

Age-group
Frequency Percentage
(years)
<14 630 3.54
15-24 867 4.87
25-34 1,841 10.35
35-44 2,685 15.09
45-54 5,387 30.28
55-64 2,849 16.02
65-74 2,473 13.90
75-84 801 4.50
85-94 214 1.20
>95 41 0.23
Total 17,788 100
Table 11.7 shows the top five types of cancer position. Stomach cancer (5.2%), esophageal
according to sites of occurrence among the cancer (4.9%), and liver cancer (4.3%) occupied
males and females. These data were extracted the next successive places. Among the females,
from draft cancer registry report of 2015 breast cancer (26.4%) was the leading one,
(n=12044). In males, lung cancer topped the followed by cervical cancer (18.4%), lung cancer
list (25.2%). Cancer of the lymph node and (6.1%), cancer of the lymph node (5.5%), and
lymphatic channel (11.8%) was in the second gall bladder cancer (3.6%).

Table 11.6. Distribution of admitted cancer patients at the NICRH by department in 2015
Department Frequency Percentage
Medical Oncology 3,552 48.76
Surgical Oncology 833 11.43
Pediatric Oncology 758 10.40
Radiation Oncology 717 9.84
Gynecological Oncology 437 6.00
Hematology 301 4.13
Genito-urinary Surgical Oncology 253 3.47
ENT Oncology 211 2.90
Dental & Faciomaxillary Surgical Oncology 118 1.62
Plastic & Reconstructive Surgical Oncology 105 1.44
Total 7,285 100
Table 11.7. Distribution of patients by top five types of cancer according to the site of occurrence at
the NICRH in 2015 (n=12044)
Male (n=6,793) Female (n=5,251)
Site Number (%) Site Number (%)
Lungs 1709 (25.2) Breast 1387 (26.4)

Lymph node &
801 (11.8) Cervix 967 (18.4)
lymphatic channel
Stomach 354 (5.2) Lungs 322 (6.1)
Lymph node &
Esophagus 334 (4.9) 291 (5.5)
lymphatic channel
Liver 291 (4.3) Gall bladder 191 (3.6)
National Institute of Mental Health & Arsenic in groundwater: mitigation program

Research of the DGHS
During 2015, the National Institute of Mental Acutely poisonous and carcinogenic, arsenic is
Health & Research (NIMHR) provided services a colorless and tasteless chemical element. The
presence of arsenic in harmful level was first
to 42,703 outdoor patients, 2,501 emergency
detected in 1993 by the Department of Public
patients, and 3,085 indoor patients. Among the Health Engineering (DPHE) in tubewell waters
outdoor patients, 21,311 (49.90%) were males, of Chamagram village of Chapainowabganj
15,675 (36.70%) females, and 5,717 (13.38%) Sadar Upazila. Since the discovery of the arsenic
were children. Among the emergency patients, problem in the country, significant work, such
as identification of severity of the problem,
1,471 (58.82%) were males, 920 (36.79%)
advocacy, awareness, and mitigation program
females, and 110 (4.40%) were children. Among activities, have been carried out. Despite the
the indoor patients 1,917 (62.14%) were males, efforts made to provide safe water, a water
1.067 (34.59%) females, and 101 (3.27%) were quality survey in 2009 revealed that 12.6% of
children. drinking-water samples collected from 13,423

households around the country exceeded the (xi) updating national arsenic mitigation
drinking-water quality standards (GOB,1997) policy and strategy; (xii) strategic partnership
for Bangladesh (BBS; UNICEF, 2010). The with local bodies and community-based
total population still being exposed to arsenic organizations regarding the mitigation of
contamination is about 20%. arsenicosis; (xiii) further collaboration between
the DGHS and the DPHE at the field level to
strengthen water screening at the community
Despite the efforts made to level; (xiv) strengthening of the existing BAN-
provide safe water, a water net and InfoBase and further inclusion of
electronic database at the DGHS (logistics,
quality survey in 2009 revealed human resource, and IT network); and
that 12.6% of drinking-water (xv) strengthening routine MIS for hospital
statistics on arsenicosis and interlinking with
samples collected from MIS of the DGHS.
13,423 households around The DGHS, in future, will work for having
the country exceeded the the national prevalence data for skin lesions
and analysis for estimating death events due
drinking-water quality to cancers, and heart diseases resulted from
exposure to arsenic.
standards (GOB,1997) for
The cumulative number of arsenic patients
Bangladesh (BBS; UNICEF, from 1996 to 2012 is shown in Figure 11.5. The
2010). cumulative number stood at 65,910 in 2012.
The Department of Occupational and Figure 11.5. Cumulative number of arsenic

Environment Health of the National Institute of patients in Bangladesh detected in different
Preventive and Social Medicine (NIPSOM) first years by National Arsenic Program of the DGHS
detected health problems in 8 persons due to
65,910
drinking of arsenic-contaminated water in 1994.
The commonly-reported symptoms of chronic
56,758
arsenic exposure are: melanesia, keratosis,
gangrene skin cancer, bladder cancer, etc. The
National Arsenic Program of the Directorate
38,320
General of Health Services, with technical

support from WHO, has been conducting
several key activities, viz. (i) consultations
24,389
and workshops for the development of

methodology, tools, database, and data sources;
(ii) orientation training of government and
non-government health service providers, like
nurses, medical assistants, technologists, and
field-level health and family planning workers;
(iii) mass awareness programs on consumption
86
23
42
of arsenic-free safe drinking-water; (iv) testing

tubewell water at health facilities for prevention
of arsenicosis; (vi) screening of patients through 1996 1997 1998 2008 2009 2010 2012
house-to-house searching programs; (vii) The distribution of arsenicosis patients by
identification, diagnosis, and management of administrative division of Bangladesh shows
arsenicosis patients; (viii) capacity-building that Chittagong division has nearly half of the
of human resources and improving facilities identified patients (48%; n=31,230), followed
for effective case management and referral; by Khulna (21%; n=13,598), Dhaka (17%;
(ix) establishment of rehabilitation centers for n=11,090), Rajshahi (9%; n=6,120), Rangpur
disabled arsenicosis patients; (x) conducting (3%; n=1,674), Barisal (2%; n=1,512), and Sylhet
surveys and research on arsenicosis; (1%; n=686) as shown in Figure 11.6.

Figure 11.6. Distribution of arsenicosis patients by administrative division of Bangladesh (2012)

Rangpur Sylhet Barisal
Rajshahi 1674 686 1,512
6,120 3% 1% 2%
9%
Khulna
13,598
21%
Chittagong
31,230
47%
Dhaka
11,090
17%
Climate change and response will support informed decision to define

policy and strategy to addressing the impact
The Non-communicable Disease Control Unit of climate change. Development process of
of the DGHS, with technical support from the Health-National Adaptation Plan (H-NAP)
WHO, has an action plan which includes raising may also be benefited from findings of this
awareness and building capacities of medical assessment.
professionals towards understanding the
potential impact of climate change on human Injury situation in Bangladesh
health and adaptation. Accordingly, training
modulesone for doctors and another for nurses, In 2016, the Non-communicable Disease
paramedics, health assistants, and family welfare Control Program of the DGHS and the
assistantswere developed and published. Centre for Injury Prevention and Research,
Bangladesh (CIPRB) collaborated in the second
Several training and orientation sessions
nationwide injury survey titled Bangladesh
have been organized at the central, district
Health and Injury Survey (BHIS 2016). Data
and upazila levels. A total of 26,000 field-
collection was done from March through June
level personnel have been trained on climate
2016 from a nationally-representative sample
change, its health impact, and management.
with 80,071 households covering a population
A total of 3,900 teachers have been oriented.
of 299,216.
After receiving training, the field-level health
workers are now organizing courtyard sessions Injury-related mortality
at the communities. They are also registering
climate-sensitive diseases in their respective The survey showed that injuries accounted for
areas. Necessary collaborations are being made 12.2% of all deaths among all age-groups, and
to strengthen the activities of Climate Change thus the injury-related mortality rate was found
Health Promotion Unit (CCHPU) of the Ministry 66.8 per 100,000 population per year for all
of Health and Family Welfare. ages. Figure 11.7 shows the mortality rates in
different age-groups. The rates were quite high
The WHO-IEDCR has jointly conducted among toddlers (1-4 years) and the older (over
the Health Vulnerability and Adaptation 60 years) age-groups.
assessment of the current and future
scenarios. Later, another regional assessment Leading external causes in terms of fatality rates
of Vulnerability and Adaptation was carried included suicide, transport accidents, drowning,
out in the coastal and drought-prone areas of and falls. Figure 11.8 shows mortality rates by
Bangladesh. The assessment generated primary different external causes or injury-mechanisms.
qualitative and quantitative information Injury-related morbidity
regarding the health, including the WASH
components (water, sanitation and hygiene) The injury-related morbidity rate was 12,417
vulnerabilities of the study population, which per 100,000 population per year in all ages as

Figure 11.7. Injury mortality rate per 100,000 population by age as found in BHIS 2016
148.9
117.8
106.7
95.3
65.4
51.1 52.3
42.2
37.8
Infant 1-4 5-9 10-14 15-17 18-24 25-39 40-59 60 +
Figure 11.8. Mortality rates per 100,000 population by injury-mechanisms as found in BHIS 2016
14.7 14.4
11.7
9.4
5.7
4.0
2.0 1.7 1.7

1.0
0.3 0.3
Suicide
Road traffic
Drowning
Falls
Electricity
Homicide
Animals
Burns
Poisoning
Blunt objects
Cuts
Machines
found in the BHIS 2016. Figure 11.9 shows the 360,000 babies are born in the world. Sadly,
rates by different age-groups. Among the people one in every 68 of them is born with an autism
aged between 40 and 59 years, the injury-related spectrum disorder.
morbidity rate was the highest.
The challenge of autism is compounded by
Autism limited financial, professional and technical
resources in a developing country like
One of the most intriguing and challenging Bangladesh with a population of over 160
neurodevelopmental health problems faced by million. However, the bigger challenge has been
people all over the world is autism spectrum that of social stigma and isolation, even more
disorder (ASD). It is estimated that every day than the lack of services.

Figure 11.9 Injury-related morbidity per 100,000 population by age-group
14,215.7
13,442.5
12,722.8
12,960.9
12,000.7
113,72.2
11,371.4
10,033.7
3,307.5
Infant 1-4 5-9 10-14 15-17 18-24 25-39 40-59 60 +
Families living in poverty face immeasurable upazilas, one in each division, has been
challenges with their autistic child. The conducted;
following activities have been undertaken since 8. Doctors have been trained on autism;
the national health program has identified this
9. IEC materials on autism have been
problem as a priority area:
developed, printed, and distributed;
1. National Advisory Committee on Autism 10. Center for Neurodevelopment and
and Neurodevelopmental Disability, Autism in children has been established
headed by Saima Wazed Hossain, has been at Bangabandhu Sheikh Mujib Medical
constituted; University, which is now the Institute of
2. A 17-membered Autism Technical Guidance Pediatric Neurodisorder and Autism (IPNA);
Committee has been created;
11. Study of Prevalence of maternal depression
3. A National Steering Committee on autism of children with autism in Dhaka and pilot
by involvement of 15 ministries/divisions/ testing of feasibility of the implementation
organizations has been created; of household-based training for mothers has
4. A national strategic plan on autism has been been done;
formulated, along with a short-term and a 12. World Autism Awareness Day 2015 has
long-term action plan; been observed.
5. Autism has been incorporated in
Under the initiative of Bangladesh Government,
undergraduate medical curriculum;
resolutions on autism have been approved by
6. Child development centers (Sishu Bikash the United Nations General Assembly (2012),
Kendra) have been established in 15 medical Regional Committee Meeting of the WHO
college hospitals; South-East Asia (2012), and the Executive
7. Piloting of home-based screening of autism Board of the WHO (May 2013), thus placing
and neurodevelopmental disorders in Bangladesh in the leadership and forefront
children aged 0-9 year(s) in selected 7 position in global awareness creation on autism.

From blood banking to transfusion medicine
SAFE BLOOD TRANSFUSION

To ensure maximum safety for both donors
and recipients of blood or blood-derived
products, the Safe Blood Transfusion Program
(SBTP) was launched in 2000.
Blood transfusion services were started in 1972 at the then Institute of Postgraduate Medicine and Research
(IPGMR), with the establishment of a blood bank inaugurated by Father of the Nation Bangabandhu
Sheikh Mujibur Rahman. From blood banking to transfusion medicine, the journey was not smooth.
To ensure maximum safety for both donors and recipients of blood or blood-derived products, the Safe
Blood Transfusion Program (SBTP) was launched in 2000 by Prime Minister Sheikh Hasina. The SBTP
was operated under the Health and Population Sector Program (HPSP) 1998-2003, with the assistance of
UNDP. Under this program, blood-screening facilities were developed in 99 blood transfusion centers. In
2004, the activities of the SBTP received financial support from the World Bank and DFID through IDA
credit. A Memorandum of Understanding (MoU) was signed between the Ministry of Health and Family
Welfare and WHO under HIV/AIDS Prevention Project (HAPP), with technical assistance from the latter.
This continued till 2007. Since then, the activities were being implemented under the Health, Nutrition
and Population Sector Program (HNPSP) 2003-2011. The activities are now being continued under the
current Health, Population and Nutrition Sector Development Program (HPNSDP) 2011-2016 Previously,
it was guided by Director NASP. Now, the Director HSM is serving as the line director of SBTP. The Safe
Blood Transfusion Law 2004 of Bangladesh is in place that circulated the rules and regulations in 2008.
Notable activities of SBTP are as follows: 4. Quality assurance: The Safe Blood
Transfusion Program and the voluntary
1. Licensing: So far, one hundred and two blood-donation organizations could
private blood banks have been licensed consistently keep the percentage of paid
under the DGHS. donors at zero. The paid donors are sources
2. Monitoring: According to the feedback of of transfusion-transmitted infections (TTIs),
the monitoring team, licenses of 7 private viz. hepatitis B and C, syphilis, malarial
blood banks were cancelled. parasites, HIV, etc. They dominated the
blood donors before inception of the
3. Providing logistics: Essential logistics for Safe Blood Transfusion Program and
blood banking, like blood bags (360,000 emergence of the voluntary blood-donation
units, including single-, double- and triple- organizations. The absence of paid donors
unit bags), testing reagents (anti-A, B, and D and screening of collected blood before
groups; 6,000 units) and testing kits for HBV, transfusion substantially reduced the risk of
HCV, HIV, TPHA, and MP (360,000 units) TTIs.
were supplied. An approach for introducing
affordable modern technologies, like 5. Capacity development: The SBTP developed
aphaeresis, automated blood grouping guideline for voluntary blood donation,
system, PCR, and CLIA is being adopted for guideline for clinical use of blood for intern
safe blood transfusion. doctors. The program supported awareness

CHAPTER 12: SAFE BLOOD TRANSFUSION
campaign for voluntary blood donation; Currently, the number of blood transfusion
training of medical technologists, medical centers supported by SBTP is 219; number of
officers; management training for health blood transfusion centers at the upazila level is
managers; orientation of intern doctors on 92; number of centers where blood-component
blood safety and rational use of blood. separation facilities exist is 24; and the
number of centers with mobile vans for blood
6. Maintaining reference laboratory: There is collection is 6.
a reference laboratory for blood transfusion
at Dhaka Medical College Hospital. The Figure 12.1. Percentage of blood units rejected
function of the reference laboratory is to due to various reasons from 2001 to 2015 (Total
support various organizations. The reference units rejected=60,311)
laboratory also tests the referred samples
and validates kits and reagents. Malarial parasites
2%
The professionals engaged in the Safe Blood HIV
1% Syphiis
Transfusion Program deeply feel that a National
Blood Center be established as soon as possible 9%
to further streamline the stewardship role
and coordination functions for the current Hepatitis C
fragmented blood transfusion services operating 10%
throughout the country.
The Safe Blood Transfusion Program made

a good progress over the past years through
reduction in the number of paid donors Hepatitis B
from 70% to 0%, capacity-building for blood 78%
screening for HIV, hepatitis B and C, syphilis,
and malaria in all blood transfusion centers
and expansion of activities down to the upazila
health complex level.
Table 12. Screening report for blood with TTIs, 20012015

No. of Malarial
HIV Hepatitis B Hepatitis C Syphilis
Year units parasites
tested No. % No. % No. % No. % No. %
2001 99,653 2 0.002 1,381 1.386 82 0.082 290 0.291 7 0.007
2002 170,948 4 0.002 2,433 1.423 246 0.144 655 0.383 53 0.031
2003 180,015 1 0.001 1,900 1.055 1,024 0.569 428 0.238 13 0.007
2004 121,993 36 0.030 1,284 1.053 251 0.206 257 0.211 8 0.007
2005 203,575 8 0.004 1,689 0.830 201 0.099 305 0.150 6 0.003
2006 228,127 20 0.009 1,814 0.795 242 0.106 209 0.092 1 0.0004
2007 324,005 27 0.008 2,764 0.853 251 0.077 215 0.066 1,013 0.313
2008 369,026 13 0.004 2,996 0.812 309 0.084 143 0.039 4 0.001
2009 358,067 9 0.003 2,135 0.596 181 0.051 115 0.032 7 0.002
2010 384,447 6 0.002 3,313 0.862 374 0.097 182 0.047 37 0.010
2011 415,372 21 0.005 4,356 1.049 272 0.065 179 0.043 39 0.009
2012 541,682 56 0.010 5,052 0.933 676 0.125 399 0.074 58 0.011
2013 593,774 37 0.006 5,184 0.873 597 0.101 573 0.097 98 0.017
2014 651,718 74 0.011 5,529 0.848 462 0.071 754 0.116 48 0.007
2015 679,681 46 0.007 5,428 0.799 752 0.111 605 0.089 72 0.011
Total 5,322,083 360 0.01 47,258 0.89 5,920 0.11 5,309 0.10 1,464 0.03

Figure 12.2. Year-wise number of blood units collected by the blood centers under SBTP during 2001
through 2015 (Total units: 5,342,083)
800,000
679,681
700,000 651,718
593,774
600,000 541,682
500,000
Blood units
384,447
400,000 369,026 415,372
344,005
358,067
300,000
180,015 228,127
200,000 170,948
203,575
121,993
100,000
99,653
0
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Year
Figure 12.3. Distribution of voluntary and During 2001-2015, a total of 5,322,083 units of
directed relative blood donors in 2015 blood were tested in 219 centers, out of which
(n=679,681) 60,311 units were rejected due to the evidence
of transfusion-transmitted infections (TTIs).
These are shown in Table 12. Of the rejected
units, 47,258 were rejected for hepatitis B, 5,920
Relatives of for hepatitis C, 5,309 for syphilis, 1,464 for
recipients malarial parasites, and 360 for HIV. Figure 12.1
30% shows the percentages.
Voluntary In 2015, a total of 138,216 units of blood
donors
70% components were produced by the blood
centers. These included 62,887 units of
red blood cell concentrate, 42,882 units of
fresh frozen plasma, 31,672 units of platelet
Figure 12.4. Number of blood units collected by different voluntary blood-donation organizations
during 2009 through 2015
97,019
96,700
87,165
65,641
62,950
61,795
60,892
60,150
55,977
55,977
55,695
55,211
54,380
48,253
47,580
46,045
46,002
45,400
45,407
43,901
43,077
42,636
36,647
36,251
35,360
34,733
33,347
25,663
4,232
3,754
Sandhani Red Crescent Quantum Blood Bank Badhan Police Blood Bank
2009 2010 2011 2012 2013 2014 2015

CHAPTER 12: SAFE BLOOD TRANSFUSION
concentrate, 316 units of platelet-rich plasma the rest (478,475 bags) were collected from
(PRP), 272 units of fresh plasma (FP), and the relatives of the recipients. The percentage
272 units of cryo-precipitate. The cumulative distribution of voluntary and directed
production of blood components up to 2015 relative blood donors is shown in Figure
was 710,705 units. 12.3.
The blood centers under the Safe Blood A number of voluntary or non-profit
Transfusion Program collectively gathered organizations also contribute to encouraging
a total of 5,342,083 units of blood from healthy donors for donating blood voluntarily.
2001 to 2015. The year-wise distribution of Figure 12.4 shows the year-wise number of
collection is shown in Figure 12.2. It shows blood units collected by the major voluntary
an increasing trend in the numbers over the blood-donation organizations. It reveals that
years. In 2015 alone, 679,681 units of blood their contributions to safe blood transfusion
were collected. Out of these, 200,906 bags in terms of number of collected bags are also
were collected from voluntary donors, and increasing over the past 6 years.

Chapter Integrated Activities under National Nutrition Services
13 NUTRITION SITUATION IN
BANGLADESH
Malnutrition during pregnancy increases the
risk of complications and maternal death
as well as the likelihood of having low-
birthweight babies.
As a long-standing public-health problem in Bangladesh, malnutrition is responsible for one-third

of deaths in children below 5 years of age. Malnutrition during pregnancy increases the risk of
complications and maternal death as well as the likelihood of having low-birthweight babies. It has
also a great impact on health, cognitive development for education, and work productivity, resulting
in a major impediment to the economic growth and development of the country. Despite significant
progress in sustained economic growth, reduction in maternal and child mortality, Bangladesh still
remains one of the countries with the highest level of malnutrition among the developing countries,
with children and women being the most affected.
Public health nutrition program under (iii) community/area-based nutrition-

MOHFW related activities, (iv) human resource
development, (v) providing micronutrients
Beginning in 2011, the National Nutrition to the target population, (vi) supply of
Services (NNS) was created to steward nutrition-related logistics and medicines,
mainstreaming of nutrition into health, family (vii) operational research and surveys, (viii)
planning and other sectors. Through the nutrition information system, and advocacy
current Health, Population and Nutrition Sector and communication. Capacities of the
Development Program (HPNSDP) 2011-2016, upazila health complexes, district hospitals,
the Government of Bangladesh is trying to community clinics and of the facilities under
reduce maternal and childhood malnutrition by the DGFP, e.g. MCWCs, are now in the process
scaling-up the provision of community-based of strengthening. The NNS aims to cater
nutrition services throughout the country. This nutrition services through establishing IMCI
will require the implementation of nutrition- and Nutrition Corners in all the health facilities
specific and nutrition-sensitive interventions where IMCI Corners are already established.
by all relevant sectors. This has resulted in Mass awareness is also being created through
establishing a country-wide cost-effective and behavior change communication (BCC).
comprehensive system for nutrition service
delivery. Under the National Nutrition Services Current nutrition situation in Bangladesh
(NNS) housed at the Institute of Public Health
Nutrition (IPHN), both DGHS and DGFP are Although there have been some improvements in
streamlining and strengthening their nutrition the nutritional status of children over the years,
services by using the frontline government staff malnutrition among children and women is one
in the health sector. of the major health problems in Bangladesh.
According to BDHS 2014, 36% of the under-five
The prime functions of the NNS include: (i) children are stunted, with 12% being severely
training, (ii) facility-based services, stunted. Stunting is most prevalent in Sylhet

CHAPTER 13: NUTRITION SITUATION IN BANGLADESH
(50%) and at the lowest level in Khulna (28%). was the case in 2012. Less than one-quarter of
The prevalence of wasting among the under-five children in urban areas was underweight while
children is 14%. The prevalence of underweight almost one-third of the children in rural areas
children is 33%. However, the level of stunting were underweight.
has been declined from 51% in 2004 to 36% in
2014. Wasting has been declined from 17% in Figure 13.3 shows the prevalence of underweight
2007 to 14% in 2014. The level of underweight among children by administrative division
has been declined to 33% in 2014 from 43% in As shown in Figure 13.4, the levels of chronic
2004.
childhood undernutrition varied greatly by area
Figure 13.1 shows the trends in nutritional of residence. Similar to the past results, Sylhet
status of under-five children over the years as had the highest rates of childhood stunting but
revealed from BDHS 2011, 2014 and Utilization Chittagong, Rangpur, and Sylhet had the largest
of Essential Service Delivery Survey Report 2013. reduction in stunting rates between 2012 and
2013. On average, urban areas had much lower
A survey is being conducted jointly by rates of stunting than rural areas.
Bangladesh Bureau of Statistics, Helen Keller
International, and BRAC University in several Figure 13.5 shows the trends in underweight
regions of Bangladesh through Food Security and acute wasting rates over the rounds of
Nutritional Surveillance Project (FSNSP). FSNSP. Prevalence of wasting has decreased from
Through this survey, updated and seasonal Round 11 (14%) in Round 12 (9%) and that
data on nutrition and food security of six is also less than the national-level prevalence
surveillance zones in Bangladesh are being (16%). Prevalence of underweight also decreased
collected and analyzed. As per 2013 annual from Round 11 (34%) in Round 12 (28%), and
report of this survey, the prevalence of wasting that is again less than the national rate (36%)
is higher in Sylhet (15%) than in other areas/ reported in BDHS 2011.
zones (Figure 13.2) and even higher than the
prevalence (14%) found in BDHS 2014. Dhaka The recent National Micronutrients Status
and Khulna had lower rates of wasting than Survey (NMSS) 2011-2012, jointly conducted
in Rajshahi and Sylhet. Wasting rates in urban by the Institute of Public Health Nutrition
areas were markedly lower than in rural areas. (IPHN), UNICEF, icddrb, and GAIN, shows that
underweight and stunting rates are comparatively
Like wasting, Sylhet had also the highest higher in the slum area than in the improved
proportion of underweight children in 2013 as urban and rural areas (Figure 13.6).
Figure 13.1 Trends in nutritional status of under-five children over the years
41
39
36 35 36
33
BDHS 2011
UESD 2013
16
14
BDHS 2014
Underweight Stunning Wasting

Figure 13.2 Prevalence (%) of wasting among children by administrative division
13
10 10
9 9 9
8 8
Rural
3
2 2 2 2 Urban
1 1 1
al
ka
na
hi
et
l
na
pu
on
ris
lh
ha
ha
ul
io
ng
ag
Sy
Ba
Kh
js
D
at
Ra
tt
Ra
N
hi
C
Figure 13.3. Prevalence (%) of underweight among children by administrative division

30
27
24 24 25 24
21 21
10 Rural
7 8 8 7
5 5 5 Urban
l
ka
na
hi
et
l
sa
na
pu
on
lh
ha
ha
ul
ri
io
ng
ag
Sy
Ba
Kh
js
D
at
Ra
tt
Ra
N
hi
C
Figure 13.4. Prevalence (%) of stunting among children by administrative division

32
28
25 25 26 26 26
24
14
12 Rural
10 9 10 9
7 7 Urban
l
ka
na
hi
et
l
sa
na
pu
on
lh
ha
ha
ul
ri
io
ng
ag
Sy
Ba
Kh
js
D
at
Ra
tt
Ra
N
hi
C

Nutrition status of women and adolescent girls women by place (division) of residence. While
roughly an equal proportion of underweight
Figure 13.7 presents national, urban and and overweight women were found in Rangpur,
rural rates of underweight among women all other areas of the country, except Sylhet,
and adolescent girls, along with the rates of the northern char and haor areas, had a greater
overweight among adult women. Overweight proportion of women who were overweight
among adult women is much more prevalent compared to underweight. Sylhet and Barisal
in urban areas than rural areas. Over half of the had a much greater proportion of adolescent
adult women in urban areas were classified as girls who were underweight. Between 2012 and
overweight. 2013, rates of underweight among adolescents
have increased in Barisal and Sylhet while
As shown in Figure 13.8, there is a substantial the proportion of underweight women has
variation in the proportions of underweight not increased in any area. The proportion of
Figure 13.5. Trend of acute wasting and underweight over the rounds
Acute wasting Underweight
34%
27% 28%
14%
9% 9%
Round 10 Round 11 Round 12

Feb-Apr 2013 Jun-Sep 2013 Oct-Nov 2013
Figure13.6. Prevalence of underweight, stunting, and wasting among under-5 children in rural,
urban and slum areas
51.1%
47.4%
31.4%
31.3%
29.6%
28.1%
Underweight
21.1%
20.3%
Stunning
12.9%
Wasting
Rural Urban Slum

overweight adult women has increased mostly stakeholders for improving IYCF practice,
in Barisal and Khulna. including exclusive breastfeeding, Findings in the
FSNSP Annual Report 2013 show that 43% were
The nutritional status of adolescent girls continuing exclusive breastfeeding but exclusive
has not changed much over the past year, breastfeeding was 60% as per UESD report 2013.
although womens nutritional status has varied
significantly. The FSNSP report, in Round 12 Infant and young child-feeding practices
(October-November 2013), shows that 14%
Timely initiation of solid, semi-solid or soft
of adolescent girls and 17% of women were
severely and moderately underweight (Figure foods from six months of age are included in the
13.9). The Figure also shows that the proportion infant and young child-feeding (IYCF) practices.
of underweight women increased from Round Overall, 23% of children aged 6-23 months were
10 (15%) to Round 11 (19%) and then decreased fed appropriately according to the standard IYCF
in Round 12 (17%) but the underweight rate practices in 2015, and this shows an increase
among adolescent girls were increasing since from 21% observed in 2014. This was far below
Round 10 (9%) to Round 12 (14%). the HPNSDP target of 52% for 2016. However,
the UESD report reveals that 32% of children
of 6-23 months were fed as per standard IYCF
The nutritional status of practices. The FSNSP Annual Report reveals that,
in 2013, more than one-third of children were
adolescent girls has not changed fed minimally-adequate diets. This indicates a
much over the past year, considerable increase in children eating minimally-
acceptable diets since 2011 but the current level is
although womens nutritional still far short of the HPNSDP target of 52%.
status has varied significantly. Micronutrient status
Breastfeeding practices Vitamin A supplementation
The exclusive breastfeeding rate for children The Bangladesh Government prioritizes
below 6 months of age was 55% in 2014. vitamin A supplementation as an important
Intensive government programs is being public-health program and is distributing
implemented with focus on maternal, newborn vitamin A capsules to children of 6-59 months
and childcare, working in synergy with through National Vitamin A Campaign
the health programs undertaken by other (NVAC). Every year, two rounds of vitamin A
Figure 13.7. Nutritional status of adolescent girls and women by locality

Mild Moderate Severe
22%
9%
7%
14% 20%
2% 13%
2% 1% 1% 3% 4%
4%
16% 2% 15% 12% 16%
10% 11% 8% 10%
6%
10-18 yrs 19-49 yrs 19-49 yrs 10-18 yrs 19-49 yrs 19-49 yrs 10-18 yrs 19-49 yrs 19-49 yrs
Underweight Overweight Underweight Overweight Underweight Overweight

Figure13.8. Nutritional status of adolescent girls and women by division (underweight in the upper
graph and overweight in the lower graph)
5%
2%
6%
6%
4%
6%
4% 2 %
3%
4% 2%
3%
3%2%
2%
Severe
2%
4%
2%
1%
16%
1%
Moderate
14%
14%
15%
15 %
1%
11%
10%
10 %
10 %
Mild
9%
9%
9%
9%
7%
10-18 19-49 10-18 19-49 10-18 19-49 10-18 19-4910-18 19-49 10-18 19-49 10-18 19-49
yrs yrs yrs yrs yrs yrs yrs yrs yrs yrs yrs yrs yrs yrs
Barisal Chittagong Dhaka Khulna Rajshahi Rangpur Sylhet
12% 10%
7% 8% 8%
14% 12% 16% 15% 3%

15%
10%
Severe
16% 17% 16% 17% 15% 13% Moderate
Mild
19-49 yrs
19-49 yrs
19-49 yrs
19-49 yrs
19-49 yrs
19-49 yrs
Barisal Chittagong Dhaka Khulna Rajshahi Rangpur
Figure 13.9. Prevalence of underweight among adolescent girls and women (FSNSP 2013, Round 10-12)
Acute wasting Underweight
17%
19%
15%
14%
9% 11%

Feb-Apr 2013 Jun-Sep 2013 Oct-Nov 2013

capsule supplementation to children aged 6-59 on 13 November 2015 at the Bangabhaban,
months have been conducted. Through these and the field-level activities of the campaign
campaigns, health workers and volunteers was observed throughout the country on the
administer vitamin A capsules to around 20 following day. Subsequently, a more intensive
million children at more than 140,000 sites Child-to-Child (CtC) campaign was carried on
located in health facilities, health centers, and in 24 hard-to-reach upazilas of 6 districts from
schools as well as in mobile sites (bus, boat, and 15 to 18 November 2015. The first round was
railway stations) throughout the country. conducted on 25 April 2015.
Administrative coverage of both of the rounds

Every year, two rounds of the 2015 campaign was around 99% both in
of vitamin A capsule 6-11 months and 12-59 months old children.
However, the Coverage Evaluation Survey (CES)
supplementation to children 2015 shows that 85% children of 6-11 months
aged 6-59 months have been age-group and 92% of 12-59 months age-group
came under the coverage.
conducted.
The coverage during the NVAC 2015 is shown in
The Honorable President of the Peoples Table 13.1.
Republic of Bangladesh Md. Abdul Hamid
inaugurated the second round of National Figure 13.10 shows the vitamin A supplementation
Vitamin A Plus Campaign of the year 2015 coverage (%) during the last 8 years.
Table 13.1. Coverage during both rounds of the NVAC 2015

First round Second round
Age-group
No. % No. %
6-11 months old children 2,337,262 98.4% 2,272,264 99%
12-59 months old children 18,510,911 98.8% 18455519 99%
Figure 13.10. Vitamin A supplementation coverage (%) during the last 8 years
100
99 99 99 99 99 99
97
2008 2009 2010 2011 2012 2013 2014 2015

At the national level, over half of the preschool- of the recommended daily requirement across
age children (56.3%) and schoolage children age and sex of the studied population groups.
(53.5%) are having the mild grade of vitamin A
deficiency while the mild deficiency affects one-
third (34.3%) of the NPNL (non-pregnant and
The prevalence of iron-
non-lactating) women. Although the prevalence deficiency anemia in
of severe-grade deficiency was low in all the
population groups studied (less than 1.0% in Bangladesh population
most of the strata), it appeared to be somewhat appeared to be substantially
higher in the slums among the preschool-age
children (2.4%) and school-age children (2.2%). lower than the widely-held
Normal status of retinol in the preschool-age
children was 21.7%, 30.4%, and 8.5% in the
assumption.
rural, urban and slum area respectively (NMSS Control and prevention of iron-deficiency and
2011-2012). Figure 13.11 shows severity of other nutritional anemia was broadly made
vitamin A deficiency among preschool and through the countrys routine service-delivery
school-age children and NPNL women. network and the NNS. In 2013-2014, the NNS
distributed 200 million iron-folate tablets to
Control and prevention of iron-deficiency anemia
the community clinics. Control of nutritional
The NMSS report 2011-2012 shows that anemia is done by treating intestinal parasites
prevalence of anemia among the school-age through distribution of Albendazole tablets
children was 19.1% and 17.1% respectively during vitamin A campaign and separate
in the 6-11 years and 12-14 years age- deworming program.
groups. The prevalence of anemia in the
Control of iodine-deficiency disorders and other
non-pregnant and non-lactating (NPNL)
micronutrient problems
women was 26.0%. The prevalence of iron-
deficiency anemia in Bangladesh population The NNS provides training to doctors and other
appeared to be substantially lower than the health staff on iodine-deficiency disorders.
widely-held assumption. The amount of The NNS also provides training on capacity-
consumption of iron from food is short of building of managers, chemists, and relevant
the daily recommended allowance (RDA) in persons in different zones, in collaboration
all the population groups studied. The total with Bangladesh Small and Cottage Industries
consumption of iron from food was 41.0-82.0% Corporation (BSCIC). The IPHN laboratory for
Figure 13.11. The percentage of vitamin-A deficiency among preschool and school-age children and
NPNL women
35.6
24.9
20.9
20.4
19.8
19.4
19.1
20
Preschool age children
School -age children
NPNL women
6.6
5.3
5.1
4.3
2.4
2.2
1.7
0.06
1.1
0.8
0.5
0.4
0.4
0.2
0.2
0.1
Moderate Severe Moderate Severe Moderate Severe Moderate Severe
Rural Urban Slum National

testing the iodine level in salt has also been data on zinc status in the selected populations.
strengthened. The NMSS 2011-2012 report on The national prevalence of zinc deficiency
urinary iodine concentration shows 40% of the was 44.6% in the preschool children. Urban
school-age children to have iodine deficiency, children were less likely to suffer from zinc
highlighting an improved situation from 2004- deficiency than their rural and slum peers
2005 (33.8%). Among the non-pregnant and (29.5% in urban vs 48.6% in rural area). Among
nulliparous women, the prevalence of iodine the NPNL women, the national prevalence was
deficiency was 42.1%, showing an improvement 57.3%. However, over half of the NPNL women
from 2004-2005 figure (38.0%). About 80% of suffered from zinc deficiency at the national
the households used iodized salt (iodine level level and in all the strata, with the prevalence
5 ppm) while 57.6% of the households used being the highest among women living in
adequately-iodized salt (iodine level 15 ppm). slums (66.4%). The amount of consumption
In the rural area, the use of adequately-iodized of zinc was well below the recommended
salt was just 51.8%. The national rate of the use daily amount. Among the NPNL women, the
of brand salt was 75.8%; however, a substantial total consumption was 54.7% and 47.0%
proportion (30%) of households in rural area of the recommended daily amount in the
still uses open salt. The use of open salt urban and slum area respectively. Of the total
was 37.0% and 17.0% in the poorest and the consumption, most part comes from plant
richest households respectively. The proportion origin, which is poorly bio-available.
of retailer salt samples with adequately-iodized
salt (20 ppm) was 66.4%. Nutrition services through Directorate
General of Family Planning
Micronutrients consumption from foods
The Directorate General of Family Planning
Survey shows that consumption of foods of (DGFP), through its MCH Services Unit, has
animal sources is increasing in the country been providing healthcare to the pregnant
(Household Income & Expenditure Survey of mothers and under-5 children since 1975.
Bangladesh 2010). In the case of vitamin A, The DGFP, since 1975, has been providing
the median daily consumption, as expressed services, like monitoring of maternal weight,
by Retinol Equivalent (RE), was 270.0, 318.0, IFA supplementation and nutrition education
and 372.0 respectively among the preschool during ANC, growth monitoring of under-5
and school-age children, and the non-pregnant children, referral of severe malnourished
and nulliparous women, these being certainly children, and vitamin A supplementation for
short of the RDA they need. Daily median under-5 children.
consumptions of iron from foods: 4.17, 5.21,
and 6.64 mg among the preschool and school- The MCH Services Unit of the DGFP, since 2011,
age children, non-pregnant and nulliparous has been implementing MYCNSIA (Maternal
women were also short of the RDAs they and Young Child Nutrition Security Initiatives
require. The consumption of iron from animal in Asia), with collaboration of UNICEF in 22
sources, the form of dietary iron that is readily upazilas of 10 districts covering 6,765,910
absorbed in the body, was low in terms of the population. The initiatives taken are: counseling
total iron consumption. The share of iron from to mothers/caregivers about IYCF, distribution
animal sources was 23.0%, 24.0%, and 18.0% of of micronutrient powder (MNP) among 6-23
the total iron consumption respectively among months old children, counseling to pregnant
the preschool and school-age children, and the and lactating mothers on feeding practice
non-pregnant and nulliparous women. and iron and folic acid (IFA), food security
intervention, and handwashing/hygiene
Zinc status practice at the community level.
The median daily consumption of zinc from The MCH Services Unit of the DGFP has trained
foods among the preschool children was 3.2 officials of different levels (both TOT and
mg and 2.6 mg respectively in the urban and core training), developed training materials,
slum area against the RDA of 3 to 5 mg. The developed web-based MIS, conducted baseline
NMSS 2011-2012 provided, for the first time survey, and procured and distributed MNP
in Bangladesh, the nationally-representative sachets, etc., for implementing the MYCNSIA.

The DGFP, through its MCH Services Unit, Nutrition indicators have been incorporated
will scale up nutrition intervention in all in service register and reporting format of
upazilas and districts gradually. Service IMCI: Nutrition Corner, Community Clinic
registers and reporting formats were revised to Project, HMIS, and DGFPs MIS. The NNS is
include nutrition information. DGFPs MIS is extracting nutrition data from these. The
currently revisited with nutrition indicators for NNS is implementing nutrition surveillance
improvement of the situation. all over the country through James P. Grant
School of Public Health (JPGSPH) of BRAC
Mainstreaming nutrition information system University. The NNS is also working on
harmonizing nutrition information system
The IPHN, through the National Nutrition
among organizations working in urban area
Services (NNS), is implementing activities under
and through bilateral donors. For different
an operational plan of the MOHFWs Health,
nutrition-related activities, standardized
Population and Nutrition Sector Development
supervision checklists were also developed.
Program (HPNSDP) 2011-2016. The NNS is the
umbrella organization for the implementation Nutrition services
and management of nutrition-related activities
throughout the country. The NNS works closely At the district and upazila levels, 424 baby-
with the DGHS and the DGFP to implement friendly hospitals were established. Also, 200
programs for nutrition effectively. The NNS severe acute malnutrition (SAM) units and 395
supports the delivery of nutrition services and IMCI and Nutrition Corners were established.
interventions with the support of stakeholders The activities are summarized below:
at all levels.
District and upazila-level facilities
The NNS is the umbrella Total number of IMCI and Nutrition

Corners is 487 (424 UHCs + 63 DHs); of the
organization for the total, 476 corners were reported through
online whereas 360 were reported to cover
implementation and nutrition partly in December 2015.
management of nutrition- Currently, more than 13,000 community
clinics are providing monthly aggregated
related activities throughout report though online HMIS data
the country. management software DHIS2.
Out of the 200 SAM facilities, 164 have been
MIS of the DGHS has incorporated nutrition
providing reports to IPHN through email or
indicators at the level of community clinic
postal services. Reporting rate is more than
and IMCI format (DHIS2); the DGFP has
84% in December 2015.
incorporated indicators on nutrition in their
routine MIS forms. The DGHS is going to pilot At the district and upazila levels, 424 baby-
the forms in 23 upazilas prior to the nationwide friendly hospitals were established.
scale-up. Digital Archive at IPHN
The NNS has started its implementation Creation of the archive is one of the steps in
with a concept of mainstreaming with the establishing Digital Bangladesh as declared by
DGHS and the DGFP. The nutrition-related the Government of Bangladesh to implement
activities are implemented by field staff of Vision 2021. Following the decisions taken
the DGHS and the DGFP. The NNS has been in the meetings on 25 May 2014 and 21
working with the DGHS, the DGFP, IMCI August 2014, the IPHN/NNS, on principle,
and RCHCIB (Community Clinic Project) to agreed to establish the Digital Achieve at
include nutrition-related indicators within IPHN/NNS, in collaboration with Bangladesh
the existing MIS of the DGHS and the DGFP Knowledge Management Initiative (BKMI) of
rather than developing a parallel system. the Bangladesh Center for Communication
Standard nutrition indicators to assess effective Programs (BCCP). The IPHN/NNS engaged a
coverage of interventions were also defined dedicated team of personnel for operations of
to measure the scale-up and identify gaps. the Digital Archive.

eToolkit Developed nutrition-related TV spot-show:
one comic animation cartoon
eToolkit both for fieldworkers and program
Developed one documentary on growth
managers is a very useful digital IPC and
monitoring and promotion
counseling BCC materials. A lot of activities are
going on surrounding the eToolkit. Arranged street-drama called PUSHTI PALA
eToolkit was updated for the frontline
Creation of the position of District Nutrition workers to make available both online and
Officer in android version
The Government created a position of District IPHN established its Digital Archive to share
Nutrition Officer for all 64 districts. and preserve all IEC and BCC material of
the IPHN, NNS, in collaboration with BKMI
and USAID
BCC activities
Five posters were developed and utilized in
14 workshops were conducted with the field on the following topics:
participants from GO, NGOs, and INGOs, * Exclusive breastfeeding
where different nutrition-based and BCC-
* Complementary feeding
related messages were developed and finalized.
* Growth monitoring and promotion
TV spot-shows, folk songs, and drama are
being broadcast both in Bangladesh Television * Iron supplementation to prevent
(BTV) and Bangladesh Betar regularly. BTV is nutritional anemia of the pregnant
telecasting programs every Wednesday and mothers
Thursday at 11:30 am. Five Uthan Boithak * Nutritional care during pregnancy
(courtyard meetings) on balanced diet and Developed a comic story on nutrition for
maternal nutrition have already been aired by the school children
BTV. Numbers of programs are waiting to be
Voice calls relating to infant and young
aired. These are as follows: child-feeding (IYCF), maternal nutrition,
School quiz: 4 sessions and message on service availability by
Talk show: 3 sessions with nutrition issues Honorable Speaker of the Bangladesh
as priority Parliament were sent by Teletalk.

Chapter Outbreak investigations and responses to health emergencies
14 INSTITUTE OF EPIDEMIOLOGY,
DISEASE CONTROL AND
RESEARCH
The IEDCR that started in 1976 conducts
disease surveillance, investigates and
responds to outbreak of diseases, conducts
epidemiological research, and provides training
to the concerned officials.
The Institute of Epidemiology, Disease Control and Research (IEDCR) undertook and implemented
many important public-health interventions in 2014 and 2015 on behalf of the Ministry of Health and
Family Welfare of the Government of Bangladesh. Some of these interventions are highlighted here.
The IEDCR that started in 1976 conducts disease surveillance, investigates and responds to outbreak
of diseases, conducts epidemiological research, and provides training to the concerned officials. The
institute is the WHO-designated National Influenza Centre (NIC) in Bangladesh. The IEDCR comprises
eight departments, viz., Biostatistics, Epidemiology, Medical Entomology, Medical Social Science,
Microbiology, Parasitology, Virology, and Zoonosis.
National Influenza Centre (NIC), Bangladesh by the IEDCR, and some are done in partnership
with icddr,b in collaboration with various
The IEDCR was recognized as the National
national and international agencies. These are
Influenza Centre (NIC) of Bangladesh by WHO
(i) National Influenza Surveillance, Bangladesh
in 2007. All NICs throughout the world are
(NISB) in 10 district hospitals; (ii) Hospital-based
national institutions designated by national
Influenza Surveillance (HBIS) in 12 medical
ministries of health and recognized by WHO.
college hospitals; (iii) Community-based
The NICs form the backbone of the WHOs
Influenza Surveillance in Kamalapur, Dhaka; (iv)
Global Influenza Surveillance and Response
Avian Influenza Surveillance among the high-
System (GISRS).
risk groups and (v) Surveillance of Influenza-like
The National Influenza Centres (NICs) collect Illness (ILI) among the live bird-handlers in wet
virus specimens in their countries and perform markets in different city corporations.
preliminary analysis. They ship representative
clinical specimens and isolated viruses to WHO The NIC in the IEDCR, in recent years,
Collaborating Centres for advanced antigenic developed laboratory capacity and are regularly
and genetic analyses. The results form the basis testing specimens from surveillance sites for
for WHO recommendations on the composition influenza typing and subtyping and sequencing
of influenza vaccine each year as well as relevant for new/novel strains.
risk assessment activities of WHO.
National Influenza Surveillance Bangladesh
The IEDCR as an NIC is currently conducting (NISB), since its inception in 2010, has tested
several influenza surveillance throughout the more than 10,000 samples for circulating
country. Some of these are independently run influenza strains and suspected avian

influenza and identified eight A/H5N1 cases a separate elegant infrastructure of the IEDCR
in Bangladesh. The NIC under the IEDCR to handle high-risk microorganisms and novel
regularly submits data to FluNet and FluID of viruses.
WHO.
Microbiology Laboratory: Staining,
Laboratory capacity of the IEDCR bacteriological culture, microscopy, ICT and
other rapid testing facilities are available for
The IEDCR started its journey with five diagnosis of microbiological diseases. This BSL2
laboratories for (i) Virology, (ii) Parasitology, laboratory is capable of diagnosing anthrax,
(iii) Microbiology, (iv) Entomology, and cholera, salmonella, gonorrhea, syphilis, etc.
(v) Zoonosis. In recent years, the country Laboratory support for investigation of bacterial
has experienced a number of significant meningitis is also available. Water testing facility
outbreaks of emerging and re-emerging is functioning. This laboratory is working as a
infectious diseases, including dengue, Nipah focal laboratory for Antimicrobial Resistance
virus infection, chikungunya, avian influenza, (AMR) Surveillance and Foodborne Illness
pandemic influenza H1N12009, Japanese Surveillance (FBIS).
encephalitis, hepatitis E, cutaneous anthrax,
etc. In response to IHR (2005), the IEDCR has Parasitology Laboratory: The laboratory
taken initiative to augment and strengthen is capable of diagnosing malaria, kala-
its laboratory capacities to identify outbreaks azar, filariasis by staining microscopy and
or pathogens responsible for public health ICT. Limited facilities for biochemical and
disasters. The IEDCR has the national reference hematological tests for diagnosis and follow-up
laboratories for influenza, Nipah, and HIV. of cases identified by outbreak investigation are
These laboratories play a significant role in available.
the diagnosis of emerging infections, conduct
and assist in training programs for laboratory Entomology Laboratory: Biological efficacy test
personnel, and take part in quality assurance of public health insecticides are being carried
program. out in the laboratory from the very beginning
of the Institute. Previously, the insecticides used
Virology Laboratory: Virology laboratories only by the Government were tested here. Now
are able to keep pace with the advancements the laboratory is carrying out the biological
in laboratory technologies, including efficacy tests of different types of public
virological analysis and the use of molecular health insecticides supplied from different
biological tools for early diagnosis, typing, and organizations.
characterization of microorganisms. In the
Virology Department, there are three reference Quality system of the IEDCR laboratories has been
laboratories of biosafety level 2 (BSL2) standard, assessed through parameters, like internal quality
i.e. Nipah Laboratory, Influenza Laboratory as control, i.e. availability of SOPs and participation
NIC and HIV Laboratory dealing with diagnosis of laboratories in External Quality Assurance
of respective diseases and surveillance. One (EQA) program offered by WHO and CDC.
common Virology Laboratory, with a wing of Biosafety Program: Laboratory Biosafety
cell-culture lab contributed to the strengths of Program is designed to prevent injury and
the IEDCR. The IEDCR has a well-equipped PCR illness in all laboratory personnel, medical,
Laboratory with real-time and conventional technical and ancillary staff. Through a
PCR facilities. This PCR tools are very useful specialized laboratory dealing with pathogens
for early diagnosis of outbreaks, mapping the of highly-infectious nature (Nipah, avian
disease, and for selecting the vaccine strain influenza, HIV), the IEDCR has been trying to
(of influenza). It has been helping us in taking achieve safe work practices through periodic
interventional steps promptly to contain training on raising awareness, practices, and
previous pandemic and outbreaks. These availability of safety devices.
facilities are available here since July 2009.
The IEDCR also established a BSL3 laboratory, Collaboration/Referral System: The IEDCR
and it is a prefabricated laboratory bought laboratories have established collaboration with
from China, as a national asset by GOB funds the national and international public health
in 2009. This high containment laboratory is laboratories.

CHAPTER 14: INSTITUTE OF EPIDEMIOLOGY, DISEASE CONTROL AND RESEARCH
Outbreak investigations and response Disease-specific surveillance is also conducted

by the IEDCR. These include: (i) event-based
The IEDCR, since its inception, has conducted surveillanceoutbreak investigation and
numerous outbreak investigations. From response; (ii) Nipah surveillance; (iii) acute
2007, these are systematically recorded and meningo-encephalitis syndrome surveillance;
posted at IEDCR website at www.iedcr.gov.bd.
(iv) hospital-based influenza surveillance in
More than a hundred outbreak investigations
12 sites (tertiary-care hospitals); (v) National
were conducted by the IEDCR from 2007 to
Influenza Surveillance, Bangladesh (NISB) in 10
2015. Among these, Nipah virus, puffer-fish
district hospitals; (vi) surveillance for the sero-
poisoning, mass psychogenic illness, human
prevalence of antibodies to avian influenza A
case of avian influenza (AI), chikungunya,
viruses among Bangladeshi workers in poultry
unintentional pesticide poisoning, cholera,
markets; (vii) surveillance for human infections
acute hepatitis, chicken pox, cutaneous anthrax,
with avian influenza A viruses among workers of
Ghagra Shak poisoning, rubella encephalitis
live bird markets and their household members
are notable. Figure 14 shows the numbers of
in Dhaka city area; (viii) community-based
outbreak investigations from 2007 through
avian/human influenza surveillance among
2015.
poultry workers in H5-infected poultry farms;
Disease surveillance (ix) surveillance of high-risk group in wet
markets under Dhaka City Corporation; (x)
Disease surveillance is one of the main activities surveillance for hospital-acquired respiratory
of the IEDCR. Routine and disease-specific infections in patients and healthcare workers
surveillances are conducted round the year. The in three tertiary-care facilities; (xi) hospital-
routine surveillances include: (i) Web-based based dengue surveillance; (xii) hospital-based
Integrated Disease Surveillance (WBIDS); (ii) rotavirus and intussusceptions surveillance
Foodborne Illness Surveillance (FBIS); and (iii) (HBRIS); (xiii) surveillance of unintentional
Cell phone-based Disease Surveillance (CPBDS). acute pesticide poisoning due to carbamate
The WBIDS collects data on communicable and organophosphate among young children;
diseases of priority, e.g. blood dysentery, and (xiv) surveillance for lymphatic filariasis
malaria, kala-azar, tuberculosis, leprosy, transmission after mass drug administration.
encephalitis, ARI, SARI, pneumonia, anthrax,
and unknown diseases. The FBIS investigates Training and workshops
acute watery diarrhea, cholera, enteric fever, and
hepatitis A and E. Information on foodborne During 2015, the IEDCR organized 135
illnesses, fever, SARI, and behavioral risk factors workshops, training sessions, and seminars to
is collected by CPBDS. train a total of 2,770 doctors, 931 nurses, 364
Figure 14. Numbers of outbreak investigations and responses by the IEDCR from 2007 to 2015
Number of outbreak investigations
29
27
22
20
17 18
12
10
8
2007 2008 2009 2010 2011 2012 2013 2014 2015
Year

medical technologists, 141 statisticians, and Training Program). This two-year course is
132 government and non-government officials affiliated with the University of Dhaka;
for strengthening disease surveillance; outbreak (b) Masters of Public Health in One Health
investigation and response; laboratory capacity; and Biosecurity (in collaboration with Massey
biosafety and infection control, enhancing University, New Zealand and Chittagong
response to different emerging and re-emerging Veterinary & Animal Science University);
infections, including Ebola virus disease (EVD), (c) Clinical Epidemiology Course for Medical
Middle East Respiratory Syndrome Corona Virus Professionals; (d) Frontline FETP,B (Shorter
(MERS-CoV), avian influenza (H5N1, H7N9, version of FETP course); and (e) Improving
H9N2), Nipah, and other emerging infectious Public Health Management for Action (IMPACT)
diseases, enhancing foodborne illness surveillance courses. This two-year course is started to build
(FBIS); and climate change. Important activities up public health management specialist in
conducted include the following: Bangladesh.
Orientation of 524 national and upazila Activities of the IEDCR in 2015

rapid response team members on newly-
Research and surveys
emerged Ebola virus infections, MERS-CoV,
avian influenza (H5N1, H7N9, H9N2), Tuberculosis prevalence survey, Bangladesh
Nipah, and other emerging infectious
diseases Assessing prevalence and risk factors of
mild/asymptomatic influenza A(H5N1)
Doctors (1,172), nurses (931), and medical infections among persons exposed to
technologists (364) were trained for influenza A(H5N1)-infected poultry
enhancing preparedness and emergency
response to different emerging and re- Estimating the risk of mild human infection
emerging infections, including Ebola virus among persons exposed to influenza
infections, MERS-CoV, avian influenza A(H5N1)-infected poultry
(H5N1,H7N9, H9N2), Nipah, and other Dengue prevalence survey in Dhaka City
emerging infectious diseases Corporation area
A total of 55 doctors were trained on Chikungunya prevalence and entomological
epidemiology, control and prevention, and survey in Dhaka City Corporation area
emergency response to foodborne illnesses
in Bangladesh Antibiotic medication and antimicrobial
resistance of the bacteria causing upper
A total of 420 doctors, 500 nurses, and respiratory tract infection
139 medical technologists were trained on
biosafety and infection control Research on understanding of ecology of
Nipah virus in Bangladesh
Medical technologists (152) were trained on
detection of emerging infectious diseases Investigation of anthrax outbreaks and risk
factors for anthrax in humans and livestock
Refreshers training on web-based disease in Bangladesh
surveillance was conducted, and 141
statisticians were trained on the subject Piloting hospital infection control
interventions for severe infections spread by
Training on needs assessments of biosafety respiratory droplet and direct contact routes
and infection control, with organization
of advocacy meeting with policy-makers Estimating the incidence of maternal and
and health managers, covered 522 health neonatal deaths from hepatitis E virus (HEV)
managers. in Bangladesh
Academic courses A pilot study of a mobile technology

platform to improve evidence-based practice
A few academic courses, some with degrees, are for the treatment and epidemiological
offered by the IEDCR. These include: (a) MSc surveillance of diarrheal diseases in
in Applied Epidemiology (Field Epidemiology Bangladesh

CHAPTER 14: INSTITUTE OF EPIDEMIOLOGY, DISEASE CONTROL AND RESEARCH
Development of the protocol to study the Surveillance of unintentional acute pesticide

effectiveness of household and community- poisoning among young children in
level WASH interventions in reducing health Bangladesh
vulnerability to climate change
Post-mass drug administration surveillance
Surveillance for lymphatic filariasis transmission
National Influenza Surveillance, Bangladesh Foodborne illness surveillance system,

(NISB) in 10 district hospitals Bangladesh with 4 components:
Web-based surveillance
Hospital-based Influenza Surveillance in 12
sites (tertiary care hospitals) Cell-phone based surveillance
Nipah Virus Transmission Surveillance Laboratory-based surveillance for
diarrhea, jaundice, and febrile illness
Cell phone-based Behavioral Risk Factor (enteric fever and leptospirosis)
Surveillance System (BRFSS)
Foodborne emergency response.
Acute Meningo-Encephalitis Syndrome
(AMES) Surveillance focused on Japanese Others
Encephalitis and Nipah
8th One Health Bangladesh Conference:
Sero-prevalence of antibodies to avian A total of 420 participants attended this
influenza A viruses among Bangladeshi important event
poultry market workers MoU signing with Columbia University and
EcoHealth Alliance
Surveillance for human infections with
avian influenza A viruses among live- Four-way linking workshop.
bird market workers and their household
members in Dhaka City Corporation area, International affiliation
Bangladesh
The IEDCR is a member of the International
Avian/Human Influenza Surveillance among Association of National Public Health Institutes
poultry workers in A(H5)-infected poultry (IANPHI), Director of IEDCR is a member of
farms the Executive Board of IANPHI. The IEDCR is
a member of the Global Outbreak Alert and
Surveillance for hospital-acquired Response Network (GOARN). The IEDCR is
respiratory infections in patients and also a member of the 11-member Emergency
healthcare workers in three tertiary-care Committee on Middle East Respiratory
facilities Syndrome Corona Virus (MERS-CoV) and
Committee for International Certification
Web-based integrated disease surveillance
of Polio Eradication formed by Director
up to upazilla (subdistrict) level
General of WHO. The IEDCR has collaborative
Hospital-based dengue surveillance activities with the Centers for Disease Control
and Prevention (CDC) of USA, Rockefeller
Hospital-based rotavirus and Foundation, icddr,b, and IANPHI. The institute
intussusceptions surveillance (HBRIS) in is supported by WHO, UNICEF, FAO, USAID,
collaboration with icddr,b and other UN and international agencies.

Chapter
15
Production, quality control, and health education
INSTITUTE OF PUBLIC HEALTH

The IPH was established combining the
public health laboratories in 1952. Major
activities of this institute is to support
preventive and curative healthcare through
laboratory support, production of different
biological products, chemicals, quality
control, academic courses, training, and
research in the field of public health.
The Institute of Public Health (IPH) is one of the oldest national organizations under the Ministry of
Health and Family Welfare of the Government of Bangladesh. The IPH was established combining the
public health laboratories in 1952. Major activities of this institute is to support preventive and curative
healthcare through laboratory support, production of different biological products, chemicals, quality
control, academic courses, training, and research in the field of public health.
The institute has a land area of 47.80 acres 4. Quality Control Unit
and a total of 926 personnel. The institute
has a previous long reputation for production 5. Academic Wing
of vaccines. During the 1970s, the IPH In 2015-2016 academic sessions, the IPH started
played an important role in eradication of undergraduate courses called BSc (Bachelor of
smallpox from the country by producing and
Science) in Health Technology (Laboratory).
supplying smallpox vaccines to the National
BSc in Health Technology (Food Safety), and a
Immunization Program. Now the institute is
postgraduation course MPH (Masters of Public
working through the following infrastructure:
Health) will be started very soon. For academic
1. Biological Production Unit purpose, a well-decorated, enriched library
having a huge number of medical books and
Production of different types of journals was established.
intravenous fluid
Very recently, the IPH has established a
Production of diagnostic reagents and
CAPD (Continuous Ambulatory Peritoneal
chemicals
Dialysis) Fluid Unit for the management
Production of blood-bags of end-stage renal disease patients. The
Production of ORS (oral rehydration Dhaka Unit of oral rehydration salts (ORS)
salts), including five units in different was shifted to the IPH main campus from
locations Tejkunipara, Tejgaon and is now showing its
utmost performance.
2. Public Health Laboratory and National Food
Safety Laboratory The IPH is now on track for the digital health
development goal. Under the umbrella of
3. Microbiology and Virology Laboratory
information desk, all departments are connected
National Polio and Measles Laboratory to the digital network, interlinking with one

CHAPTER 15: INSTITUTE OF PUBLIC HEALTH
another as well as with the DGHS. The IPH has Production of blood-bags and related accessories
its own website at: www.iph.gov.bd.
Table 15.2 shows the quantity of blood-bags and
The IPH personnel are working round-the- related accessories produced by IPH over the last
clock, with a vision to establish the institute 5 years (2011 to 2015).
as a regional and international reference
center to support the public health activities in Production of diagnostic reagents
Bangladesh.
Table 15.3 shows the quantity of different types
Production of intravenous fluids of diagnostic reagents produced by IPH from
2011 to 2015.
The intravenous fluid production unit was
established in 1973 and expanded in 1981-1982. Production of oral rehydration salts
Table 15.1 shows the production of intravenous The oral rehydration salts production unit was
fluids by IPH over the last 5 years (2011 to 2015). established in 1980-1981 financial year.
Table 15.1. Production of intravenous fluids by IPH over the last 5 years (2011 to 2015)
Pack-size Year
Item
(mL) 2011 2012 2013 2014 2015
1,000 70,700 81,590 111,008 88,015 94,035
Glucose saline
500 143,225 127,255 130,733 121,345 170,067
1,000 66,225 82,810 88,499 80,660 79,697
Glucose aqua
500 120,235 112,785 118,525 114,705 126,960
1,000 51,078 61,471 93,860 79,030 100,741
Normal saline
500 101,394 12,179 114,010 120,630 170,620
1,000 56,367 81,227 87,585 74,105 105,695
Cholera saline
500 107,320 124,120 118,030 112,950 191,225
1,000 21,192 25,530 40,125 36,250 44,650
P.D. fluid
500 - - - - -
1,000 - - - - -
3% Normal saline
500 11,130 10,479 10,149 16,131 15,423
1,000 - - - 52,450
Baby saline
500 30,475 36,355 33,864 42,065 -
Hemodialysis fluid 1,000 7,830 10,700 5,868 1,670 4,080
Hartmanns 1,000 - - - 3,500

Solution 500 110,305 86,465 24,380 89,450 185,450
Table 15.2. Production of blood-bags and accessories by IPH over the last 5 years (2011 to 2015)
Year
Item Pack type
2011 2012 2013 2014 2015
CPD blood-bag Single 62,272 105,523 66,117 114,783 110,192
CPD blood-bag Double - - - 600 -
Baby bag 150 mL 1,400 - 300 2,390 -
Transfusion set - 3,800 58,000 127,830 38,000 21,223
Infusion set - 10,200 75,600 32,200 110,000 52,095

Table 15.3. Production of diagnostic reagents by IPH (2011 to 2015)
Year
Item
2011 2012 2013 2014 2015
Benedicts Solution (L) 360 400 140 240 575
ESR fluid (L) 89 160 180 99 280
20% Sulfuric acid solution (L) - - - - 50
N/10 Hydrochloric acid solution (L) 41 70 40 40 70
Acetone alcohol (L) - 60 2 - 40
5% Acetic acid solution (L) 10 60 30 50 175
WBC fluid (L) - 40 - 50 80
RBC fluid (L) - 30 - - 47
30% Sulfosalicylic acid (L) - 10 - 30
20% Sodium hydroxide solution (L) - - - - 5
20% Potassium hydroxide solution (L) - - - - -
Semen analysis fluid (L) 10 - - 40
Normal saline (L) - 20 40 10 120
Methylene blue (L) - - - - 25
Crystal violet (L) - - - 20
Basic fuchsin (L) - 10 - - -
Carbol fuchsin (L) - - - 5
Gram iodine (L) 5 5 - 5 25
Lugols iodine (L) 15 10 - 31
Leishman stain (L) 50 72 26 17 70
Giemsa stain (L) 43 40 34 14 50
Glucose kits 48 99 - - -
Bilirubin kits - 149 - 100 198
Creatinine kits 250 298 - 191 328
Uric acid kits - - - - -
EDTA vials - - - - 500
Urea kits 48 50 - - -
Figure 15.1. Production and distribution of oral rehydration salts (ORS) by IPH over the last 5 years
(2011 to 2015)
36.27 32.02 30.78 31.13
29.75
35.53
30.95 30.27 31.17
27.13
Distribution (million packs) Production (million packs)
2011 2012 2013 2014 2015

Figure 15.1 shows the quantity of oral Table 15.5 shows the number of drug samples received
rehydration salts (ORS) produced and during 2011-2015 by IPH, with the test results.
distributed by IPH from 2011 to 2015.
The National Polio Laboratory of the IPH is a
Testing of food, water, drug and stool samples WHO-accredited laboratory established to assist
in the eradication of wild polio virus from the
Table 15.4 shows the number of food samples
country. It is a partner of SEARO-WHO Polio
tested by IPH from 2011 to 2015. The table
Network. Table 15.6 shows the number of stool
also shows the distribution of satisfactory and
samples tested by IPH for polio virus from 2011
unsatisfactory samples out of the total samples
tested each year. to 2015, with results of the tests.
Figure 15.2 shows the results of water samples, Serological tests for measles and rubella
for which bacteriological test was done by IPH The Measles Laboratory of the IPH is involved
during 2011 to 2015. with the serological study of measles and
Table 15.4. Food samples tested by IPH over the last 5 years (2001 to 2015)
Satisfactory Unsatisfactory
Year Total samples
No. % No. %
2011 5,812 2,671 45.96 3,147 54.15
2012 5,322 2,734 51.37 2,558 48.06
2013 4,967 2,830 56.98 2,137 43.02
2014 5,396 3,249 60.21 2,147 39.79
2015 6,746 4,376 64.87 2,370 35.13
Figure 15.2. Result of water samples tested chemically by IPH in the last 5 years (2011to 2015)
Satisfactory Unsatisfactory
0.80%
1.60% 3.81% 2.10%
5.48%
99.20%
98.40% 97.90%
96.19%
94.52%
2011 2012 2013 2014 2015
Table 15.5. Number of drug samples received and tested by IPH, with the test results (2011 to 2015)
Samples received Feedback given
Year Satisfactory Unsatisfactory Not analyzed
(Total) to senders
2011 3,720 2,583 104 1,033 -
2012 4,239 2,276 95 1,868 264
2013 5,618 4,635 162 21 962
2014 7,336 5,272 141 1,923 44
2015 7,001 6,859 6,603 256 142

rubella to support measles control program in of the tests done on such samples by IPH from
the country. Table 15.7 shows the numbers of 2011 to 2015.
measles-positive, rubella-positive and negative
Visits by medical and dental students
blood samples tested by the Measles Laboratory
of the institute from 2011 to 2015. Figure 15.3 shows the numbers of medical/
dental students who visited the IPH during
Routine tests for blood, serum, stool, urine, 2009-2013 and in 2015. Graduate medical and
sputum, throat-swab and ear-swab samples dental students from almost all medical colleges
The IPH performs routine tests on the samples come to see the activities of the IPH for learning.
of blood, serum, stool, urine, sputum, throat- The IPH is a designated site for field visit by
swab, ear-swab, etc. Table 15.8 shows a summary medical students in the country.
Table 15.6. Number of stool samples tested by IPH for polio virus from 2011 to 2015, with the test
results
Year
Item
2011 2012 2013 2014 2015
AFP cases (N) 1,600 1,570 1,433 1,473 1,408
Samples (N) 3,619 3,450 3,206 3,112 3,010
Polio virus isolates (N) 75 84 68 34 42
Wild polio viruses (N) - - - - -
Vaccine (Sabin) viruses (N) 75 84 68 34 42
NPEV (Non-polio enteroviruses) (N) 638 489 590 706 611
Negative samples (N) 2,906 2,877 2,584 2,372 2,357
Table 15.7. Numbers of measles-positive, rubella-positive (IgM antibody) and total negative blood
samples (both measles and rubella) tested by the Measles Laboratory of IPH from 2011 to 2015
Year
Test
2011 2012 2013 2014 2015
Measles-positive 1,788 714 77 143 158
Rubella-positive 672 481 639 223 152
Total negative 1,633 1,359 1,047 1,676 2,530
Total samples 4,093 2,590 1,763 2,042 2,840
Table 15.8. Number of routine tests done on various samples by IPH during 2010-2012 and in 2015
Year
Test
2010 2011 2012 2015
Biochemical (blood) - - 9 1,057
Serological - 11,043 6,449 294
Routine examination
162 157 79 443
(stool, blood-CP, urine, sputum)
Culture and sensitivity
30 - - 52
(stool, blood, urine, sputum, throat-swab, ear-swab)
Table 15.9. Summary of the tested food samples by the National Food Safety Laboratory in 2015
Samples from Samples from
government non-government Survey samples Total samples Parameters tested
sources sources
472 235 1,107 1814 33,875

Figure 15.3. Numbers of medical/dental students who visited the IPH during 2009-2013 and in 2015
2015 1,918
2013 1,056
2012 1,828
2011 1,889
2010 1,590
2009 1,129
National Food Safety Laboratory (NFSL) and foodborne pathogens in different food
items. Table 15.9 shows a summary of the 2015
With the financial support of the European activities.
Union and the Kingdom of the Netherlands
Government, the Food and Agriculture Academic activities in the IPH
Organization (FAO) established the National
Food Safety Laboratory (NFSL) in the 2nd Recently, the IPH has started academic activities
floor of the Institute of Public Health. It was under the University of Dhaka. In the 2015-
inaugurated in October 2012 by Honble 2016 academic session, a BSc program in Health
Minister for Health and Family Welfare. Technology (Laboratory) was started with 28
students. From the next session, other programs,
NFSL is playing a key role in the determination like BSc in Health Technology (Food Safety) will
of pesticide residues, heavy metals, antibiotics, be started. The IPH has also taken steps to start
formaldehyde, coloring agents, myco-toxins, MPH courses under the BSMMU.

Chapter More coordination needed for integrated service
16 HEALTH WORKFORCE
SITUATION IN BANGLADESH
Health workforce deployment and
redeployment are ongoing processes;
attrition due to death, retirement, resignation,
termination, migration, transfer, replacement,
and filling-in is constantly occurring.
The chapter gives a summary of the health workforce situation in the DGHS and allied departments, viz.
Directorate General of Family Planning and Directorate of Nursing Services. The numbers of sanctioned
and filled-up posts, along with vacancies, are highlighted in tabular forms. Medical teaching/training
institutions and programs, along with training courses, have also been shown. Health workforce
deployment and redeployment are ongoing processes; attrition due to death, retirement, resignation,
termination, migration, transfer, replacement, and filling-in is constantly occurring. Therefore, by the
time this bulletin is published, the status of health workforce as reported here may not remain the same.
With the initiatives of the newly-appointed 0.42% of the sanctioned posts and 0.22% of
Director General, the human resource (HR) the available staff. Table 16.1 also shows that
information is now being kept up-to-date in 21,737 sanctioned posts remained vacant as of
the online HR management system developed June 2016, which constituted 17% of the total
by the Management Information System (MIS) sanctioned posts. Vacancy rate was 6.88% (1,654
of the DGHS. In the near future, any change in posts) for doctors, 56.46% (306 posts) for Class I
the HR situation, either by new recruitments non-doctors, 16.37% (3,486 posts) for Class II
or by transfers, postings, retirements, etc. will staff, 17.12% (9,062 posts) for Class III staff, and
be incorporated in the system in real-time. The 24.89% (7,229 posts) for Class IV staff.
updated information will be available at the
DGHS web portal (dghs.gov.bd). The percentage distribution of male and female
staff under the DGHS remained the same
Overall health workforce situation of DGHS in 2016 as it was in June 2015 (Figure 16.1).
Slightly less than two-thirds (61.29%) of the
A summary of health workforce situation in the
total staff members (n=106,162) were male,
DGHS is shown in Table 16.1. The Annex to this
and just above one-third (38.71%) of them
chapter shows the division-wise distribution of
were female (38.71%) (Figure 16.1) Among the
health workforce.
doctors (Class I), almost three-quarters (70.85%)
Table 16.1 reveals that, out of 127,841 were male, and slightly more than one-quarter
sanctioned posts under the DGHS, about half (29.55%) were female. Class I non-doctors also
(41.41%) are of Class III category, physicians had similar distribution (75.53% male vs 24.47%
(Class I) comprise 18.80%, Class II 16.66%, and female). For the Class II staff, the scenario was
Class IV employees comprise the rest 22.71%. quite opposite (7.30% male vs 92.70% female).
Of the available 106,104 health personnel, However, this was due to the fact that the bulk
41.35% are of Class III, 21.09% are doctors of Class II staff comprised nurses, and most
(Class I), 16.78% are of Class II, and 20.55% are of the nurses were female. Among the Class
of Class IV. The Class I non-doctors comprise III staff, 73.03% were male, and 26.97% were

CHAPTER 16: HEALTH WORKFORCE SITUATION IN BANGLADESH
female. Among the Class IV staff, 73.35% were Medical technologists

male, and 26.65% were female.
The numbers of sanctioned, filled-up and
Figure 16.2 shows the total number of vacant posts of medical technologists as in 2013
sanctioned posts for the DGHS in 2014, 2015, through 2015 are shown in Table 16.3.
and 2016 (up to June). Between 2015 and
2016, there was an increase of 11,114 posts Sub-Assistant Community Medical Officers
comprising 392 Class I posts for doctors, 17 Table 16.4 shows the numbers of sanctioned,
Class I posts for non-doctors, 411 Class II filled-up and vacant posts of Sub-Assistant
posts, 10,184 Class III posts, and 110 Class IV Community Medical Officer (SACMO) in the
posts. three-year period from 2013 through 2015 under
Administrative, managerial, academic and the DGHS. Percentage of vacancy has been slightly
clinical positions increased in 2015 to 15% from 13% in 2014.
The numbers of sanctioned, filled-up and vacant Domiciliary staff (Health Inspectors, Assistant
posts at administrative, managerial, academic Health Inspectors, and Health Assistants)
and clinical positions under the DGHS, as of Table 16.5 shows the numbers of sanctioned, filled-
June 2016, are shown in Table 16.2. up and vacant posts of domiciliary staff (Health
Table 16.1. Number of sanctioned, filled- up and vacant posts under DGHS (June 2016)
Sanctioned post Filled-up post Vacant
As % of As % of
Category of post As % of all sanctioned sanctioned
As % of all
No. sanctioned No. posts in No. posts in
filled-up posts
posts respective respective
categories categories
Doctors 24,028 18.80 22,374 21.09 93.12 1,654 6.88

Class I
Non-doctors 542 0.42 236 0.22 43.54 306 56.46
Class II 21,294 16.66 17,808 16.78 83.63 3,486 16.37
Class III 52,939 41.41 43,877 41.35 82.88 9,062 17.12
Class IV 29,038 22.71 21,809 20.55 75.11 7,229 24.89
Total 127,841 100.00 106,104 100.00 83.00 21,737 17.00
Figure 16.1 Percent distribution of male and female staff in DGHS (June 2015)
92.70
Male Female
75.53
73.35
73.03
70.85
61.29
38.71
29.55
26.97
26.65
24.47
7.30
Class I Class I Class II Class III Class IV Total

Doctors Non-doctors (n=18,215) (n=43,649) (n=22,270) (n=106,162)
(n=21,840) (n=188)

Figure 16.2. No. of sanctioned posts by year
2014 2015 2016 (June)
127,841
123,832
116,727
52,939
52,477
42,755
29,038
28,928
27,427
24,028
23,636
22,982
21,294
20,883
20,432
514
525
542
Class I Class I Clas II Class III Class IV Total

Doctors Non-doctors
Table 16.2. Numbers of sanctioned, filled-up and vacant posts at administrative, managerial, academic
and clinical positions under DGHS (June 2016)
Total no. of Filled-up Vacant
Name of post
sanctioned posts No. (%) No. (%)
Director General 1 1 100 0 0
Additional Director General/Equivalent 5 4 80 1 20
Director/Principal/Vice-Principal/Equivalent 109 102 94 7 16
Deputy Director/Equivalent 128 95 74 33 26
Assistant Director/Civil Surgeon/
208 154 74 54 26
Equivalent
Deputy Civil Surgeon/UHFPO 935 774 83 161 17
Professor 617 402 65 215 35
Associate Professor 945 731 77 214 23
Assistant Professor 1,442 1,115 77 327 23
Senior Consultant 539 325 60 214 40
Senior Lecturer 8 6 75 2 25
Junior Lecturer 32 28 88 4 13
Junior Consultant/Equivalent 3,661 1,824 50 1,837 50
Assistant Surgeon/Equivalent 14,768 16,313 11 1,545 10
Other posts 369 268 73 101 27
Total 23,767 22,142 93 1,625 7

Table 16.3. Numbers of sanctioned, filled-up and vacant posts of medical technologists by discipline
in the last three years
Year Phar- Radio- Radio- Physio- Sanitary MT

Post Lab Dental Total
(Month) macy graphy therapy therapy inspection (EPI)
Sanctioned 2,934 1,922 737 66 216 535 491 - 6,901

2013
Filled-up 2,126 1,498 629 41 144 501 436 5,375
(Dec)
Vacant 808 424 108 25 72 34 55 - 1,526
Sanctioned 2,944 2,170 784 66 264 539 496 499 7,762
2014
Filled-up 2,113 1,642 644 40 177 501 439 473 6,029
(May)
Vacant 813 528 140 26 87 38 57 26 1,733
Sanctioned 2,944 2,172 785 66 286 540 497 500 7,790
2015
Filled-up 2,106 1,629 623 38 171 484 432 462 5,945
(Dec)
Vacant 438 543 162 28 115 56 65 38 1,445
Table 16.4. Numbers of sanctioned, filled-up and vacant posts of Sub-Assistant Community Medical
Officer (SACMO) in the three-year period (2013, 2014, and 2015) under DGHS
No. of posts Vacancy
Year (Month)
Sanctioned Filled-up No. (%)
2013 (Dec) 5,411 4,917 494 9.13
2014 (Dec) 5,411 4,684 727 13
2015 (Dec) 5,411 4,578 833 15
Table 16.5. Numbers of sanctioned, filled-up and vacant posts of domiciliary staff (Health Inspectors,
Assistant Health Inspectors, and Health Assistants) under DGHS from 2013 through 2015.
Assistant
Health Health Total field Vacancy
Year (Month) Post Health
Inspector Assistant staff (%)
Inspector
Sanctioned 1,399 4,202 20,881 26,482
2013 (Dec) Filled-up 1,313 4,042 16,690 22,045 16.75
Vacant 86 160 4,191 4,437
Sanctioned 1,399 4,205 20,877 26,481
2014 (Dec) Filled-up 1,282 4,006 17,532 22,820 14
Vacant 117 199 33,45 3,661
Sanctioned 1,399 4,205 20,877 26,481
2015 (Dec) Filled-up 1,232 3,891 17,332 22,455 15
Vacant 167 314 3,545 4,026
Inspectors, Assistant Health Inspectors, and Officers and staff in alternative medicines
Health Assistants) under the DGHS in the last
three-year period (2013, 2014, and 2015). The Table 16.6 shows the numbers of sanctioned,
rate of vacancy dropped to 15% in 2015 from filled-up and vacant posts of various officers and
16.75% in 2013, although in 2014, the situation staff in alternative medicines under the DGHS,
was slightly better with a 14% vacancy rate. as of June 2016.

Table 16.6. Numbers of sanctioned, filled-up and vacant posts (revenue and development) of various
officers and staff in alternative medicines under DGHS (June 2016)
Sanctioned post Fill-up post Vacant post
Name of post
Revenue Development Revenue Development Revenue Development
Director 1 0 1 0 0 0
Line Director 1 0 1 0 0 0
Principal-cum-
2 0 2 0 0 0
Superintendant
Professor 2 0 0 0 2 0
Deputy Director 1 0 1 0 0 0
Assistant Professor 9 4 6 2 3 2
Assistant Director 1 0 1 0 0 0
RMO/RP/(U/A/H),
0 5 0 5 0 0
Register(U/A/H)
Lecturer 21 35 15 31 6 4
Medical Officer
0 3 0 3 0 0
(U/A/H), DGHS
Medical Officer for
61 95 10 68 51 27
Unani Medicine
Medical Officer
for Homeopathic 51 90 0 74 51 16
Medicine
Medical Officer
61 90 10 63 51 27
(Ayurvedic)
Medical Officer:
6 18 0 15 6 3
IMO
Other posts
equivalent to 14 4 14 2 0 2
Medical Officer
Research Officer 0 3 0 3 0 0
Deputy
1 0 1 0 0 0
Superintendant
Nurse/Staff Nurse 12 0 12 0 0 0
Secretary 1 0 1 0 0 0
Accountant 0 1 0 0 0 0
Support personnel
(compounders
157 277 2 63 155 214
for alternative
medicine)
Herbal Assistant
0 474 0 433 0 41
for Herbal Gardens
Other Class III
100 2 82 0 18 2
personnel
Other Class IV
184 2 124 2 50 0
personnel
Total 686 1,103 283 764 403 339

Table 16.7. Numbers of sanctioned, filled-up and vacant posts under DGFP from 2012 through 2014
Year (Month) Class Sanctioned Filled-up Vacant Vacancy rate (%)
2012 (Dec) 1,954 1,049 905 46.3
2013 (Apr) Class I 1,954 1,021 933 47.7
2014 (Dec) 1,953 1,039 914 46.80
2012 (Dec) 1,022 401 621 60.8
2013 (Apr) Class II 1,074 401 673 62.7
2014 (Dec) 1089 525 564 51.79
2012 (Dec) 16,937 14,646 2,291 13.5
2013 (Apr) Class III 16,886 14,760 2,126 12.6
2014 (Dec) 16,881 14,665 2,216 13.13
2012 (Dec) 32,507 29,845 2,662 8.2
2013 (Apr) Class IV 32,516 29,103 3,413 10.5
2014 (Dec) 32,512 29,116 3,396 10.45
Table 16.8. Numbers of sanctioned, filled-up and vacant posts under the DNS in 2014 and 2015
Year (Month) Category Sanctioned Filled-up Vacant Vacancy rate (%)
Class I
2014 (June) Nursing 311 166 145 46.95
Non-nursing 1 - 1 100.0
2015 (June) Nursing 313 148 165 52.71
Non-nursing 1 0 1
Class II
2014 (June) Nursing 22,357 12,928 5,429 24.28
Non-nursing 20 9 11 55.0
2015 (June) Nursing 21,234 16,082 5,152 24.26
Non-nursing 20 9 11 55
Class III
2014 (June) Nursing 611 611 0 0
Non-nursing 368 289 79 21.47
2015 (June) Nursing 610 610 0 0
Non-nursing 368 299 69 18.75
Class IV
2014 (June) Non-nursing 704 664 40 5.68
2015 (June) Non-nursing 704 623 81 11.50
Table 16.9. Type of institutions offering postgraduate medical courses, with numbers of seats
(December 2015)
Type of No. of No. of seats
organization organizations MS MD M. Phil Diploma MPH MTM MMED Total
Autonomous
1 140 150 70 106 0 10 0 476
(BSMMU)
Government 22 312 360 242 478 185 0 15 1,592
Private 10 21 38 15 95 0 0 0 169
Total 33 473 548 327 679 185 210 15 2,237

Figure 16.3. Number of persons receiving FCPS and MCPS postgraduate degrees by year
FCPS MCPS
149
163
118
79
108
126
677
100
550
384
320
288
239
198
2009 2010 2011 2012 2013 2014 2015
Workforce in Directorate General of Family MMED. Detailed list of the organizations, with
Planning courses and number of seats, is shown in the
Annex.
Table 16.7 shows the numbers of sanctioned,
filled-up and vacant posts under the Directorate Figure 16.3 shows the number of doctors who
General of Family Planning (DGFP) from 2012 obtained FCPS and MCPS degrees from the
through 2014. Bangladesh College of Physicians and Surgeons
(BCPS) from 2009 to 2015. Detailed data are
Directorate of Nursing Services given in the Annex.
Table 16.8 shows the numbers of sanctioned, Institutions offering MBBS degree
filled-up and vacant posts under the
Directorate of Nursing Services (DNS) in 2014 Table 16.10 shows the number of institutions,
and 2015 along with the total number of seatsboth in the
government and private sectorswhich offer MBBS
Institutions offering postgraduate medical degree. Detailed list of institutions, with number
degrees of seats in each, is provided in the Annex.
The numbers of institutions both in the
government and private sectors providing Table 16.10. Government and private
postgraduate medical degrees are shown in institutions offering MBBS degree, with the
Table 16.9. Thirty-three institutions23 in number of seats (June 2016)
public sector (including autonomous BSMMU) Type of No. of
No. of seats
and 10 in private sectoroffer such degrees. organization institutions
Table 16.9 also shows the titles of the courses
offered by each institution, along with the Government 36 3,812
number of seats in each course. One institution, Private 68 6,145
namely Bangladesh College of Physicians and
Surgeons (BCPS), offers FCPS (Fellow of the Total 104 9,957
College of Physicians and Surgeons) and MCPS
Institutions offering undergraduate dental
(Member of the College of Physicians and degrees
Surgeons) degrees. Any eligible candidate can
sit for the examinations, and results depend The number of institutions, along with the total
on the candidates competence shown in the number of seats both in the government and
examinations. The number of seats is, therefore, private sectors, which offer BDS degree, is shown
variable. Other institutions offer courses, like in Table 16.11. Detailed list of institutions, with
MS, MD, M.Phil, Diploma, MPH, MTM, and number of seats in each, is provided in the Annex.

Table 16.11. Government and private sectors, offering different types of nursing
institutions offering BDS degrees, with number degrees is shown in Table 16.13. Detailed list
of seats (June 2016) of institutions and number of seats in each
institution is provided in the Annex.
Type of No. of
No. of seats
organization institutions Institutions producing midwives
Government 9 532
Twelve junior midwifery institutions in the
Private 25 1,385 private sector exist, with total seats of 320, to
Total 34 1,917 produce midwifery professionals (18-month
course). Table 16.14 shows the list.
Institutions offering degrees and diplomas in
alternative medicines Training facilities for production of communi-
ty-based skilled birth attendants
The list of academic institutions, along with
the numbers of seats both in the government The Ministry of Health and Family Welfare
and the private sectors, offering degrees and has a program to produce community-
diplomas in alternative medicines is provided in based skilled birth attendants to facilitate
Table 16.12. attendance at childbirths by skilled health
Institutions offering nursing degrees personnel. There are 47 facilities45 in the
government sector and 2 in the private sector.
The number of institutions, along with the Table 16.15 shows the location of the training
number of seats in both government and private facilities.
Table 16.12. Institutions for teaching and training on alternative medicines in Bangladesh (June
2016)
Duration No.
Name of Duration
Total Govt. Private of Degree offered of
institution of course
internship seats
BUMS (Bachelor of Unani

Govt. Unani
Medicine and Surgery);
and Ayurvedic
1 1 0 5 years 1 year BAMS (Bachelor of 50
Medical
Ayurvedic Medicine
College
and Surgery)
Govt.
BHMS (Bachelor of
Homeopathic
2 1 1 5 years 1 year Homeopathic Medicine 50
Medical
and Surgery)
College
Tibbia College/
DUMS (Diploma in Unani
Unani Diploma 16 1 15 4 years 6 months 25*
Medicine and Surgery)
College
Ayurvedic DAMS (Diploma in

Diploma 9 0 9 4 years 6 months Ayurvedic Medicine and -
College Surgery)
DHMS (Diploma in
Homeopathic
53 0 53 4 years 6 months Homeopathic Medicine -
Diploma College
and Surgery)
*Only in government institutions

Table 16.13. Number of nursing institutions, along with the numbers of seats, offering different types
of nursing degrees (June 2016)
Course Ownership Affiliation No. Seats
BSc Government MOHFW 7 700
Armed Forces Medical Institute, Dhaka Cantonment, Dhaka 1 60
Faculty of Nursing BSMMU, Dhaka 1 25
Sub-total (Government) 9 785
Private Private (one institution has been closed) 13 430
Sub-total (BSc in Nursing) 22 1,215
Post-basic BSc Government MOHFW 4 500
Private Private 10 345
Sub-total (Post-basic BSc in Nursing) 14 845
Specialized
education
Sub-total (Specialized education in Nursing) 4 80
Diploma Government MOHFW 43 2,580
Armed Forces Medical Institute 1 50
Sub-total (Government) 44 2,630
Sub-total (Diploma in Nursing) 91 4,540
Total 131 8,740
Table 16.14. Junior midwifery institutions, with number of seats in each (June 2016)
No. of
Division Name of junior midwifery institution
seats
Junior Midwifery Institute, Red Crescent Matrisadan Hospital,
Chittagong 1. 20
Chandpur
2. Jemison Red Crescent Midwifery Institute, Agrabad, Chittagong 50
3. Christian Hospital, Chandraghona, Rangamati 20
Junior Midwifery Institute, Memon Hospital, City Corporation,
4. 30
Chittagong
Dhaka 5. Junior Midwifery Institute, Holy Family Red Crescent Hospital, Dhaka 60
Junior Midwifery Institute, Shaheed Moyez Uddin Memorial Red
6. 20
Crescent
Matrisadan Hospital, Bangla Bazar, Dhaka
7. Junior Midwifery Institute, Kumudini Hospital, Mirzapur, Tangail 20
8. Central Hospital Nursing Institute, Green Road, Dhanmondi, Dhaka 20
Khulna 9. Junior Midwifery Institute Ad-Din Matrisadan Hospital, Jessore 20
10. Junior Midwifery Institute, Fatema Hospital, Jessore 20
Rajshahi 11. Junior Midwifery Institute, Christian Hospital, Bogra 20
Rangpur 12. Prime Nursing College, Rangpur 20
Total seats 320

Table 16.15. Training institutions for production of community-based skilled birth attendants
(June 2016)
No. of
Ownership Type of facility Location
facilities
CSBA Institution run ICMS, Matuail, Dhaka. Narayanganj (WHO),

by civil surgeon and Manikganj, Kishoreganj, Jamalpur, Habiganj,
attached with Gopalganj, Narsingdi, Nilphamari, Natore,
Government 20
general Naogaon, Kurigram, Panchagarh, Gaibandha,
hospital/district Jhenaidah, Bagerhat, Rajbari, Madaripur,
hospital Munshiganj, and Chandpur
Family Welfare Tangail (WHO), Barisal, Faridpur, Comilla (WHO),

Visitor Kushtia, Sylhet, Rangamati, Dhaka, Rajshahi, 11
Training Institute Bogra, and Khulna (WHO)
Noakhali, Jessore, Satkhira, Thakurgaon,

CSBA Institution
Feni, Joypurhat, Pabna, Brahmanbaria,
attached with
Netrakona, Chuadanga, Coxs Bazar, Patuakhali, 16
nursing
Chapainowabganj, Rangpur, Dinajpur, and
institutions
Sirajganj
Kumudini Hospital, Mirzapur, Tangail; Lamb

Hospital, Parbotipur, Dinajpur; Christian Hospital,
Private CSBA Institution Chandraghona, Rangamati; OGSB Hospital, 5
Mirpur, Dhaka; Model Family Planning Clinic,
Rangpur
Total 52
Training schools for production of medical Table 16.16. Government Medical Assistant
assistants Training Schools (MATS), with the number of
Medical assistants (now to be designated as seats (December 2015)
Sub-Assistant Community Medical Officer) Ownership No. of MATS No. of seats
assist the medical doctors posted at health Government 8 716
facilities at the upazila health complex level
Private 181 11,955
and below. Medical Assistants are produced
by Medical Assistant Training School (MATS) Total 189 12,610
through a three-year academic course
Institutes of Health Technology (IHT) for
comprising theoretical and practical classes. production of medical technologists
Currently, there are 8 MATS in the government
sector and 181 MATS in the private sector Medical technologists are laboratory personnel
(total 189). Total annual production-capacity responsible for technical jobs under the
is 12,610, of which 716 are produced by the supervision of medical experts. A few years
government MATS and 11,955 by the private back, there was an acute shortage of medical
MATS (Table 16.16). Annex shows the detailed technologists in the country. However, for a
list of institutions, with the number of seats in steady growth of private institutions, by now
each institution. there are 137 institutions to produce medical

Table 16.17. Number of institutions of health technology, along with the number of seats
(June 2016)
Type of No. of No. of

Ownership Discipline
course institutions seats
Lab (415); Radiology (405); Physiotherapy

(370); Sanitary inspection (400); Dentistry
Government Diploma 8 (405); Pharmacy (405), and Radiotherapy (140) 2,596
Note: Offspring of freedom fighters and tribal
students have 41 reserved seats
Lab; Radiology; Physiotherapy; Sanitary

Inspection; Dentistry; Pharmacy; and
Private Diploma 104 13,266
Radiotherapy (Note: Offspring of freedom
fighters and tribal students have reserved seats)
Lab (85); Physiotherapy (110) Dentistry (120),

Government BSc 3 355
and Radiology (40)
Lab (395); Physiotherapy (320); Dentistry (320);

Private BSc + MSc 18 1,235
Occupational (10), and others (115)
Total (diploma + BSc + MSc) 17,451
Optometrist, refraction, ophthalmic assistant,

Government +
Certificate 4 ophthalmic nursing assistant, cath-lab 180
Private
technician
Total 137 Grand total 17,631
Table 16.18. Number of participants in on-the-job training given under the operational plan of in-
service training in FY 2014-2015
Area/subject of the training/ No. of No. of
Duration
workshop/seminar batches participants
A. Local training (short-term)
Essential service delivery 121 day(s) 710 17,574
Management training 315 days 382 8,617
Orientation of the members of District Training
Coordination Committee (DTCC) and District 1 day 41 1,025
Upazila Training Team (DUTT)
Development and review of curriculum and
3 days 6 120
training policy
Upgrading Training Management Information
1 day 5 5
System (TIMS)
Subject-wise specialized training implemented by
1 day3 month(s) 84 1,708
ICMH, IPH, NIPSOM, IEDCR, BCPS, and CME
Sub-total: local training - 1,228 29,049
B. Overseas training
a. Different clinical specialties
Short-term (4 weeks or less) clinical training for
14 week(s) 4 35
health service providers
Contd.

Table 16.18 Contd.

Area/subject of the training/ No. of No. of
Duration
workshop/seminar batches participants
Short-term (4 weeks or less) training for basic
14 week(s) 2 14
science and paramedical teachers
b. Different management and public health specialists
Short-term (4 weeks or less) training on
training and teaching technology, hospital
14 week(s) 2 32
management, waste management, exposure
visit of teachers for curriculum development
c. Specialized overseas training
Short-term (4 weeks or less) hands-on clinical
training for health service providers in local 14 week(s) 8
institutions (resource persons from abroad)
Sub-total: overseas training - 16 100
Grand total - 1,244 29,149
Table 16.19. Year-wise number of new doctors produced in 2010-2015

No. of students graduated
Name of institution
2010 2011 2012 2013 2014 2015
Dhaka Medical College 132 178 202 195 195 145
Sir Salimullah Medical College 146 170 167 220 224 164
Rajshahi Medical College 170 164 205 208 190 117
Rangpur Medical College 185 23 214 131 188 185
Mymensingh Medical College 184 155 207 212 184 170
Chittagong Medical College 181 147 225 174 203 175
MAG Osmani Medical College, Sylhet 160 155 203 203 189 194
Sher-e-Bangla Medical College, Barisal 166 164 190 201 178 188
Faridpur Medical College 59 60 117 108 203 106
SZR Medical College, Bogra 56 93 130 121 156 131
Dinajpur Medical College 52 75 119 83 110 129
Khulna Medical College 46 80 116 119 112 126
Comilla Medical College 60 49 147 115 211 85
Dhaka Dental College 97 129 84 132 95 80
Chittagong Dental College 36 59 43 38 40 45
Rajshahi Dental College 33 13 47 46 88 47
Pabna Medical College - - - - - 51
Noakhali Medical College - - - - 34 19
Coxs Bazar Medical College - - - - - 34
Shaheed Suhrawardy Medical College - - - - 132 133
Jessore Medical College - - - - - 26

technologists (Table 16.17). Eleven government staff receive on-the-job training each year
institutions and 104 private institutions under the operation plan of in-service training.
offer diploma and/or BSc/MSc courses. Four A summary of the types of training programs
institutions (government plus private) offer and the number of participants is given in
certificate course in medical technology. The Table 16.18. Details of on-the-job training are
total number of seats in diploma, BSc and MSc provided in the Annex.
courses is 17,451, and that for certificate course
is 180. Annex shows the detailed list of IHTs, Yearly output from medical and dental
colleges of Bangladesh
along with the number of seats in each.
On-the-job training Table 16.19 shows year-wise number of new

doctors produced from various medical and
A large number of health personnel and support dental colleges of Bangladesh during 2010-2015.

Chapter
17
Bangladesh at the principal focus
HEALTH INFORMATION
SYSTEM, eHEALTH, AND MBT
International recognitions in the form of
prestigious awards received during the past
few years hallmark Bangladeshs glorious
efforts for digitalization of the health systems.
Bangladesh has made remarkable progress in developing and deploying a country-wide health
information system (HIS) which includes a robust routine health information system (RHIS). Several
of its HIS and eHealth initiatives, coming mainly from the Government, are being appreciated and
recognized both at home and abroad. International recognitions in the form of prestigious awards
received during the past few years hallmark Bangladeshs glorious efforts for digitalization of the health
systems.
Inter-country Conference on Measurement country. Bangladesh was considered because

and Accountability for Results in Health of its readiness for measurement of progress in
(MA4Health) health during the post-2015 period, and South
Africa for quality of cause-of-death data for
In June 2015, the United States Agency for
understanding the national and subnational
International Development (USAID), the
health situations. It was decided in the Summit
World Bank (WB), and the World Health
that a follow-on regional conference would be
Organization (WHO) organized a global event
hosted by Bangladesh. Accordingly, the Regional
titled Measurement and Accountability for
Conference on MA4Health was held in Dhaka
Results in Health (MA4Health) Summit at
during 26-27 April 2016.
the World Bank Headquarters in Washington,
DC. More than 600 delegates from different As many as 63 international participants
agencies of 60 countries participated and representing countries and development partners,
endorsed a roadmap towards measurement and including NGOs, and a similar number of local
bringing accountability in the health sector and participants representing ministries, government
drafted a 5-point call to action. Bangladesh departments, civil societies, universities, and
was one of the two countries invited to co- donors attended the conference. Senior officials
host this summit, South Africa being the other from Nepal, Myanmar, Bhutan, the Philippines,
Photos from the Inter-country Conference on Measurement and Accountability for Results in Health Summit, Dhaka, 2016

Indonesia, Laos, and South Africa participated. hence, leadership and political ownership
The last day of the conference was dedicated are required to move forward with systemic
to field trips in 3 sites in urban and rural areas changes.
where the visitors observed the implementation
of DHIS2 and OpenMRS in facilities in Dhaka Strengthening accountability requires horizontal
and in Kaliganj (a subdistrict in the district monitoring: Involving local leaders and
of Gazipur); the sites included community the community is a sustainable way to
clinics. They also observed the implementation improve accountability in the health sector.
of Routine Health Information System (RHIS) Apart from close supervision by the line
in Tangail where the work of community-level ministries (vertical monitoring), community
public-sector health workers has been digitized supervision and support play important
using mHealth solutions. roles in improving measurement and
accountability.
Key points highlighted and discussed at the
conference were the following: Strengthening systems requires effective use
of resources: Most countries in the region
Demand for data will continue to increase: The are working to improve measurement and
Sustainable Development Goals (SDGs) pose accountability systems but they require
a unique challenge for measurement, with technical assistance and financial resources
many indicators that will increase demand to carry out their action plans.
for data. The SDGs also focus on equity,
which will require disaggregation of data at At the conference, a marketplace was also set
multiple levels. up, which ran for two days, where different
organizations displayed many innovative
Country measurement and accountability solutions.
systems are inherently complicated: The overall
measurement and accountability systems NCD interventions are also to be undertaken by
in a country have many components, and COIA Initiative
bringing all of these together for sustainable Established with the aim to register and track
improvement is a challenge. It is essential pregnant women and under-five children
to have a visual blueprint to show how the electronically, the Commission on Information
components fit together to make the whole. and Accountability for Womens and Childrens
A blueprint also provides a common plan so Health (COIA) is an initiative of the United
that all the actors can work collaboratively. Nations for improving the womens and
Bangladesh provides a good example of childrens health and attainment of MDG 4
government and development partners working and 5 in countries lagging behind the targets.
in close collaboration for systems improvement. The Bangladesh COIA Secretariat, established in
The process is more important than the 2014 with support from WHO-HQ, is operating
technology: When developing measurement the COIA activities country-wide. COIA program
and accountability systems, it is essential created momentum in the MNCH activities
to start from the public-health problems among the collaborative partners, viz. HIS-EH,
to be addressed, then work from there to CBHC, MNCAH-DGHF, MCH-DGFP, MIS-DGFP,
understand which data are needed and what WHO, UNICEF, UNFPA, JICA, SAVE, USAID,
kind of technology can support those data. Plan International, icddr,b, BRAC, CIPRB,
etc. The UNICEF further expanded the COIA
Human resources are essential to the development model to local-level planning to facilitate
of measurement and accountability systems: overall improvement of health situation at
Leadership, ownership, political will, and the district and upazila levels through using
collaboration are the key factors behind the government healthcare platform. The
Bangladeshs achievement. Both human evidence is being generated through the
elements and technology are essential to the same national HMIS portal based on DHIS2.
development of large systems for health- The unique feature of the COIA model is
related measurement and accountability. tracking of individuals; community health
Introducing new technology where systems workers; the community clinics register every
are already in place can be challenging; pregnant woman and under-five child living

CHAPTER 17: HEALTH INFORMATION SYSTEM: eHEALTH AND MBT
in the respective community catchments Planning Officers (UH&FPO) to analyze MNCH

through DHIS2. A routine weekly meeting is and NCD-related data, understand the issues,
being held in the community clinic where and plan realistically for the next period.
the government community health workers
(CHCP, HA, and FWA), NGO healthcare Giving more priority on NCD-related issues,
workers, and members of the community the COIA Secretariat, in consultation with the
clinic management committee and community national experts on NCDs from both public
support group review the local maternal and and private health institutions and on clinical
child health data; if required, they clean and aspects, such as the Non-Communicable Disease
further update these data, make intervention Control (NCDC) program of the Directorate
plan for the next week, and implement the General of Health Services (DGHS), MIS-DGHS,
plan. This routine cycle continues to track, DGFP, IEDCR, WHO, UNFPA, NHFH&RI, NICRH,
follow up, and improve maternal and child NCCRF&HD, NIPSOM, NIMH, BUHS, icddr,b etc.)
health situations. As the WHO-HQs support developed data-collection tools and guideline to
was extended through a catalytic seed fund collect NCD-related data from the community.
for the COIA Secretariat, it was a concern how Data-entry on NCD-related issues has been started
to sustain the growing momentum of the from August 2016 as a pilot process and soon will
COIA program in Bangladesh. The Joint Donor be started nationally in full scale.
Technical Assistance Fund (JDTAF), which With an aim to ensure quality of data,
provides technical assistance for HPNSDP 2011- completeness of reporting, and timeliness of
2016 of the MOHFW of Bangladesh, came as a data, the COIA Secretariat conducts regular
rescue for the period until the end of HPNSDP monitoring visits to the community clinics
2011-2016. However, given the context of and provides hands-on training to the service
high morbidity and mortality burden of non- providers and respective upazila statisticians. Two
communicable diseases in Bangladesh, JDTAF national guidelines on the use of information
also proposed to include community-based and data quality assessment are also at the
NCD interventions into the COIA program as a end of development process that will be utilized
requirement for funding support; For operating by health managers, monitoring authorities,
the COIA Secretariat on behalf of the MOHFW and service providers. The COIA Secretariat has
and implementing the extended COIA program also prepared dashboard for respective health
for two focusesMNCH and NCDsicddr,b was managers, implementers, policy-makers, and other
selected as the contractual partner. development partners with an aim to increase
From July 2015 to October 2016, major the use of health information for better decision-
accomplishments of COIA Secretariat in making and program planning. The project
Bangladesh are as follows: is heading towards its endline; however, it is
extremely important to continue the momentum
With the assistance of the COIA Secretariat, now created by the COIA Secretariat in Bangladesh.
around 90.5% community clinics are providing
online data on pregnant women and under-five
children in DHIS2, where community health
With an aim to ensure quality
workers and community clinics are assigned of data, completeness of
to register every pregnant woman and under-
five child living in the respective community
reporting, and timeliness of
catchments. Although online data are still less, data, the COIA Secretariat
compared to the number of services entered in the
register, enrolment of both maternal and under- conducts regular monitoring
five children significantly increased. visits to the community
During May-June 2016 and September-October clinics and provides hands-
2016 periods, about 1,350 health managers
and statisticians from the division, district on training to the service
and upazila levels received HMIS training,
which would help the Divisional Directors,
providers and respective
Civil Surgeons, and Upazila Health and Family upazila statisticians.
Piloting Shared Health Recordsplatform for Memorandum of Understanding with A2I of
citizens electronic health records the Prime Ministers Office
A platform for maintaining life-time electronic A Memorandum of Understanding (MoU) was

health records of all citizens, designated by signed on 12 July 2015 between the Ministry
the MIS-DGHS as the Shared Health Records of Health and Family Welfare and the Access to
(SHRs), has been deployed in two hospitals. Information (A2I) project of the Prime Ministers
These are Kaliganj Upazila Health Complex, Office to expand effective collaboration between
Gazipur and Gazipur District Hospital. This the two parties with respect to promotion of
platform of the Shared Health Records has digital health information in the country. The
been developed as the initial step toward priorities at the short-term have been identified
introducing universal electronic health to focus on scaling-up of the platform of Shared
records in the country. However, it also has Health Records, development of an electronic
future potential to contribute in other fields platform for nationally-managed appointments
from at least two perspectives. One of the with health service providers, development of
perspectives is the release of a global reference a GIS-supported system for finding and calling
list of 100 core health indicators by the WHO ambulance located at the best nearby location
and other members of the International anywhere in the country, promoting eLearning
Health Partnership. This list is minimal but system in healthcare, and provision of technical
comprehensive to allow collection of health assistance to improve the quality of service of
data for measuring progress of different health the planned health call center of the MIS at the
targets proposed in the post-2015 Sustainable Directorate General of Health Services.
Development Goals (SDGs), inclusive of those
for universal health coverage (UHC). Another Local Health Bulletins and Annual MIS
Conferences 2016
perspective is the global drive toward promoting
establishment of universal civil registration and Online Local Health Bulletins published by
vital statistics (CRVS) system in the countries. different health organizations, beginning since
The Government of Bangladesh is also pushing
the CRVS agenda forward. The SHR platform,
due to its plan to register and track every citizen
for health encounters, routine check-ups, and
surveillance, is best suited for measurement of
progress of UHC and health in the SDGs as well
as for linking to CRVS, especially for notification
of birth and death to the National Birth and
Death Registration Authority and capturing data
on cause of death. The days to come will say
how far the SHR platform is contributing to this
ambitious vision but the preliminary feedback
from the pilot project is encouraging. We
acknowledge that DFID is providing technical
assistance to the development of this platform.
A platform for maintaining

life-time electronic health
records of all citizens,
designated by the MIS-DGHS
as the Shared Health Records
(SHRs), has been deployed in
two hospitals.
Screenshot of the cover of a Local Health Bulletin 2015

fiscal 2011-2012, are much appreciated. The NGOs, DPs, and urban health dataset managed
number of organizations that published online by DMIS as well as financial data for annual
Local Health Bulletins in fiscal 2014-2015 is 630 development program are also being received
(www.dghs.gov.bd >> data). As a convention, by the national HMIS. Besides, administrative
the online Local Health Bulletins are presented and service-related data from IEDCR, IPH,
by the heads of respective organizations, NIPSOM, DGFP, DGDA, DNS, and a number
where health managers, MIS focal points, and of government and private organizations have
statistical staff, along with technical experts been collected and also summarized in Health
from the MIS-DGHS, development partners, and Bulletin 2016.
major NGOs remain present. Open discussion,
New photo album added to the social media
critical analysis, and feedback follow after each
portals of the DGHS
presentation. In May-June 2016, eight annual
MIS conferences were heldseven in the seven The DGHS web portal is increasingly better
divisional headquarters for hospitals and serving as a popular platform for information
organizations at the division level and below, dissemination. The major social media portals,
with the eighth at the MIS-DGHS, Dhaka, for viz. Facebook, Twitter, Google+, YouTube,
the tertiary-level hospitals. In the annual MIS etc. are also used as channels for information
conference for tertiary hospitals, Mr. Zahid dissemination. It is estimated that over half a
Maleque, MP, Honorable State Minister for million visitors come every month to see one
Health and Family Welfare was present as Chief or more component(s) of the integrated web
Guest in the inaugural session, with Professor portal. In 2014, an electronic photo album has
Dr. Deen Mohd. Noorul Huq, Director General been added, which has now become the living
of Health Services as the Special Guest. Among archive of pictures on health programs being
others, Prof. Dr. Samiul Islam, Director (Hospitals run throughout the country.
and Clinics) and Dr. Ehtemshamul Haque
Choudhury, Director (Administration) of the Publications and dissemination of information
DGHS spoke in the inaugural session. Professor The successes and various elements of digital
Dr. Abul Kalam Azad, Additional Director General progress of the MIS-DGHS have been discussed
(Planning & Development) and Director (MIS) in well over 20 international events between
made a presentation in the inaugural session to 2014 and 2015. Nationally, there were also
highlight the findings of Local Health Bulletins many more similar events where the current
of all tertiary-level public hospitals. progress, lessons learnt, challenges, and future
Monthly and annual reporting for Cabinet potentials have been discussed. The information
Division and statistics generated were also disseminated
through web and social media portals, online
Routine monthly and annual reports are national and Local Health Bulletins, printed
submitted by the MIS-DGHS to Cabinet Division health bulletins, newsletters, manuals, modules,
of the Government of Bangladesh, using a and other publications. Annual MIS conferences,
standard proforma. Exhaustive information seminars, training courses, workshops, and
items on the overall health sector is provided in meetings have also serve as channels for
these reports. information dissemination.
Data-collection and use Remarkable improvement of dashboards
Collection and use of data through DHIS2 on The MIS-DGHS has recently given more
the Shared Health Records have been further attention to improving quality and use
improved, and technical experise has been of data after satisfactory improvement in
scaled up among different development partners platform of the foundation work. For this
and organizations through providing training. reason, user-friendly dashboards are being
Data from community clinics and programs, like created for advocacy programs with the
MNCAH, IMCI, EPI, TB, NCDs, communicable help of development partners and research
diseases, HIV/STD, nutrition, COIA, cervical organizations. The dashboards give importance
cancer and breast cancer screening, obstetric to visualization, including increase in the use
fistula screening and care program are being of geospatial data. Further development in this
flown to the national HMIS. Data from DGFP, area is expected in the coming days.

eMIS: digitizing health services through (HAs) and Family Welfare Assistants (FWAs
innovative approaches belonging to DGFP). All 12 upazilas of
Tangail and 2 upazilas of Habiganj district
Digital strategies are entrenched in the work have been covered. As on 31 October
of MIS-DGHS as it vigorously pursues the goal
2016, the community health workers
of Digital Bangladesh. It also provided a great
have successfully registered 3.4 million
springboard for launching eMIS solutions. Four
individuals. The population data are used
implementing partners of USAID (MEASURE
for identifying the individuals and building
Evaluation, icddr,b, MaMoni HSS, and SIAPS)
their service history.
joined together to develop and implement
comprehensive electronic software solutions Community and facility modules are
for the use by rural community health workers intended for covering all activities of HAs.
in the public sector. These organizations had It includes immunization and other services
worked previously with the DGHS and DGFP provided by HAs, such as maternal and
to improve paper-based registers and MIS- newborn care, care for under-five children,
forms to generate reliable information on time, limited preventive care, etc. by household
streamline MIS tools to minimize information visits or at the EPI sessions and community
gaps and duplication, and reduce the burden clinics.
of data collection and compilation. In due
course, it was intended to improve the use of Administrative modules address the need
information at the local level and promote of inspection and supervisory work of
evidence-based decision-making in the health, AHI and HIs who act as supervisors to the
population and nutrition (HPN) sector. Such community-level workers as HAs. These
experiences were elaborated in comprehensive modules allow approval of workplan and
digitization efforts initially at the community communication with supervisors. The
and facility levels through Routine Health supervisors can plan for inspection of
Information Systems (RHIS), now known as areas and individuals and monitor the
eMIS or electronic Management Information work of the HAs as recorded in their job
Systems. descriptions.
Organizations under the MOHFW have All service-related data could be saved instantly
increased investment in hardware and are and later updated into a central database. It
continuously improving the use of software. is also possible to work offline and sync data
Mobile technology and improvement in later if Internet connection is problematic. The
connectivity have opened up windows for field workers need not spend time for filling up
collection of population-based data through the forms. Thus, their work becomes entirely
routine health information systems. The paperless. This improves the quality of work. It
demonstration phase of eMIS that started would be possible to measure performance and
in January 2015 addresses institution-wide increase accountability.
digitization, the scope of which is very
comprehensive. It started with digitizing the The community health workers were given
work of field-level workers in rural areas. The training to perform their work. The skills
eMIS tools are being implemented in two required are easy to acquire. There is a close
districts: Tangail and Habiganj. The eMIS tools interaction among the DGHS and the DGFP
are arranged in several layers: on development of modules, and the district
and upazila officials are providing leadership
Population Registration System (PRS): It
in the efforts. On the basis of experience of
performs census of the catchment area
demonstration phase, a national roll-out plan
of the CHWs effectively. Population
and a training plan would be prepared.
registration using PRS app on tablet PC
was introduced in March 2015. It is based The MOHFW is currently in the process
on GR or geographical reconnaissance of finalizing the 4th sector-wide program.
yearly conducted by the DGHS till 2010 to It is happening in the era of SDGS, with
collect demographic information for health requirement of tracking the services provided
service delivery and planning. Registration to the individuals, and there is emphasis on
work is performed by the Health Assistants measurement and accountability at all levels.

A health assistant registering a woman App mimics existing EPI card
National scale-up of eMIS solutions would make high Internet bandwidth, large screen display,
the MOHFW well-prepared for these tasks as it good-quality telemedicine camera, and
would make it possible to count all with any telemedicine peripherals, like telestethoscope,
level of disaggregation. teleECG, telemicroscope, teleglucometer, etc.
The first few advanced telemedicine centers were
Telemedicine services established in fiscal 2009-2010 in 8 hospitals
Telemedicine services are provided by the and were formally inaugurated by Honorable
MIS-DGHS in various forms, which include Prime Minister Sheikh Hasina on 6 July 2011.
mobile phone-based health service, advanced Subsequently, similar telemedicine centers were
telemedicine, and Skype-based teleconsultation. expanded to 34 additional hospitals. To support
Between 2014 and 2015, all platforms have seen expansion of advanced telemedicine service to
expansion. The mobile phone-based health over 20 new hospitals, the Ministry of Science
service was introduced in 2009 in 418 upazila and Technology is currently working with the
MIS-DGHS.
health complexes and 64 district hospitals (in
total 482). Each hospital has a mobile phone to In addition to mobile phone-based health
be carried round-the-clock by an on-duty doctor. service and advanced telemedicine, Skype-based
People living in the catchment areas call the teleconsultation is also pursued. All functioning
doctor, if need arises, and the doctor answers to community clinics (~13,000) and all union
give appropriate medical advice free of charge. health centers (~1,275) have been brought
Due to simplicity and no cost involvement for under coverage of Internet connectivity through
operation, the community healthcare providers provision of one laptop and one broadband
(CHCPs) have been advised to provide similar wireless Internet modem in each. In community
health service using their own mobile phone for clinics or most of the union health centers,
the people living in the respective community no qualified doctor is posted. However, there
catchments. The mobile phone-based health may be occasions when some patients need to
service received recognition through ICT4 consult a more qualified medical practitioner. In
Development Award (2010) and special mention such cases, a Skype video-conferencing can be
in Manthan India Award (2011). set up to hook the community clinic or union
health center to a doctor sitting in the nearby
An advanced telemedicine service which is upazila hospital to have a direct conversation
currently being provided from 42 hospital- between the patient and the doctor. The laptop
based centers across the county has also been computers in the community clinics and
introduced by the MIS-DGHS. Additional 15 union health centers are also being used for
telemedicine centers were under consideration multiple purposes, viz. telemedicine, updating
by the end of 2015. These telemedicine centers community health data, health education to
are considered advanced because these use people, training of health staff, monitoring of

clinic operation time, email communication, create opportunity for doing remote meetings,
and Internet-browsing. The National ICT4 conferences, training, etc., thus minimizing
Development Award in 2011 was won for the travel requirement.
telemedicine project of MIS-Health.
An additional monitoring tool based on citizens
complaints:The Third Eye
In addition to mobile phone- The SMS-based complaint-suggestion box
continues to remain as the innovative and
based health service and effective mechanism to know citizens feedback
advanced telemedicine, on the quality of service in the public hospitals.
This system is frequently recommended for
Skype-based teleconsultation further promotion to improve accountability
is also pursued. and transparency of public hospitals. This
system is working in about 800 public hospitals
and health organizations. In each of these, a
Video-conferencing display board is mounted on the wall (Figure
17). The display board describes how to
Procurement order, on behalf of the MIS-
send complaints about quality of services or
DGHS, has been placed, in fiscal 2014-2015,
suggestions for improvement of services. Clients
by the Central Medical Stores and Depot to
of the hospitals or health organizations make
install 77 video-conferencing system in 77
complaints or suggestions in the form of SMS
strategic locations (MOHFW. DGHS. DGFP,
to a particular mobile number. A web server
offices of 7 division directors and 65 civil
located at the MIS-DGHS receives the complaints-
surgeons. Once launched, the system will
Figure 17. Example of some complaints excerpted from the DGHS web portal
suggestions, and these are instantly displayed complaint in Bangladesh and many other
on the web portal; some details also go for public countries. To track the office attendance of
viewing. Responsible staff members at the MIS- government health staff in workplaces, the MIS-
DGHS check the complaints and suggestions DGHS installed remote biometric time-attendance
and talk to the SMS senders to know more about machines in all upazila and district hospitals and
the message. The staff members then talk to the in some tertiary hospitals. These are low-cost
local or other responsible authority to solve the fingerprint biometric machines, and the recorded
problem or work on the suggestions .The public touch-encounter scan can be tracked from central
view of the complaints-suggestion box is available office with the help of software developed locally.
at www.dghs.gov.bd>>Data >>Complaint & During installation, staff members fingerprints
Suggestion Box. were recorded in the database. Every day, the staff
members need to touch the sensor of the machine
Monitoring of staff attendance through
during their check-in and check-out. The machine
fingerprint machines in remote public hospitals
itself can keep in memory 30,000 encounters.
Absenteeism from workplace, particularly from Connected to a local computer through USB cable,
the remotely-located workplaces, is a common the machine becomes empty of touch-records

through transferring the same to the computer Bulk SMS

when the latter is switched on. At the MIS-DGHS, a
web server captures the attendance data whenever Introduced in 2009 by the MIS-Health, an
the server finds the local computers switched on innovative bulk SMS system remains as an
and connected to Internet for any purpose. Pre- effective solution to disseminate quick and
defined web-based reports can be generated on the urgent messages to health staff. The use of bulk
server-side, which can be accessed through web- SMS was frequent and demand-driven. For the
browser from any place. bulk SMS system, mobile phone numbers of all
health managers and staff members down to the
grassroots level were collected and grouped. One
To track the office attendance or multiple group(s) can receive customized text
of government health staff messages instantly.
in workplaces, the MIS-DGHS Digitally-managed medical and dental admission

tests
installed remote biometric
time-attendance machines For both public and private medical and dental
colleges of Bangladesh, the digitally-managed
in all upazila and district medical and dental admission tests were
hospitals and in some tertiary started in 2001, and the system still continues.
Admission-seekers submit applications online by
hospitals. using electronic forms. The system then checks
and authenticates prerequisite educational
MAMA and the multipurpose round-the-clock
qualifications from secondary and higher
health call center
secondary school examinations databases.
A multipurpose health call center, launched by Students then submit test-fees by mobile phone
the MIS-DGHS in September 2015, is round-the top-up. On successful fee submission, a text
clock (24 hours all 7 days a week) call center, alert informs the students for collecting the
with support from DFID and is being operated admit cards from a specified website. Locations
through a professional company. A short calling and seating plans for students admission tests
code 16263 is being used for receiving calls are also managed and informed digitally. The
and text messages from the clients. The call answer-sheets of examinations use OMR (optical
center is providing live health counseling, mark reader) technology. After the examination,
complaints management, and content delivery. all the answer-sheets are transported to Dhaka
A partnership program is also being operated the same day from all over the country. The next
with D.Net to provide an mHealth service called day, all answer-sheets are read by OMR machine,
MAMA (Mobile Alliance for Maternal Action). and results are prepared with intelligent software
MAMA Bangladesh uses a short code 16227 and to inform the eligible candidates about which
provides lifesaving information on pregnant institutions they qualified for admission. Results
and new mothers, including also advice for their are sent to students mobile phone numbers and
newborn babies and children through SMS, also published through website on the same day
IVRs, and direct counseling. This program is or the next day.
supported by USAID, partnered by Smiling Sun
Clinic, and Save the Children, and coordinated
by Abt Associates and D.Net. The MIS-DGHS For both public and private
is also actively working with Johns Hopkins
Bloomberg School of Public Health to develop
medical and dental colleges
and implement mCare (for pregnancy care) and of Bangladesh, the digitally-
mTika (for immunization) to track pregnant
mothers and under-five children in Gaibandha
managed medical and dental
district of Bangladesh. In 2011, a global admission tests were started
competition arranged by mHealth Alliance of
the United Nations Foundation recognized in 2001, and the system still
mCare project as one of the top 11 innovations
of the world.
continues.

Automation of hospitalization processes Technical partners
Automation of hospitalization processes will Along with the MOHFW, other technical partners
soon be started in two new hospitals (DMCH assist the MIS-DGHS. to make technology-related
and NINS), for which supply of ICT equipment solutions, training, and capacity-building; these
is in the pipeline. These are in addition to include A2I Project, World Bank, WHO, UNICEF,
the earlier hospitals that started automation DFID, UNFPA, Rockefeller Foundation, JICA,
functions, viz. National Institute of Kidney USAID, icddr,b, Measure Evaluation, CIDA,
Diseases & Urology (NIKDU); Government UNESCAP, JPGSPH-BRAC University, BRAC, JHU,
Employees Hospital; Azimpur Maternity MSH (SIAP), Save the Children, D.Net, CIRPB,
Hospital; Bangladesh Secretariat Clinic; National CARE Bangladesh etc.
Institute of Traumatology, Orthopedics and
Rehabilitation (NITOR); and National Institute Medical Biotechnology (MBT)
of Cardiovascular Diseases (NICVD). However, Medical biotechnology (MBT) is the third
the real expansion of automation for the component of HIS and eHealth operational
reasonable number of hospitals will be seen plan.
through scaling-up of the Shared Health Records
as explained earlier. Medical biotechnology is the use of living
cells and cell materials to research and
Digital training facility and connectivity as other produce pharmaceuticals and diagnostic
eHealth initiatives products that help treat and prevent diseases.
Including an auditorium created by the MIS- Two modern technologies that are currently
Health in 2009, the digital training facility was reshaping worldwide have opened window
efficiently used over the past years. Its attraction of opportunities for development and
as one of the best meeting and seminar places include IT (information technology) and BT
continues to increase. Equipped with state-of-the- (biotechnology). IT had a head start earlier and
art gadgets, such as digital podium and sound has flourished to become a part of our daily life.
system, interactive board, wireless presentation, On the other hand, biotechnology is quite new
wi-fi network, video-conferencing, etc., the but is quickly expanding as a promising tool
facility attracts several organizations to hold for developing a nation as well as the world.
their workshops, meetings, and symposia. The Experts predict that the 21st century will be
MIS-DGHS is still in the forefront in spreading the one of biotechnology, and the effect of
Internet connection all over the country, which biotechnology will be enormous compared to
now extends down to the grassroots-level the effect of IT.
health facilities and workers (all union health Among the many branches of biotechnology,
centers, community clinics, and community red biotechnology or medical biotechnology
health workers).The union health centers and is the area of our interest as tremendous
community clinics have laptop computers development in this sector around the globe
and wireless modems, and the community has enabled scientists to understand more about
health workers have android tablets. To ensure
appropriate support for the HIS and eHealth
solutions, a robust, highly-secured, and never-
sleep data center with plenty of storage space
has been put in place. A world-class state-of-
the-art data center, equipped with RAID servers,
firewalls, VMware, underground cable system,
automatic fire protection and humidity control,
four tiers of power supply system, anti-spy and
anti-hacking system to prevent unauthorized
entry, remote monitoring system, text alerts by
mobile phone, etc. exists in the MIS-DGHS. In
Khulna, an area not prone to earthquake and
located 300 km away from Dhaka, there exists a
Medical biotechnology laboratory at the Center for Medical
disaster-recovery center also. Biotechnology at the Institute of Public Health

disease processes and cure the patients in more Biotechnology at the Institute of Public Health.
accurate and effective ways. Current prospect National Guidelines on Medical Biotechnology
of medical biotechnology depicts its economic 2010 includes guidance to implement
growth larger than the combined economic provisions in the National Biotechnology
growth of all other aspects of biotechnology. Policy and describes deliverables for short,
Important sectors of medical biotechnology are medium and long-term goals. To implement
pharmaceutical products, vaccines, newer and these goals, Medical Biotechnology Program
more accurate diagnostic techniques, such as was included in HIS and eHealth operational
polymerase chain reaction (PCR), monoclonal plan of the HPNSDP 2011-2016. Subsequently,
antibodies, transgenic animal, microarray nano- the Center for Medical Biotechnology (CMBT)
medicines, bioinformatics, and many others. began an inclusive effort in cooperation with
ideSHi (Institute for Developing Science and
The Government of Bangladesh has shown Health Initiatives) and relevant stakeholders
interest in using medical biotechnology for for capacity-building. Till today, over 1,500
development in health and nutrition sectors stakeholders, professors, physicians, journalists,
and has developed the first National Guideline entrepreneurs, scientists, and members
on Medical Biotechnology in 2006. Later, of Medical Curriculum Committee were
the guideline was revised and republished as trained through various training sessions and
gazette on 21 December 2010. Six successive workshops, including core committee meeting,
meetings of the National Technical Committee consultative workshop for updating medical
on Medical Biotechnology (NTCMB) were curriculum, training workshop for journalists,
held between 2004 and 2012, on direct sensitization workshop and a 14-day hands-on
recommendations of the National Executive training for teachers and scientists. MBT-related
Committee on Biotechnology (NECMB) and books were distributed among the medical
supervision of the National Taskforce on university, medical colleges, and other health
Biotechnology of Bangladesh (NTBB), with science institutions, and necessary equipment
Honorable Prime Minister as Chair that ended for biotechnology labs were distributed among
up with the establishment of Center for Medical different institutions.
CMBT has conducted several activities in 2015-2016 sessions as follows:
1. Training/workshops on medical biotechnology supported by HPNSDP (2015-2016) fund:
Duration Participants
Type of training/workshop Venue Batch (No.)
(day) (No.)
Hands-on training for medical teachers and

Dhaka 14 4 40
scientists
Training/workshop for medical teachers Dhaka 2 5 150
2. An equipment set of 23 instruments relating properly and to provide diagnostic

to medical biotechnology has been supplied services to people.
to 4 medical colleges: Sir Salimullah Medical
College; Rajshahi Medical College; MAG 4. Local Medical Biotechnology Unit has been
Osmani Medical College, Sylhet; Chittagong formed with a separate laboratory, including
Medical College; and two institutions: necessary equipment in 12 medical colleges,
CMBT-ideSHi and National Institute of which will serve both academic and clinical
Preventive and Social Medicine. purposes.
3. Local Medical Biotechnology Committee 5. Development Project Proforma has been

comprising 6 members has been formed completed and submitted for conversion
in 12 medical colleges to build their of the Center for Medical Biotechnology to
capacity through hands-on training and National Center for Medical Biotechnology
motivation for running related activities as a center of excellence where academic

and clinical services will be provided to 6. Academic pursuits of PhD students doing
develop our national capability in this sector their theses at CMBT in collaboration with
and take it to the level of international ideSHi:
competition.
Name Designation Title of thesis
Assistant Professor, Development of non-invasive diagnostic

Dr. Nusrat Sultana Department of Virology, method for prenatal diagnosis of Down
Dhaka Medical College Syndrome and thalassemias
Profiling of cutoff values of amino acids and

Suprovath Kumar
Research Fellow, ideSHi acylarnitines for universal screening of inborn
Sarker
errors of metabolism
7. Diagnostic services provided by CMBT in collaboration with ideSHi:
Title No. of services provided

Glucose-6-phosphate dehydrogenase deficiency 121
diagnosis
Basic metabolic screening (Inborn Errors of 139
Metabolism diagnosis)
8. Current research projects going on at CMBT in collaboration with ideSHi:
Sl. Title of research

Prevalence of acute respiratory and enteric infection among under-five children in two
1.
hospitals in Dhaka
Genetic analysis and clinical patients with suspected hereditary neurodegenerative disorder in
2.
Bangladesh
Study of common mutation determination of glucose-6-phosphate dehydrogenase deficiency
3.
in children in Bangladesh
4. Typhoid diagnostics for measuring disease burden-supplement study
Collaborative management platform for detection and analysis of re-emerging and food-borne
5.
disease outbreaks in Europe (COMPARE)
Innovative approaches for development of diagnostic methods for detecting IEM and genetic
6.
disorders using high throughput metabolomics profiling as well as monoclonal antibody
7. Strategic Typhoid Alliance across Africa and Asia
8. Foodborne illness surveillance
9. Scientific papers published in international journals from CMBT in collaboration with ideSHi:
Title of article Name of journal

Examination of Huntingtons disease with atypical clinical features Wiley Publishing Group
in a Bangladeshi family tree-clinical case report
Molecular analysis of glucose-6-phosphate dehydrogenase enzyme PLOS ONE
deficiency in Bangladeshi individuals: screening of deficiency
using both qualitative and quantitative enzyme assay methods and
detection of mutations in gene performing sequencing

Capacity improvement and maintenance staff. Other staff members are also being trained
to play their roles in real-time data-entry at the
Human resource for HIS and eHealth source of data. The distribution of 785 statistical
There are 785 sanctioned posts of statistical staff staff members by type of organization is shown
throughout the country. These staff members in Table 17.1. By class category, the distribution
are already made skilled through training and of these sanctioned posts is as follows: Class
engagement in practical work since 2009. These I (122, 15.54%); Class II (17, 2.17%); Class III
personnel are used as dedicated HIS and eHealth (636, 81.02%); and Class IV (10, 1.27%).
Table 17.1. Distribution of sanctioned posts of HIS and eHealth staff by type of organization and their vacancy situation (June 2015)
Upazila
District Postgradu- TB clinic at
hospital Divisional Medical 100- to
Staffing civil MIS- ate teaching Chankhar
and health DGHS college 300-bed Total
situation surgeons DGHS institute and Pool of
health office hospital hospitals
office hospital Dhaka city
office
Sanctioned 483 120 92 23 20 8 17 21 1 785

posts 61.53% 15.29% 11.72% 2.93% 2.55% 1.02% 2.17% 2.68% 0.13% 100.0%
Existing
365 61 40 20 12 6 7 11 1 523
staff
118 59 52 3 8 2 10 10 0 271
Vacant
24.43% 49.17% 56.52% 13.04% 40.00% 25.00% 58.82% 47.62% 0.0% 33.38%
Training, workshops, and seminars another 800 and 2,212 personnel participated
respectively. It may be mentioned that some
Several types of training courses, workshops, participants might have attended more than one
and seminars of different durations were held
training, workshop, or seminar.
in 2014-2015 both at the MIS-DGHS office
in Dhaka as well as at the local hospitals/ Supply of ICT equipment and computer
health offices. A total of 29,149 officers and stationeries
staff members participated in the training
courses, workshops, and seminars held under Table 17.2 provides information on different
the HPNSDP (2011-2016). In the WHO- types of hardware and machinery procured and
and UNICEF-supported training programs, distributed from 2011-2012 through 2014-2015.
Table 17.2. Hardware and machinery procurement from fiscal 2012-2013 through 2015-2016
FY 2012- FY 2013- FY 2014- FY 2015-
Hardware Distribution
2013 2014 2015 2016
1,725 Hospitals, health offices, academic and
Desktop
4,360 6,000 - (All-in-one training institutions from upazila to the
computer
desktop) national level across the country
FY 2011-2012: To 3,465 com-
munity clinics
FY 2012-2013: To union health
Laptop facilities and to the remaining
12,471 2,000 - -
computer functional community clinics
FY 2013-14: To newly-functional
community clinics and other
health facilities and organizations
UPS (offline Accompanies one for each
4,000 6,000 - 1,500
- 600 VA) desktop computer
Contd.

Table 17.2 Contd.
FY 2012- FY 2013- FY 2014- FY 2015-
Hardware Distribution
2013 2014 2015 2016
Tablet To community healthcare pro-
84,00 10,000 - 4,025
device viders (HA, HI, and AHI)
Equipment
for tertiary-
NICVD DMCH
level
and and - - -
hospital
NITOR NINH
automa-
tion
FY 2009-2010: 8 telemedicine
centers established in 8 hospi-
tals and 1 coordination center
at the MIS-DGHS
Equip- FY 2011-2012: 10 additional tel-
ment for emedicine centers in 10 hospitals
telemedi- FY 2012-2013: 10 additional
cine cent- 10 15 15 10 centers in 10 hospitals
ers and
FY 2013-2014: 15 more centers
peripher-
in 15 hospitals
als
FY 2014-2015: 15 more centers
in 15 hospitals
FY 2015-2016: 10 additional
centers in 10 hospitals
FY 2011-12: Data center at the
MIS-DGHS established
FY 2012-2013: Disaster recov-
Disaster Upgrad- ery service (DRS) center in
Data recovery ing the Upgrading Khulna established
center service existing the existing - FY 2013-2014: Data center and
equipment center at data cent- data centers disaster-recovery service center
Khulna ers upgraded
FY 2014-2015: Data center and
disaster recovery service center
upgraded
Equipment
for research,
development FY 2014-2015: Total: 6, one
Medical
and innova- each in 4 medical colleges,
biotech-
tion activities - BSMMU, and CMBT-ideShi
nology
on molecular Laboratory
equipment
biology and
genetic diag-
nosis
Installation
Equip-
Installa- of LAN in 32
ment for
tion of LAN civil surgeon FY 2014-2015: All UHCs and
Local Area
in health offices and district-level hospitals
Network-
facilities 11 tertiary
ing (LAN)
hospitals
Printer - - - 3,450 -

Table 17.3. Number of desktop and laptop computers, monitors, printers, UPSs, and PDAs repaired
in FY 2014-2015 by the MIS-DGHS
Institution CPU Laptop Monitor Printer UPS PDA Total
DGHS 76 37 12 73 18 10 226
Specialized institutes 19 13 8 15 0 0 55
Civil surgeons 28 47 10 31 3 33 152
offices
District hospitals 12 16 5 11 5 7 56
Upazila hospitals 29 280 16 51 10 392 778
Total 164 393 51 181 36 442 1,267
Repair and maintenance of computers, printers, and other accessories
The MIS-DGHS repaired 1,267 CPUs and laptop computers, monitors, printers, UPSs, and PDAs. Table
17.3 summarizes the information.

Chapter Allocations distributed among 17 operational plans of DGHS
18 FINANCING HEALTHCARE
In fiscal 2015-2016, the total allocation under

revised annual development program (RADP)
for the Directorate General of Health Services
(DGHS) was BDT 238,508.00 lakh.
The Health, Population and Nutrition Sector Development Program (HPNSDP) 2011-2016 provided
development budget of the Ministry of Health and Family Welfare (MOHFW) and its agencies. In fiscal
2015-2016, the total allocation under revised annual development program (RADP) for the Directorate
General of Health Services (DGHS) was BDT 237,590.00 lakh. This allocation were distributed among
17 operational plans of the DGHS as per respective work plans.
Table 18.1 shows the allocation, expenditure, and 2011-2016 fund against different operational plans of
utilization in FY 2015-2016 (revised ADP) of HPNSDP the DGHS. Detailed breakdown is shown in the Annex.
Table 18.1. Allocation, expenditure, and utilization in FY 2015-2016 of HPNSDP 2011-2016 fund
against different operational plans of the DGHS
Allocation Expense Utilization
Program
(BDT in lakh) (BDT in lakh) rate (%)
Maternal, Neonatal, Child and Adolescent Health 57,788.00 48,145.19 83.31
Essential Services Delivery 11,500.00 4,510.00 39.22
Community-based Healthcare 25,000.00 18,046.76 72.19
TB and Leprosy Control 13,250.00 9,242.75 69.76
National AIDS/STD Program 3,950.00 2,549.34 64.54
Communicable Diseases Control 14,000.00 12,674.27 90.53
Non-communicable Diseases 4,173.00 2,714.22 65.04
National Eye Care 432.00 333.18 77.12
Hospital Services Management & Safe Blood Transfusion 51,700.00 46,395.68 89.74
Alternative Medical Care 3,500.00 3,132.56 89.50
In-service Training 3,100.00 2,413.68 77.86
Pre-service Education 17,500.00 17,215.70 98.38
Planning, Monitoring, and Research (Health) 400.00 392.18 98.04
Health Information System and eHealth 6,600.00 6,551.75 99.27
Health Education and Promotion 3,200.00 2,232.28 69.76
Procurement, Logistics and Supplies Management 12,597.00 11,640.84 92.41
National Nutrition Services 8,900.00 4,444.78 49.94
Total OPs of DGHS 237,590.00 192,635.16 81.08

CHAPTER 18: FINANCING HEALTHCARE
Figure 18.1 shows the allocation and (BDT 80,547.03 lakh), and that of RPA fund
expenditure (in lakh taka) against operational (RPA-GOB plus RPA-others) was 86.61% (BDT
plans of the DGHS in fiscal 2015-2016 under 136,422.47 lakh out of BDT 157,517.00 lakh).
HPNSDP. The RPA (GOB) fund utilization rate was 86.88%
(BDT 100,243.28 lakh against allocation of BDT
As of June 2016, the total expenditure was
115,382.00 lakh). RPA (others) fund utilization
BDT 192,635.16 lakh, the utilization rate
being 81.08%. Of the total RADP allocation, rate was 0.14%. In fiscal 2014-2015, the overall
the GOB fund was BDT 80,991.00 lakh. The fund utilization rate was 80.43% (GOB: 97.03%;
utilization rate of the GOB fund was 99.45% RPA: 77.00%; RPA-GOB: 76.36%; RPA-others:
Figure 18.1. Allocation and expenditure (in lakh taka) against operational plans of the DGHS
in fiscal 2015-2016 under HPNSDP (values in parentheses show % of fund utilization against
allocation)
237,590.00
192,635.16
Allocation Expenditure
157,517.00
136,422.47
115,382.00
100,243.28
80,991.00
80,547.03
465.00
0.67
Total = GOB RPA (total) RPA (GOB) RPA (other)
(81.08%) (99.45%) (86.61%) (86.88%) (0.14%)
Figure 18.2. Fund utilization rate (%) of the DGHS operational plans in FY 2015-2016
99.27
98.38
98.04
92.41
90.53
89.74
89.50
83.31
81.08
77.86
77.12
72.19
69.76
69.76
65.04
64.54
49.94
39.22
CDC
PLSM
PSE
HSM
IST
NEC
NASP
HEP
AMC
TLC
PMR
MNCAH
NNS
CBH
ESD
NCDC
HIS & eH
Average

Table 18.2. Allocation, expenditure, and utilization in FY 2015-2016 under HPNSDP 2011-2016 for
different investment projects
Allocation Expense Utilization
Investment project (BDT in (BDT in rate
lakh) lakh) (%)
Establishment of 250 bed National Ophthalmology Inst. and
20.00 6.76 33.79
Hospital (1st Phase: 250 beds)
Upgradation of National Institute of Cancer Research and
750.00 485.99 64.80
Hospital from 50 beds to 300 beds
Establishment of National Institute of Laboratory Medicine
4,885.00 3,576.53 73.21
and Referral Centre
Establishment of Essential Drugs Company Limited, 3rd
11,615.00 5,929.72 51.05
Plant, Gopalganj
Expansion and Quality Improvement of Nursing Education 2,405.00 1,314.64 54.66
Conversion of BSMMU to a center of excellence 6,862.00 6,191.65 90.23
Establishment of National Centre for Cervical and Breast
210.00 206.58 98.37
Cancer Screening and Training at BSMMU
Establishment of Sheikh Sayera Khatun Medical College and
4,800.00 4,796.71 99.93
Hospital and Nursing Institute, Gopalganj
Establishment of Satkhira Medical College & Hospital 3,446.00 3,208.32 93.10
Establishment of Faridpur Medical College & Hospital 10,926.74 10,647.75 97.44
National Institute of Digestive Diseases Research & Hospital 20.00 19.07 95.35
Establishment of Kushtia Medical College and Hospital 6,003.00 5,148.05 85.76
Establishment of Shaheed Sayed Nazrul Islam Medical
12,277.00 10,581.00 86.19
College, Kishoreganj
Extension of Shaheed Sheikh Abu Naser Specialized Hospital,
1,990.00 0.00 0.00
Khulna
Establishment of Trauma Centre at Gopalganj 735.00 232.00 31.56
Sustaining Influenza Surveillance Networks and Response to
134.90 223.00 165.31
Seasonal and Pandemic Influenza in Bangladesh
Provision for equipment and professional training for Ahsania
2,000.00 2,000.00 100.00
Mission Cancer Hospital
Extension of National Institute of Orthopedic Hospital and
5,000.00 4,457.88 89.16
Rehabilitation Center (NITOR) (RADP-1)
Establishment of Nursing Institute of Pabna 607.00 606.73 99.99
Establishment of National Institute of Advanced Practice
750.00 0.00 0.00
Nurses in Bangladesh
Establishment of Sheikh Lutfar Rahman Dental College 187.58 0.00 0.00
Establishment of the Institute for Pediatric Neuro-disorder
425.00 151.80 35.72
and Autism in BSMMU
One Health FellowshipsIntegrating Education and Action for
100.46 65.73 65.43
One Health in Bangladesh
Establishment of Medical College and 250-bed Hospital in Manikganj 40.00 39.85 99.62
Establishment of National Institute of Burn and Plastic
200.00 102.84 51.42
Surgery, Dhaka
Total 76,389.68 59,992.61 78.53

CHAPTER 18: FINANCING HEALTHCARE
Figure 18.3. Allocation and expenses (in lakh taka) of 25 investment projects of the MOHFW under
HPNSDP in fiscal 2015-2016 (values in parentheses show fund utilization rate in %)
76,389.68 75,789.64 Allocation Expenditure
59,992.61 59,673.34
600.04 319.27
Total (78.53%) GOB (78.74%) DPA (53.21%)
Table 18.3. THE, GDP, and annual growth rates, 1997-2012

Total health
expenditure GDP Per-capita Ratio
(THE) of THE
Year
Amount Nominal Amount Nominal GDP THE to PPP
(Taka in growth (Taka in growth (%)
million) rate (%) million) rate (%) Taka US$ PPP $
1997 46,356 1,807,013 14,767 379 $9 $19 2.60

1998 51,101 10.20 2,001,766 10.80 16,039 409 $9 $20 2.60
1999 56,529 10.60 2,196,972 9.80 17,270 444 $9 $21 2.60
2000 62,474 10.50 2,370,856 7.90 18,519 488 $10 $23 2.60
2001 71,959 15.20 2,535,464 6.90 19,452 552 $10 $26 2.80
2002 81,488 13.20 2,732,010 7.80 20,760 619 $11 $29 3.00
2003 87,429 7.30 3,005,801 10.00 22,532 655 $11 $30 2.90
2004 100,251 14.70 3,329,731 10.80 24,628 741 $13 $33 3.00
2005 114,338 14.10 3,707,070 11.30 27,059 835 $14 $36 3.10
2006 134,873 18.00 4,157,279 12.10 29,952 972 $14 $41 3.20
2007 153,887 14.10 4,724,769 13.70 33,604 1,095 $16 $44 3.30
2008 178,943 16.30 5,458,224 15.50 38,330 1,257 $18 $49 3.30
2009 205,120 14.60 6,147,952 12.60 42,635 1,422 $21 $52 3.30
2010 244,331 19.10 6,943,243 12.90 47,524 1,672 $24 $58 3.50
2011 289,017 18.30 7,967,040 14.70 53,220 1,931 $25 $64 3.60
2012 325,094 12.50 9,181,414 15.20 60,563 2,144 $27 $68 3.50
Source: Summary Bangladesh National Health Accounts 1997-2012, BHNA Cell, Health Economics Unit, MOHFW
32.16%). Thus, the overall fund utilization was Figure 18.3 shows the allocation and expenses of
lower in FY 2015-2016. 25 investment projects of the MOHFW in fiscal
Figure 18.2 shows the fund utilization rate of 2015-2016 under HPNSDP 2011-2016. Total
different operational plans of the DGHS in fiscal allocation was BDT 76,389.68 lakh, and total
2013-2014 under the HPNSDP 2011-2016. expense was BDT 59,992.61 lakh. The utilization

rate was 78.53%. The GOB allocation was BDT 19972012 was officially published in 2015
75,789.64 lakh, and expense was BDT 59,673.34 by the Health Economics Unit (HEU) of
lakh. The utilization rate was 78.74%. The Direct the Ministry of Health and Family Welfare.
Project Aid (DPA) allocation was BDT 600.04 According to the publication, the total health
lakh, and the expense was BDT 319.27 lakh. The expenditure (THE) in Bangladesh was Taka
utilization rate was 53.21%. 325.1 billion ($4.1 billion) in 2012. It was also
Table 18.2 shows the allocation, expenditure, mentioned that, in recent years, THE grew at
and utilization rate in FY 2015-2016 under an annual average of around 14% in nominal
HPNSDP 2011-2016 for different investment terms, and, in real terms, the growth level has
projects of thr MOHFW. Detailed breakdown is been approximately 8% annually. Table 18.3
shown in the Annex. shows THE, GDP, and annual growth rates from
1997 through 2012. The original publication
Bangladesh National Health Accounts (NHA) is available in the website of the HEU at www.
The Bangladesh National Health Accounts heu.gov.bd.

ANNEX TO CHAPTER 5
Number of sanctioned beds, free beds, departments, wards, cabins, and operation theaters in some
private hospitals (arranged alphabetically), 2015
Number
Name and location of private health facility
Sanctioned beds Free beds Departments Wards Cabins Operation theaters
A K Eye Hospital, Magura 10 0 1 6 4 1
Ad-Din Medical College Hospital, Dhaka 500 290 23 15 98 7
Ahamedia General Hospital, Mymensingh 10 0 0 2 2 1
Ahsania Clinic, Debhata, Satkhira 10 0 2 2 2 1
Akota Clinic & Diagnostic Center, Rajshahi 10 1 3 3 6 1
Akota Clinic, Satkhira Sadar 10 0 2 2 2 1
Al Hera Private Hospital, Magura 10 0 0 3 4 1
Al Modina Genaral Hospital, Kishoreganj 10 0 2 2 3 1
Al Safa (Pvt.) Hospital, Mymensingh Sadar 10 0 0 2 4 1
Al Zannat (Pvt.) Hospital, Mymensingh Sadar 10 0 0 2 4 1
Al-Amin Nursing Home, Mymensingh Sadar 10 0 0 2 8 1
Albaraka Clinic, Laxmipur, Rajshahi 10 0 4 2 2 1
Al-Baraka Clinic, Magura 10 0 0 7 3 1
Al-Modina Clinic, Magura 10 0 0 6 4 1
Al-Shefa Clinic, Joypurhat 10 0 2 2 4 1
Ambia Hospital, Bogra Road, Barisal 50 0 4 6 15 2
Ambia Hospital, Pirojpur, Barisal 10 0 2 2 3 1
Amena Clinic, Talaimari, Rajshahi 10 0 2 4 4 1
Amina Hospital, Bonpara, Natore 30 2 4 4 5 1
Anowara Clinic, Satkhira Sadar 10 1 3 2 1 1
Anwara Private Hospital, Jhenaidah 10 0 2 2 3 1
Apollo Hospital &Diagnostic Complex, Maijdee Bazar, Noakhali 20 0 3 12 8 2
Apollo Hospitals, Dhaka 304 0 31 15 49 8
Apollo Nursing Home, Sipaipara, Rajshahi 10 0 3 3 3 1
Arafat Clinic &Diagnostic, Munshiganj 10 0 2 2 3 1
Aroggo Clinic, Magura 10 0 4 6 4 1
Asha (Pvt.) Hospital, Mymensingh Sadar 10 0 0 2 1 1
Avicena Hospital Ltd., Sirajganj Sadar 30 0 4 10 20 4
Bangladesh Clinic, Uposhohor, Rajshahi 10 1 4 4 1 1
Baral Clinic LTD, Pabna 10 0 1 2 3 1
Barisal Poly Clinic, Bangla Bazar, Barisal 10 0 3 2 6 1
Bashundhara (Pvt.) Hospital, Mymensingh Sadar 10 0 0 2 8 1
Bengal Community, Ullapara, Sirajganj 20 0 3 2 4 1
Bhai Bhai Private Hospital, Jhenaidah 10 0 2 2 3 1
BIRDEM Hospital, Dhaka 596 118 0 27 117 11
BNSB Eye Hospital, Sirajganj Sadar 100 20 4 9 11 2
Bonshepur Nursing Home, Shyamnagar, Satkhira 10 0 2 2 2 1
Brizee Hospital, Laxmipur, Rajshahi 10 2 3 2 2 1
Care Nursing Home, Laxmipur, Rajshahi 10 0 4 2 3 1
Central Hospital, Sirajganj Sadar 15 3 5 12 10 2
Chowmohani General Hospital, Begumganj, Noakhali 10 0 1 0 10 1
Christian Hospital, Chondroghona, Chittagong 125 0 10 10 10 3
City Clinic, Satkhira Sadar 10 0 3 2 2 1
City Hospital Private, Maijdee,Noakhali 40 2 5 2 27 2
Cure Nursing Home, Laxmipur, Rajshahi 10 0 4 2 5 1

Number
Dr. Moklessur Clinic, Sadar Road, Barisal 40 0 4 3 12 2
Damien Foundation. Netrakona TB & Leprosy Hospital, Anantapur,

52 52 1 10 0 0
Netrakona
Dastagir Private Hospital, Narsingdi 10 0 1 2 3 1
Desh Eye Hospital, Gazipur Sadar 10 0 2 2 3 1
Dhaka Community Hospital, Dhaka 250 75 14 3 20 2
Dhaka Hospital, icddr,b 300 300 2 15 29 13
Dobir Uddin Hospital, Kasiadanga, Rajshahi 10 1 5 4 2 1
Doctors Care Clinic and Hospital, Barguna, Barisal 10 0 2 2 3 1
Dolphin Clinic, Bornalimur, Rajshahi 30 2 6 2 15 2
Dr.Khadem Hossain Clinic, Bangla Bazar, Barisal 10 0 3 3 2 2
Dream Hospital, Begumganj, Noakhali 30 0 5 15 15 1
East West Medical College Hospital, Uttara, Dhaka 400 80 14 14 29 6
Ebnee Hashman (Pvt.) Hospital, Feni, Chittagong 10 0 2 2 3 1
Eden Nursing Home, Alekanda, Barisal 20 2 3 3 8 1
Ehsan Genaral Hospital, Magura 10 0 0 5 5 1
Ekushey Hospital (Pvt), Mymensingh Sadar 10 0 0 2 2 1
EM Center, Mohishbathan, Rajshahi 10 0 5 3 5 1
Fair Health Clinic, Barisal 40 0 3 2 18 2
Faruk Al-Nasir Hospital, Kazipur, Sirajganj 10 0 - - - 0
Farzina Clinic, Kazipur, Sirajganj 10 0 3 2 4 1
Fatema Nursing Home, Mymensingh Sadar 10 0 0 2 7 2
Fatima Nursing Home, Laxmipur, Rajshahi 10 0 5 5 3 1
Good Heal Hospital, Maijdee, Noakhali 40 5 3 4 22 2
Gorib Shah Clinic, Magura 10 0 1 3 4 1
Gorib-E-Nawaz Clinic, Talaimari, Rajshahi 10 1 3 3 3 1
Hasina Clinic & Nursing Home, Magura 10 0 0 7 3 1
Hathazari Adhunic Hospital, Chittagong 25 2 4 4 5 1
Health Care Clinic, Parara Road, Barisal 20 0 4 4 8 1
Impact Masudul Haque Community Health Centre, Chuadanga 10 0 2 2 1 2
Islami Bank Hospital, Chandmary, Barisal 50 0 16 4 20 2
Islami Bank Hospital, Dhaka 160 0 9 8 76 5
Islami Bank Hospital, Laxmipur, Rajshahi 63 0 8 6 30 2
Islami General Hospital, Keshorhat, Rajshahi 10 0 2 3 1 1
Islami General Hospital, Nowhata, Rajshahi 10 0 5 2 2 1
Islamia Poly Clinic, Bangla Bazar, Barisal 10 0 2 2 2 1
Jahangir Health Complex, Mymensingh Sadar 10 0 0 2 6 1
Jalalabad Ragib-Rabeya Hospital, Sylhet 890 9 14 18 120 10
Jam-Jam Islami Clinic, Laxmipur, Rajshahi 10 2 3 3 3 1
Jamuna (Pvt.) Hospital, Mymensingh Sadar 10 0 0 2 4 1
Jamuna Clinic, Kaliganj, Satkhira 10 0 2 2 2 1
Jamuna Clinic, Laxmipur, Rajshahi 10 0 3 2 4 1
Janani Clinic, Jiban Nagar, Chuadanga, Khulna 10 0 2 2 3 1
Janani General Hospital, Noakhali Sadar 40 0 0 2 23 1
Janaseba Clinic & Nursing Home, Magura 10 2 3 3 2 1
Janaseba Clinic, Assasuni, Satkhira 10 0 3 2 2 1
Janata Clinic & Nursing Home, Magura 10 0 0 1 3 1
Janata Clinic, Shipaipara, Rajshahi 10 1 2 2 5 1
Jayeda Hospital, Bonpara, Natore 10 0 2 2 2 1
Kaisar Memorial Hospital, Uposhahor, Chittagong 9 0 3 2 2 1

ANNEX
Number
Khadiza Clinic, Kalia, Narail 10 0 2 2 3 1
Khawja Yunus Ali Medical College and Hospital, Chowhali, Sirajganj 400 40 67 19 72 9
Labib (Pvt.) Hospital, Mymensingh Sadar 10 0 0 2 8 1
Life Care Hospital, Mymensingh Sadar 10 0 0 3 4 1
Lion Eye Institute & Hospital, Dhaka 84 10 6 6 10 4
Luthern Health Care of Bangladesh, Dumki, Patuakhali 40 0 3 2 8 2
Mamota Clinic, Kali Bari Road, Barisal 20 0 4 2 18 2
Maya Clinic, Mymensingh Sadar 10 0 0 2 1 1
Medical College for Women and Hospital, Uttara, Dhaka 350 50 11 7 23 4
Medinova Hospital, Sirajganj Sadar 30 2 5 16 14 2
Mediplus Hospital & Diagnostic Center, Mymensingh Sadar 10 0 0 2 6 1
Micropath Diagnostic and Clinic, Laxmipur, Rajshahi 10 1 5 3 5 1
Mita Private Hospital, Narsingdi 10 0 2 2 4 1
Modern Central Hospital, Barguna, Barisal 10 0 1 3 4 1
Modern Clinic, Munshiganj 20 0 3 3 3 1
Modern Hospital Private, Maijdee, Noakhali 40 0 5 8 32 2
Mohanagar Clinic, Kazihata, Rajshahi 10 1 3 3 5 1
Moin Uddin Hospital, Sirajganj Sadar 10 0 1 2 8 2
Monowara Hospital, Hatkhola Road, Dhaka 74 4 6 26 48 3
Mother Clinic, Bhurungamari, Kurigram 10 0 2 2 2 1
Motherland Clinic, Laxmipur, Rajshahi 10 2 3 2 6 1
Mothers Clinic, Uposhohor, Rajshahi 10 0 2 3 2 1
Mukta Clinic, Shibchar, Madaripur 10 0 1 2 3 1
Muktar General Hospital, Gopalpur, Lalpur, Natore 10 0 2 2 3 1
Mukti Clinic, Laxmipur, Rajshahi 30 0 4 3 15 2
Mukti Clinic, Magura 10 0 2 2 2 1
Muslim Aid Community Hospital, Pirojpur Sadar 20 0 3 3 5 1
Nabila General Hospital, Begumganj, Noakhali 10 0 4 1 7 1
Nagorick (Pvt.) Hospital, Mymensingh Sadar 10 0 0 2 5 1
Nalta Hospital, Kaliganj, Satkhira 20 0 6 2 3 2
Nasima Nursing Home, Mymensingh Sadar 10 0 0 2 6 3
Nazma Nursing Home, Mymensingh Sadar 10 0 0 2 5 1
New Arafat Clinic, Magura 10 0 0 4 2 1
New Surgical Clinic, Magura 10 0 0 7 3 1
Nibedita Nursing Home, Assasuni, Satkhira 10 0 2 4 1 1
Niramoya Clinic, Mymensingh Sadar 10 0 0 2 4 2
North Bengal M. C & Hospital, Sirajganj Sadar 400 120 12 10 30 6
Padma Clinic, Kazihata, Rajshahi 20 1 2 2 10 1
Padma Clinic, Magura 10 0 1 2 3 1
Paricharja (Pvt.) Hospital, Mymensingh Sadar 10 0 0 2 5 1
Paromita Eye Hospital, Mymensingh Sadar 10 0 0 2 4 2
PKS Clinic, Satkhira Sadar 10 0 1 1 5 1
Poly Clinic, Magura 10 0 2 6 4 1
Prime Hospital Ltd., Hospital Road, Maijdee, Noakhali 60 2 3 4 34 2
Rabeya Banu General Hospital, Biswanath, Sylhet 6 1 11 2 0 1
Rafia Clinic, Ati bazar, Keranjganj, Dhaka 10 0 1 2 3 1
Raihana Clinic, Puthia, Rajshahi 10 0 2 4 2 1
Rajdhani (Pvt.) Hospital, Mymensingh Sadar 10 0 0 2 3 1
Razzak Memorial Clinic, Alekanda, Barisal 10 0 2 2 3 1
Rokeya (Pvt) Hospital, Mymensingh Sadar 10 0 0 2 6 1

Number
Safeway (Pvt) Hospital, Mymensingh Sadar 28 0 0 2 6 2
Saiam (Pvt) Hospital, Mymensingh Sadar 20 0 0 2 9 2
Saleha Clinic, Magura 10 0 0 2 4 1
Salma Clinic, Mymensingh Sadar 10 0 0 2 1 1
Samata Nursing Home, Laxmipur, Rajshahi 10 2 2 4 0 1
Santi Private Hospital, Magura 20 0 2 14 6 1
Sarmin Private Clinic & Nursing Home, Magura 10 0 2 2 4 1
Satata Clinic, Satkhira Sadar 10 1 3 2 2 1
Satata Private Hospital, Sreepur, Magura 10 0 0 8 2 1
Sea Side Hospital, Coxs Bazar 10 0 2 2 3 1
Seba Hospital, Raipur, Laxmipur 10 0 2 2 4 1
Seba Clinic, Magura 10 0 0 2 2 1
Seba General Hospital, Ullapara, Sirajganj 10 0 2 2 1 1
Shagata Clinic, Tala, Satkhira 10 0 2 2 2 1
Shahid Mansur Ali Medical College Hospital, Uttara, Dhaka 500 200 19 13 20 6
Shahin Clinic (PVT.) Hospital, Feni, Chittagong 10 0 2 2 3 1
Shapla Nursing Home, Mymensingh Sadar 10 0 0 2 9 1
Sharmin Nursing Home, Rajshahi 10 1 2 2 7 1
Sheba Clinic, Jiban Nagar, Chuadanga, Khulna 10 0 2 2 4 1
Sheba Clinic, Kalaroa, Satkhira 10 0 2 2 2 1
Shemul Clinic, Satkhira Sadar 10 0 2 2 2 1
Shurakkha Nursing Home, Mymensingh Sadar 10 0 0 2 10 1
Soudia Hospital, Rajpara, Rajshahi 10 0 4 2 2 1
Sreepur Clinic, Sreepur, Magura 10 0 2 2 2 1
Sunmoon Clinic, Magura 10 0 3 3 4 1
Sunrise Clinic, Magura 10 0 2 2 2 1
Surgecare Clinic, Pirojpur Sadar 40 0 0 3 14 2
The Akota Clinic, Ghose Para, Rajshahi 10 0 6 2 2 1
The Ibn-sina Clinic, Magura 10 0 2 2 2 1
Trauma Center and General Hospital, Mymensingh Sadar 10 0 0 2 5 1
Ullapara Hospital, Ullapara, Sirajganj 10 3 2 3 2 2
Upasam (Pvt.) Hospital, Mymensingh Sadar 10 0 0 2 3 1
Uttara Adhunik Medical College Hospital, Uttara, Dhaka 500 0 12 12 0 11
Uttaran Nursing Home, Mymensingh Sadar 10 0 0 2 8 1
Uttarbanga Islami Hospital, Laxmipur, Rajshahi 10 0 3 4 4 1
Woodland Hospital & Diagnostic Complex, Maijdee, Noakhali 20 0 3 8 12 1
Z.H.Sikder Women`s Medical College Hospital, Dhaka 100 0 - 2 17 2

ANNEX TO CHAPTER 6
1. OPD and emergency visits in health facilities under DGHS in 2015
A.Tertiary-level facilities
OPD visits Emergency visits
Type Name >5 years <5 years >5 years <5 years >5 years <5 years >5 years <5 years
Total Total
Female Male Female Male
Hospitals of Govt. Homeopathic Medical College Hospital, Dhaka 46,764 4,847 45,941 5,658 103,210 176 46 297 52 571
alternative
medical
colleges Govt. Unani & Ayurvedic Medical College Hospital, Dhaka 13,421 1,352 12,530 1,483 28,786 4,382 1,127 3,784 1,236 10,529
(2)
Chittagong Medical College Hospital, Chittagong 36,882 176,849 56,549 214,665 484,945 77,065 8,645 98,082 11,458 195,250
Comilla Medical College Hospital, Comilla 106,174 23,332 97,051 18,454 245,011 29,505 7,491 32,477 5,893 75,366
Dhaka Medical College Hospital, Dhaka 321,795 24,614 415,942 37,545 799,896 141,236 12,088 173,517 19,739 346,580
Dinajpur Medical College Hospital, Dinajpur 92,558 5,815 77,970 7,739 184,082 19,231 2,938 19,414 2,711 44,294
Faridpur Medical College Hospital, Faridpur 5,577 44,632 6,583 46,575 103,367 475 1,787 508 5,286 8,056
Khulna Medical College Hospital, Khulna 141,078 9,717 85,541 6,350 242,686 2,416 628 3,914 510 7,468
Medical
collehe Mymensingh Medical College Hospital, Mymensingh 267,817 43,934 257,521 37,927 607,199 5,671 2,117 5,891 2,189 15,868
hospital Rajshahi Medical College Hospital, Rajshahi 280,503 117,189 226,724 87,394 711,810 25,088 13,256 28,351 16,556 83,251
(14)
Rangpur Medical College Hospital, Rangpur 161,733 6,427 143,009 6,027 317,196 785 410 520 310 2,025
Shaheed Suhrawardy Medical College Hospital, Dhaka 320,807 53,068 380,791 71,067 825,733 47,834 14,553 61,805 22,173 146,365
Shahid Ziaur Rahman Medical College Hospital, Bogra 163,731 18,838 151,136 20,023 353,728 23,692 4,054 25,668 5,037 58,451
Sher-e-Bangla Medical College Hospital, Barisal 201,415 19,561 197,405 17,899 436,280 45,214 3,161 49,971 3,659 102,005
Sir Salimullah Medical College (Mitford) Hospital, Dhaka 312,827 44,821 240,788 43,612 642,048 76,376 2,495 35,376 2,624 116,871
Sylhet MAG Osmani Medical College Hospital 427,875 42,580 343,673 47,706 861,834 57,329 11,077 69,682 14,466 152,554
Bangladesh Institute of Tropical and Infectious Disease, Foujdarhat,

15,195 1,828 10,995 1,893 29,911 2,790 68 2,972 106 5,936
Chittagong
Other
tertiary Dhaka Dental College Hospital, Dhaka 40,332 2,235 44,395 2,560 89,522 - - - - -
hospitals
(4) Pabna Mental Hospital, Pabna 24,354 11 22,577 57 46,999 - - - - -
Shaheed Sheikh Abu Naser Specialized Hospital, Khulna 67,770 0 69,975 0 137,745 3,711 0 4,223 0 7,934

Type Name >5 years <5 years >5 years <5 years >5 years <5 years >5 years <5 years
Total Total
Institute of Child and Mother Health, Matuail, Dhaka 82,921 48,987 22,988 55,239 210,135 12,541 16,186 5,943 18,698 53,368
National Center For Control Of Rheumatic Fever & Heart Disease 16,349 364 10,218 316 27,247 - - - - -

National Institute of Cancer Research and Hospital (NICR&H), Mohakhali,
84,562 1,277 86,565 1,633 174,037 1,836 32 2,545 66 4,479
Dhaka
National Institute of Cardiovascular Disease (NICVD), Sher-e-Bangla Nagar,

40,797 1,872 94,691 2,257 139,617 27,032 184 55,075 278 82,569
Dhaka
National Institute of Diseases of the Chest and Hospital (NIDCH),

29,857 356 44,474 496 75,183 2,118 88 7,677 151 10,034
Specialty Mohakhali, Dhaka
institute
National Institute of ENT, Dhaka - - - - - - - - - -
hospital
(11) National Institute of Kidney Disease and Urology (NIKDU), Sher-e-Bangla
26,828 381 53,451 673 81,333 2,547 38 4,421 70 7,076
Nagar, Dhaka
National Institute of Mental Health & Research (NIMHR), Sher-e-Bangla

17,798 0 24,905 0 42,703 957 0 1,544 0 2,501
Nagar, Dhaka
National Institute of Neurosciences and Hospital (NINH) , Dhaka 80,576 9,502 89,698 10,262 190,038 7,107 838 7,912 905 16,762
National Institute of Ophthalmology (NIO), Sher-e-Bangla Nagar, Dhaka 107,372 4,390 135,503 3,185 250,450 723 127 2,441 292 3,583
National Institute of Traumatology and Rehabilitation (NITOR), Sher-e-

39,885 2,574 58,514 3,988 104,961 11,284 1,787 31,433 2,933 47,437
Bangla Nagar, Dhaka
TB hospital TB Hospital, Khulna 0 0 0 0 0 - - - - -

(2) TB Hospital, Rajshahi 3,076 10 2,675 10 5,771 - - - - -
B. Secondary (district-level) facility
Division District Name >5 years <5 years >5 years <5 years >5 years <5 years >5 years <5 years
Total
Female Male Total Female Male
Barguna Barguna District Hospital 44,451 9,170 31,405 6,608 91,634 10,738 1,619 11,519 2,123 25,999
Barisal Barisal General Hospital 19,500 30,365 11,500 25,200 86,565 880 4,050 1,000 11,000 16,930
Bhola Bhola District Hospital 54,342 10,216 32,757 8,581 105,896 5,751 866 6,232 750 13,599
Barisal
Jhalokathi Jhalokathi District Hospital 34,490 8,100 38,561 8,114 89,265 24,264 3,947 27,084 5,182 60,477
Patuakhali Patuakhali 250-bed Sadar Hospital 79,171 13,340 52,739 10,974 156,224 14,387 5,190 16,222 3,277 39,076
Pirojpur Pirojpur District Hospital 58,553 7,812 39,873 11,697 117,935 16,809 3,532 15,762 3,677 39,780
Total
Bandarban Bandarban District Hospital 18,839 6,658 14,818 8,139 48,454 8,073 2,853 6,350 3,488 20,764
Brahmanbaria Brahmanbaria 250-bed District Sadar Hospital 114,174 31,969 106,525 30,423 283,091 22,363 3,217 27,374 3,915 56,869
Chandpur Chandpur 250-bed General Hospital 59,780 39,360 59,904 26,240 185,284 15,305 8,717 17,847 5,811 47,680
Chittagong Chittagong General Hospital 24,918 85,687 23,678 93,282 227,565 1,964 6,377 2,296 6,478 17,115
Comilla Comilla General Hospital 41,668 13,229 26,912 14,621 96,430 4,148 1,162 8,166 1,720 15,196
Coxs Bazar Coxs Bazar 250-bed District Sadar Hospital 49,338 68,643 42,902 53,628 214,511 7,683 10,690 6,681 8,351 33,405
Chittagong
Feni Feni 250-bed District Sadar Hospital 94,545 55,275 72,562 46,720 269,102 16,433 10,340 11,390 6,430 44,593
Khagrachhari Khagrachhari District Hospital 31,804 6,290 26,642 6,395 71,131 1,135 191 2,330 349 4,005
Lakshmipur Lakshmipur District Hospital 92,356 9,159 43,062 6,597 151,174 4,555 340 7,709 554 13,158
Noakhali Noakhali 250-bed General Hospital 82,225 22,561 65,989 24,121 194,896 9,079 18,112 10,125 21,045 58,361
Rangamati Rangamati General Hospital 22,534 3,448 21,160 4,089 51,231 3,608 521 3,122 794 8,045
Kurmitola 500-bed General Hospital 190,000 11,130 266,466 12,023 479,619 14,017 731 18,817 1,022 34,587
Dhaka
Mugda 500-bed Hospital 171,814 13,948 109,725 15,848 311,335 4,522 796 4,787 1,129 11,234
Faridpur Faridpur General Hospital 52,244 22,174 34,921 15,542 124,881 19,772 1,707 10,404 2,010 33,893
Gazipur Gazipur District Hospital 47,577 23,018 48,504 22,932 142,031 35,847 5,732 37,231 6,034 84,844
Gopalganj Gopalganj 250-bedded District Sadar Hospital 79,857 10,826 85,548 11,522 187,753 7,528 1,891 9,561 2,178 21,158
Kishoreganj Kishoreganj 250-bed District Sadar Hospital 130,948 12,177 138,064 14,144 295,333 15,497 4,025 27,668 4,492 51,682
Madaripur Madaripur District Hospital 59,396 11,690 37,792 9,188 118,066 9,939 1,980 12,040 2,108 26,067
Manikganj Manikganj District Hospital 86,263 29,513 78,155 27,203 221,134 23,191 9,844 22,673 9,568 65,276
Dhaka Munshiganj Munshiganj District Hospital 65,776 14,690 50,308 12,914 143,688 22,744 5,686 21,095 4,908 54,433
Narayanganj Narayanganj 300-bedded Hospital 147,993 16,241 103,692 15,415 283,341 26,461 1,459 24,623 1,032 53,575
Narayanganj General Hospital 117,240 31,525 62,401 23,516 234,682 60,075 13,630 59,320 11,445 144,470
Narsingdi 100-bed Zilla Hospital 66,893 11,096 55,093 10,136 143,218 16,995 2,227 17,658 1,993 38,873
Narsingdi
Sadar Hospital Narsingdi 32,014 21,927 31,609 22,830 108,380 21,176 6,139 21,736 6,252 55,303
Rajbari Rajbari District Hospital 74,101 5,431 57,824 4,453 141,809 5,957 882 6,986 812 14,637
Shariatpur Shariatpur District Hospital 44,388 20,880 30,620 28,560 124,448 24,329 3,403 14,200 2,560 44,492
Tangail Tangail 250-bed District Hospital 17,995 145,310 23,897 110,022 297,224 3,829 10,281 3,932 23,207 41,249
ANNEX

Total
Bagerhat Bagerhat District Hospital 70,281 14,162 36,649 8,447 129,539 2,087 430 3,084 357 5,958
Chuadanga Chuadanga District Hospital 58,271 21,475 54,710 15,265 149,721 25,262 14,530 20,292 6,710 66,794

Jessore Jessore 250-bed General Hospital 190,910 30,492 155,225 20,492 397,119 8,793 1,472 14,680 1,070 26,015
Jhenaidah Jhenaidah District Hospital 147,481 12,381 90,489 14,980 265,331 5,283 173 6,246 268 11,970
Khulna Khulna General Hospital 106,402 8,475 59,962 6,148 180,987 8,011 5,245 12,930 4,048 30,234
Khulna
Kushtia Kushtia 250-bed General Hospital 141,531 17,002 130,119 17,151 305,803 6,749 863 11,307 1,123 20,042
Magura Magura District Hospital 72,172 14,403 65,661 13,230 165,466 4,598 379 4,308 278 9,563
Meherpur Meherpur District Hospital 81,416 18,009 53,995 17,871 171,291 3,853 1,146 4,375 1,182 10,556
Narail Narail District Hospital 60,049 7,992 35,480 6,872 110,393 4,898 1,219 7,257 1,563 14,937
Satkhira Satkhira District Hospital 102,946 23,864 82,969 19,524 229,303 1,986 1,623 2,720 1,333 7,662
Jamalpur Jamalpur 250-bed General Hospital 14,604 21,248 35,852 4,641 4,952 9,593 45,445 180 101 281
Mymensingh Netrakona Netrakona District Hospital 7,899 13,781 21,680 2,807 1,663 4,470 26,150 93 56 149
Sherpur Sherpur 100-bed District Sadar Hospital 8,931 9,463 18,394 3,723 2,447 6,170 24,564 126 77 203
Bogra Bogra 250-bed Mohammad Ali District Hospital 7,326 7,709 15,035 1,820 1,149 2,969 18,004 38 33 71
Chapainowabganj Chapainowabganj District Hospital 133,082 14,157 179,332 13,225 339,796 11,086 928 12,718 1,451 26,183
Joypurhat Joypurhat District Hospital 97,148 23,538 51,335 14,040 186,061 14,430 3,444 7,378 3,934 29,186
Rajshahi Naogaon Naogaon District Hospital 105,867 30,302 56,851 24,110 217,130 9,831 4,350 7,996 3,455 25,632
Natore Natore District Hospital 95,977 27,370 91,101 22,508 236,956 22,117 7,802 17,203 5,304 52,426
Pabna Pabna 250-bed General Hospital 83,963 24,566 72,111 18,944 199,584 4,064 1,835 4,304 1,880 12,083
Sirajganj Sirajganj General Hospital 67,367 10,838 99,887 10,700 188,792 16,236 2,066 15,811 2,349 36,462
Dinajpur Dinajpur General Hospital 48,878 10,583 90,202 14,283 163,946 8,263 1,702 12,336 1,932 24,233
Gaibandha Gaibandha District Hospital 57,237 16,651 45,391 13,480 132,759 9,428 1,588 9,035 1,455 21,506
Kurigram Kurigram District Hospital 78,133 16,514 55,881 18,961 169,489 12,637 6,418 11,799 5,718 36,572
Lalmonirhat Lalmonirhat District Hospital 55,166 5,633 49,915 6,499 117,213 6,707 1,712 6,857 1,888 17,164
Rangpur
Nilphamari District Hospital 61,871 27,540 46,299 23,539 159,249 18,900 2,824 18,897 2,823 43,444
Nilphamari
Saidpur 100-bed Hospital 29,658 5,584 21,775 5,121 62,138 7,372 1,609 4,992 1,228 15,201
Panchagarh Panchagarh 100-bed District Sadar Hospital 9,051 9,547 8,949 9,347 36,894 2,167 307 4,152 427 7,053
Thakurgaon Thakurgaon District Hospital 59,578 20,967 52,222 20,225 152,992 3,155 158 5,080 304 8,697
Total
Habiganj Habiganj District Hospital 15,480 58,950 14,150 47,350 135,930 980 6,650 850 6,580 15,060
Maulvibazar Maulvibazar 250-bed District Sadar Hospital 95,024 13,245 75,532 11,158 194,959 29,778 10,665 26,316 8,216 74,975
Sylhet
Sunamganj Sunamganj 250-bed District Sadar Hospital 47,592 8,558 51,722 8,968 116,840 16,009 2,818 14,787 2,616 36,230
Sylhet Shahid Shamsuddin District Hospital 51,387 3,905 43,004 4,663 102,959 999 107 1,585 229 2,920
C. Upazila health complexes (listed alphabetically)
Sl. Name >5 years <5 years >5 years <5 years >5 years <5 years >5 years <5 years
Total Total
1 Abhoynagar UHC 37,726 5,889 26,771 4,864 75,250 6,872 1,087 8,931 1,431 18,321
2 Adamdighi UHC 40,126 5,569 24,874 4,838 75,407 3,579 378 4,246 507 8,710
3 Aditmari UHC 20,062 5,855 13,799 4,789 44,505 2,234 300 1,845 221 4,600
4 Agailjhara UHC 4,803 1,261 4,441 1,360 11,865 1,827 324 1,670 380 4,201
5 Akhaura UHC 23,603 4,043 20,046 4,246 51,938 1,083 592 1,495 612 3,782
6 Akkelpur UHC 22,181 5,941 15,487 5,312 48,921 4,741 353 3,119 283 8,496
7 Alamdanga UHC 29,811 7,293 20,561 5,489 63,154 1,714 31 2,866 48 4,659
8 Alfadanga UHC 26,996 5,443 16,128 3,500 52,067 559 234 899 210 1,902
9 Alikadam UHC 20,605 4,219 14,023 3,197 42,044 279 45 298 73 695
10 Amtali UHC 14,378 2,182 9,596 2,077 28,233 3,095 403 3,151 515 7,164
11 Anwara UHC 38,873 5,403 20,230 4,060 68,566 10,441 3,183 12,424 4,196 30,244
12 Araihazar UHC 4,351 79,945 5,076 42,783 132,155 42 2,383 65 3,372 5,862
13 Ashuganj UHC 13,647 1,605 5,753 1,513 22,518 0 0 0 0 0
14 Assasuni UHC 30,416 2,387 17,727 2,690 53,220 650 130 794 194 1,768
15 Atghoria UHC 53,337 6,101 30,641 6,706 96,785 3,273 212 3,667 312 7,464
16 Atpara UHC 17,649 2,322 13,443 2,124 35,538 6,646 550 7,119 533 14,848
17 Atrai UHC 13,858 3,221 7,102 3,035 27,216 546 149 803 184 1,682
18 Atwari UHC 16,314 1,609 12,397 1,979 32,299 1,173 137 3,410 211 4,931
19 Austagram UHC 23,709 5,000 14,993 4,450 48,152 1,675 502 1,695 561 4,433
20 Azmiriganj UHC 29,633 7,006 20,651 5,987 63,277 1,336 211 2,857 187 4,591
21 Babuganj UHC 10,141 4,141 5,078 3,404 22,764 684 72 544 45 1,345
22 Badalgachi UHC 27,918 4,573 15,835 3,374 51,700 1,782 307 1,498 348 3,935
23 Badarganj UHC 26,805 6,007 21,550 6,038 60,400 6,560 1,549 4,630 1,165 13,904
ANNEX

Total Total
24 Bagatipara UHC 53,529 6,079 35,854 6,408 101,870 2,720 191 2,718 293 5,922
25 Bagerpara UHC 22,182 3,155 10,137 2,104 37,578 1,794 388 2,665 640 5,487

26 Bagha UHC 50,655 1,004 17,844 9,642 79,145 1,092 138 1,185 128 2,543
27 Baghaichhari UHC 10,035 1,794 7,025 1,778 20,632 298 39 318 54 709
28 Bagmara UHC 34,512 7,852 17,254 7,459 67,077 2,507 720 2,135 421 5,783
29 Bahubal UHC 25,242 17,331 27,147 15,928 85,648 1,637 366 2,299 662 4,964
30 Bajitpur UHC 46,812 8,240 26,825 10,240 92,117 1,675 224 3,443 396 5,738
31 Bakerganj UHC 32,088 4,478 28,877 4,669 70,112 645 526 777 607 2,555
32 Bakshiganj UHC 30,607 1,968 29,805 1,815 64,195 4,194 617 4,288 636 9,735
33 Balaganj UHC 29,493 709 18,311 612 49,125 4,107 198 5,050 205 9,560
34 Baliadangi UHC 1,813 7,812 1,627 6,623 17,875 180 609 1,600 435 2,824
35 Baliakandi UHC 22,944 3,591 16,543 1,942 45,020 2,091 156 1,755 248 4,250
36 Bamna UHC 13,056 1,929 12,189 1,940 29,114 1,059 90 1,077 192 2,418
37 Banaripara UHC 21,049 4,921 13,577 5,297 44,844 3,840 360 1,968 582 6,750
38 Bancharampur UHC 34,944 6,458 24,468 6,542 72,412 5,124 1,289 5,213 1,346 12,972
39 Bandar UHC 35,333 4,662 11,502 4,482 55,979 1,728 174 2,824 182 4,908
40 Baniachong UHC 32,860 12,351 26,704 11,963 83,878 3,466 1,924 4,184 1,632 11,206
41 Banshkhali UHC 33,245 4,912 20,770 3,688 62,615 7,521 1,867 8,286 2,915 20,589
42 Baraigram UHC 36,711 5,382 29,926 4,298 76,317 2,010 67 2,770 75 4,922
43 Barhatta UHC 37,697 7,802 22,072 7,318 74,889 2,143 818 2,386 949 6,296
44 Barkol UHC 3,388 112 3,802 167 7,469 177 4 20 7 208
45 Barlekha UHC 39,621 7,362 31,261 6,325 84,569 4,632 3,621 8,366 4,231 20,850
46 Barura UHC 33,714 7,108 16,552 3,473 60,847 638 72 1,294 92 2,096
47 Basail UHC 65,564 3,550 46,476 3,400 118,990 2,189 127 2,232 116 4,664
48 Batiaghata UHC 27,169 1,772 18,580 1,757 49,278 2,345 4 498 7 2,854
49 Bauphal UHC 19,902 3,136 18,837 3,038 44,913 1,712 450 1,736 630 4,528
50 Beanibazar UHC 44,673 6,812 27,920 5,572 84,977 12,591 1,999 14,778 2,126 31,494
51 Begumganj UHC 43,730 7,494 17,589 7,485 76,298 3,067 1,428 5,514 1,421 11,430
52 Belabo UHC 41,681 5,126 19,767 3,567 70,141 1,417 165 1,349 96 3,027
53 Belaichhari UHC 4,152 876 4,382 859 10,269 144 36 83 47 310
54 Belkuchi UHC 6,325 4,637 5,793 4,956 21,711 3,299 389 3,264 574 7,526
55 Bera UHC 27,348 5,746 22,634 5,678 61,406 11,127 2,785 11,167 3,663 28,742
56 Betagi UHC 8,120 1,029 8,890 1,160 19,199 320 10 407 10 747
Total Total
57 Bhairab UHC 47,525 21,821 26,066 14,556 109,968 3,499 1,023 3,583 793 8,898
58 Bhaluka UHC 23,907 14,113 18,313 12,239 68,572 5,531 1,976 10,500 2,563 20,570
59 Bhandaria UHC 14,685 1,538 9,059 1,493 26,775 2,121 437 2,381 440 5,379
60 Bhanga UHC 23,233 8,020 10,409 10,056 51,718 4,262 830 4,399 1,380 10,871
61 Bhangura UHC 35,294 4,977 24,689 3,721 68,681 298 62 714 93 1,167
62 Bhedarganj UHC 18,922 3,911 12,719 2,753 38,305 2,745 1,320 1,590 1,680 7,335
63 Bheramara UHC 43,085 9,853 21,626 9,471 84,035 4,716 490 4,908 759 10,873
64 Bholahat UHC 23,851 7,157 19,816 6,565 57,389 4,291 557 2,583 899 8,330
65 Bhuapur UHC 12,712 5,781 12,187 5,102 35,782 7,821 1,385 8,525 1,405 19,136
66 Bhurungamari UHC 28,096 2,249 22,186 1,581 54,112 2,172 421 1,993 561 5,147
67 Birampur UHC 32,346 1,255 27,537 1,775 62,913 2,938 395 3,330 352 7,015
68 Birganj UHC 34,439 1,875 22,389 2,485 61,188 2,229 195 2,342 295 5,061
69 Birol UHC 16,407 3,520 16,702 3,426 40,055 2,078 276 2,842 263 5,459
70 Biswambarpur UHC 2,187 3,513 2,564 4,522 12,786 376 412 118 323 1,229
71 Biswanath UHC 1,634 34,591 1,425 17,426 55,076 157 1,547 254 1,862 3,820
72 Boalkhali UHC 16,378 37,265 15,236 20,145 89,024 5,392 6,965 3,629 8,162 24,148
73 Boalmari UHC 24,015 17,021 22,275 14,101 77,412 2,217 542 3,040 561 6,360
74 Bochaganj UHC 20,586 1,967 17,272 1,583 41,408 2,139 130 1,232 198 3,699
75 Boda UHC 30,527 8,919 20,489 8,720 68,655 1,059 184 841 156 2,240
76 Borhanuddin UHC 25,165 2,018 19,134 2,663 48,980 8,886 989 3,702 1,586 15,163
77 Brahmmanpara UHC 9,754 3,961 8,355 3,962 26,032 650 84 726 146 1,606
78 Burichong UHC 5,199 1,234 5,112 971 12,516 1,548 133 988 170 2,839
79 Chauddagram UHC 59,568 24,324 35,890 21,345 141,127 1,823 895 2,059 1,110 5,887
80 Chakaria UHC 29,292 8,349 21,976 10,544 70,161 3,820 3,459 4,509 4,469 16,257
81 Chandanaish UHC 23,645 4,511 16,843 6,523 51,522 3,732 565 3,342 801 8,440
82 Chandina UHC 21,523 5,455 12,424 6,499 45,901 4,421 797 4,226 1,245 10,689
83 Charbhadrason UHC 12,423 3,428 8,341 3,813 28,005 1,177 297 872 320 2,666
84 Char Fasson UHC 32,060 5,910 20,044 7,037 65,051 6,779 905 7,142 1,222 16,048
85 Charghat UHC 21,768 5,902 11,460 5,301 44,431 5,110 2,190 3,650 2,555 13,505
86 Chatkhil UHC 26,017 1,919 21,188 2,520 51,644 4,765 591 2,355 950 8,661
87 Chatmohar UHC 43,426 16,892 20,961 16,103 97,382 12,110 2,118 6,299 2,120 22,647
88 Chhagalnaya UHC 27,371 4,459 25,109 3,637 60,576 1,087 42 1,575 60 2,764
89 Chhatak UHC 25,009 2,900 13,054 3,813 44,776 1,311 85 3,013 143 4,552
ANNEX

Total Total
90 Chilmari UHC 15,667 1,734 12,877 1,469 31,747 1,898 193 1,803 299 4,193
91 Chirirbandar UHC 39,897 12,766 37,856 9,788 100,307 1,632 482 1,566 395 4,075

92 Chitalmari UHC 33,004 5,591 11,001 3,161 52,757 480 69 152 83 784
93 Chowgacha UHC 41,911 11,007 25,935 11,200 90,053 3,676 1,073 3,458 1,432 9,639
94 Chowhali UHC 14,524 3,395 11,357 3,215 32,491 0 0 0 0 0
95 Chunarughat UHC 22,888 2,608 16,964 2,155 44,615 2,426 616 4,084 4,590 11,716
96 Comilla Sadar Daxin UHC 9,916 1,579 7,027 1,269 19,791 160 3 318 12 493
97 Companiganj UHC, Noakhali 35,357 12,674 29,508 11,245 88,784 4,597 296 2,006 284 7,183
98 Companyganj UHC, Sylhet 20,912 5,582 19,656 4,865 51,015 4,587 667 5,020 574 10,848
99 Dacope UHC 3,645 13,862 2,204 8,387 28,098 130 355 172 320 977
100 Daganbhuiya UHC 34,510 11,190 15,152 12,523 73,375 3,579 827 2,579 697 7,682
101 Dakhin Surma UHC 13,200 4,680 9,360 3,240 30,480 60 12 36 10 118
102 Damudya UHC 29,279 10,050 24,013 7,072 70,414 1,895 596 1,798 392 4,681
103 Damurhuda UHC 29,923 5,937 18,725 4,970 59,555 4,156 913 3,922 821 9,812
104 Dashmina UHC 15,630 1,939 10,517 2,349 30,435 222 10 438 24 694
105 Daudkandi UHC 53,559 12,638 27,945 15,431 109,573 8,656 463 7,490 622 17,231
106 Daulatkhan UHC 19,969 3,373 15,755 3,779 42,876 831 169 1,716 214 2,930
107 Daulatpur UHC, Manikganj 31,654 4,326 23,654 3,721 63,355 3,832 1,425 3,708 1,345 10,310
108 Daulatpur UHC, Kushtia 34,822 2,653 16,209 3,351 57,035 5,780 326 3,756 434 10,296
109 Daxin Sunamganj UHC 0 0 0 0 0 0 0 0 0 0
110 Debhata UHC 12,543 2,803 6,841 1,372 23,559 3,876 734 2,365 570 7,545
111 Debidwar UHC 13,697 39,735 8,378 25,980 87,790 1,569 3,184 1,671 4,562 10,986
112 Debiganj UHC 26,621 1,139 29,353 1,299 58,412 726 97 1,722 99 2,644
113 Delduar UHC 1,318 631 4,143 618 6,710 2,210 157 3,221 127 5,715
114 Derai UHC 14,925 1,057 9,950 12,380 38,312 650 920 700 1,000 3,270
115 Dewanganj UHC 10,103 3,925 9,035 3,926 26,989 2,835 772 3,004 726 7,337
116 Dhamairhat UHC 19,876 6,521 15,483 5,437 47,317 753 138 1,247 132 2,270
117 Dhamrai UHC 73,499 13,874 42,575 16,159 146,107 9,539 1,193 9,198 1,761 21,691
118 Dhanbari UHC 26,558 1,856 5,364 1,645 35,423 94 89 74 141 398
119 Dharmapasha UHC 30,882 4,003 34,909 3,419 73,213 3,987 590 4,685 667 9,929
120 Dhubaura UHC 19,995 2,553 11,931 2,601 37,080 2,177 366 1,980 631 5,154
121 Dhunat UHC 30,502 5,664 21,556 3,862 61,584 1,916 437 1,961 251 4,565
122 Dhupchachia UHC 34,551 7,621 15,246 6,826 64,244 7,605 1,490 12,700 1,893 23,688
Total Total
123 Dighalia UHC 34,656 5,255 16,079 2,434 58,424 1,220 114 1,390 145 2,869
124 Dighinala UHC 14,825 3,632 13,762 2,145 34,364 2,142 230 1,872 415 4,659
125 Dimla UHC 15,571 3,374 13,599 3,025 35,569 4,597 853 3,911 711 10,072
126 Doarabazar UHC 2,901 22,747 3,277 17,199 46,124 503 1,502 602 2,301 4,908
127 Dohar UHC 30,948 13,027 19,759 12,600 76,334 4,902 613 4,282 881 10,678
128 Domar UHC 14,981 6,471 8,941 4,314 34,707 3,552 869 3,824 722 8,967
129 Dumki UHC 12,466 3,963 4,735 2,939 24,103 614 117 667 194 1,592
130 Dumuria UHC 4,266 26,571 5,025 12,806 48,668 216 888 351 1,251 2,706
131 Durgapur UHC, Netrakona 42,010 4,843 27,744 5,266 79,863 2,820 522 3,170 818 7,330
132 Durgapur UHC, Rajshahi 32,517 9,240 15,243 7,380 64,380 6,555 378 5,557 320 12,810
133 Fakirhat UHC 31,928 5,590 14,658 5,792 57,968 3,312 1,113 4,921 1,080 10,426
134 Faridganj UHC 7,347 3,112 3,241 3,817 17,517 3,051 1,186 3,059 787 8,083
135 Faridpur UHC, Pabna 20,100 7,089 19,355 9,785 56,329 4,138 1,067 4,526 1,074 10,805
136 Fatikchhari UHC 26,355 6,403 16,696 5,945 55,399 3,214 2,938 4,210 3,265 13,627
137 Fenchuganj UHC 18,609 1,210 14,471 1,050 35,340 1,544 274 1,688 309 3,815
138 Fulbari UHC, Dinajpur 39,865 2,718 28,735 2647 7,3965 4,811 346 4,001 534 9,692
139 Fulbari UHC, Kurigram 14,939 1,683 11,826 1,418 29,866 1,768 142 1,752 249 3,911
140 Fulbaria UHC 26,998 3,750 17,479 4,586 52,813 1,077 316 1,933 451 3,777
141 Fulchhari UHC 19,166 2,579 14,646 2,084 38,475 1,105 89 784 135 2,113
142 Fulgazi UHC 29,105 3,010 18,255 2,006 52,376 2,083 242 1,388 143 3,856
143 Fulpur UHC 37,209 16,204 28,066 14,956 96,435 7,372 916 7,233 1,125 16,646
144 Fultala UHC 28,198 1,930 15,177 2,819 48,124 399 69 486 71 1,025
145 Gabtali UHC 30,611 4,115 16,450 4,784 55,960 458 58 514 69 1,099
146 Galachipa UHC 12,224 2,230 8,038 1,947 24,439 791 24 1,525 38 2,378
147 Gangachara UHC 14,283 3,659 17,387 3,589 38,918 2,998 237 3,247 212 6,694
148 Gangni UHC 73,818 5,100 57,024 4,653 140,595 1,033 35 1,416 26 2,510
149 Gazaria UHC 41,360 13,055 25,314 7,054 86,783 5,367 309 4,707 295 10,678
150 Ghatail UHC 25,671 4,154 15,941 4,318 50,084 7,243 1,164 7,227 1,347 16,981
151 Ghior UHC 18,892 7,830 16,326 6,322 49,370 2,825 550 3,520 525 7,420
152 Ghoraghat UHC 33,042 3,649 31,002 3,409 71,102 1,847 120 2,638 140 4,745
153 Goalanda UHC 19,403 5,151 10,423 4,998 39,975 1,793 374 2,649 545 5,361
154 Gobindaganj UHC 31,502 3,850 11,905 3,014 50,271 276 250 733 365 1,624
155 Godagari UHC 11,405 1,278 5,231 1,474 19,388 2,512 327 2,297 286 5,422
ANNEX

Total Total
156 Gofargaon UHC 7,411 6,280 5,000 4,220 22,911 832 401 784 389 2,406
157 Golapganj UHC 33,633 12,274 18,783 12,365 77,055 3,382 1,230 3,812 1,320 9,744

158 Gomastapur UHC 32,623 4,281 28,990 3,365 69,259 3,440 781 4,286 884 9,391
159 Gopalpur UHC 31,005 3,617 27,741 3,442 65,805 2,307 243 1,406 483 4,439
160 Goshairhat UHC 31,310 5,540 19,935 3,796 60,581 2,316 435 2,125 657 5,533
161 Gouripur UHC 58,074 16,131 29,475 13,446 117,126 6,397 2,037 9,122 2,311 19,867
162 Gournadi UHC 16,939 7,150 15,040 6,598 45,727 2,891 863 3,022 760 7,536
163 Gowainghat UHC 13,359 5,381 9,320 4,439 32,499 4,992 1,794 4,244 1,193 12,223
164 Gurudashpur UHC 47,537 5,908 31,354 6,113 90,912 4,385 376 4,133 254 9,148
165 Haimchar UHC 33,005 4,345 21,345 3,185 61,880 2,180 432 1,926 236 4,774
166 Hakimpur UHC 32,117 3,374 21,949 3,701 61,141 2,853 151 2,516 209 5,729
167 Haluaghat UHC 23,711 1,727 10,806 1,685 37,929 3,642 494 4,137 625 8,898
168 Harinakunda UHC 24,939 3,593 23,498 3,859 55,889 4,187 1,496 2,025 920 8,628
169 Haripur UHC 21,253 4,112 14,375 3,158 42,898 2,207 655 1,980 507 5,349
170 Harirampur UHC 32,277 6,056 18,646 5,200 62,179 1,324 300 1,115 200 2,939
171 Hathazari UHC 49,229 10,093 39,640 12,215 111,177 9,178 2,463 7,225 2,265 21,131
172 Hatibandha UHC 15,700 3,400 16,890 4,050 40,040 3,620 1,610 4,260 1,360 10,850
173 Hatiya UHC 18,270 2,781 13,380 2,893 37,324 2,932 850 3,088 761 7,631
174 Haziganj UHC 37,562 8,993 18,801 7,817 73,173 2,707 697 3,321 777 7,502
175 Hijla UHC 11,563 2,105 3,507 1,886 19,061 4,640 244 2,560 204 7,648
176 Homna UHC 31,964 5,519 18,316 6,855 62,654 299 31 290 18 638
177 Hossainpur UHC 5,952 29,256 7,876 18,402 61,486 593 6,570 1,287 7,325 15,775
178 Islampur UHC 44,709 4,441 20,768 3,670 73,588 5,445 807 6,931 951 14,134
179 Iswardi UHC 40,355 5,231 21,727 5,670 72,983 8,578 1,768 4,664 1,524 16,534
180 Iswarganj UHC 5,354 813 4,854 708 11,729 4,926 308 4,334 219 9,787
181 Itna UHC 42,910 5,036 30,727 4,412 83,085 446 6 430 7 889
182 Jagannathpur UHC 30,749 7,457 18,954 7,351 64,511 1,910 1,262 1,968 1,356 6,496
183 Jaldhaka UHC 19,213 10,342 16,452 8,868 54,875 3,248 2,591 2,629 2,228 10,696
184 Jamalganj UHC 46,945 8,230 39,421 6,962 101,558 7,786 674 4,702 830 13,992
185 Jhenaigati UHC 53,045 6,475 27,510 7,914 94,944 1,075 61 1,841 92 3,069
186 Jhikargacha UHC 25,035 8,778 15,261 6,245 55,319 9,383 220 8,850 166 18,619
187 Jibannagar UHC 33,928 9,425 26,231 6,791 76,375 4,410 1,223 2,523 911 9,067
188 Jointapur UHC 21,049 7,412 17,980 4,560 51,001 4,424 1,626 6,206 1,431 13,687
Total Total
189 Juraichhari UHC 2,407 410 2,575 488 5,880 111 15 394 15 535
190 Juri UHC 3,987 4,654 3,547 3,122 15,310 0 0 0 0 0
191 Kabirhat UHC 2,013 18,521 3,120 12,937 36,591 85 275 120 350 830
192 Kachua UHC, Bagerhat 30,417 7,242 12,890 10,862 61,411 2,456 102 1,827 116 4,501
193 Kachua UHC, Chandpur 17,308 2,546 10,343 2,490 32,687 1,156 100 1,946 92 3,294
194 Kahaloo UHC 24,929 6,710 25,152 7,536 64,327 5,645 1,325 2,576 1,251 10,797
195 Kaharol UHC 33,238 2,889 29,344 3,050 68,521 2,370 191 3,390 289 6,240
196 Kalai UHC 49,464 6,059 22,854 6,311 84,688 7,502 1,151 7,141 1,515 17,309
197 Kalapara UHC 20,420 2,865 12,593 3,427 39,305 371 20 916 27 1,334
198 Kalaroa UHC 26,050 5,659 13,257 5,072 50,038 810 169 661 155 1,795
199 Kalia UHC 37,969 3,873 19,386 4,506 65,734 1,291 188 2,432 304 4,215
200 Kaliakair UHC 34,985 7,882 26,911 7,184 76,962 5,422 315 5,710 502 11,949
201 Kaliganj UHC, Gazipur 52,912 8,354 29,363 15,413 106,042 3,903 552 5,158 713 10,326
202 Kaliganj UHC, Jhenaidah 44,964 4,852 23,495 5,619 78,930 1,418 279 2,542 455 4,694
203 Kaliganj UHC, Satkhira 24,373 2,070 12,254 1,967 40,664 24,373 310 1,117 185 3,511
204 Kaliganj UHC, Lalmonirhat 6,828 949 6,871 1,098 15,746 3,524 338 2,936 282 7,080
205 Kalihati UHC 24,520 4,547 13,185 4,687 46,939 5,924 1,152 6,789 1,183 15,048
206 Kalkini UHC 27,813 9,987 22,338 7,591 67,729 2,768 337 2,960 533 6,598
207 Kalmakanda UHC 11,257 2,535 7,150 1,795 22,737 1,584 383 3,303 883 6,153
208 Kalukhali UHC 0 0 0 0 0 0 0 0 0 0
209 Kamalganj UHC 24,840 5,141 19,533 4,325 53,839 3,861 1,250 3,578 1,292 9,981
210 Kamarkhanda UHC 47,100 3,858 44,038 3,638 98,634 760 83 957 71 1,871
211 Kamolnagar UHC 85,103 5,874 4,641 4,413 100,031 2,422 69 1,056 93 3,640
212 Kanaighat UHC 24,855 7,587 15,419 5,448 53,309 1,743 405 2,893 739 5,780
213 Kapasia UHC 50,319 9,880 38,562 8,605 107,366 2,192 500 3,087 768 6,547
214 Kaptai UHC 13,686 1,815 9,950 1,981 27,432 731 95 943 156 1,925
215 Karimganj UHC 34,340 11,914 19,320 12,220 77,794 8,424 1,762 11,583 1,780 23,549
216 Kashba UHC 6,494 4,237 7,414 4,321 22,466 3,578 1,306 3,666 1,299 9,849
217 Kashiani UHC 27,641 16,835 21,863 14,254 80,593 4,681 2,104 2,135 1,574 10,494
218 Kathalia UHC 34,572 2,706 18,516 1,356 57,150 1,254 78 1,038 169 2,539
219 Katiadi UHC 44,422 12,115 36,345 8,077 100,959 9,584 1,305 11,715 1,065 23,669
220 Kawkhali UHC, Pirojpur 21,986 2,419 13,867 2,657 40,929 304 23 631 45 1,003
221 Kawkhali UHC, Rangamati 11,026 1,548 10,073 1,486 24,133 78 3 170 3 254
ANNEX

Total Total
222 Kazipur UHC 37,608 6,853 33,743 5,931 84,135 649 25 1,459 28 2,161
223 Kendua UHC 12,205 2,941 11,904 2,714 29,764 2,523 230 2,735 567 6,055

224 Keraniganj UHC 55,526 17,034 18,655 16,821 108,036 1,983 758 2,221 787 5,749
225 Keshabpur UHC 25,803 8,766 20,175 7,998 62,742 293 186 469 301 1,249
226 Khaliajuri UHC 20,720 4,766 15,747 4,830 46,063 897 478 1,330 512 3,217
227 Khansama UHC 55,536 10,270 27,989 9,892 103,687 2,022 172 2,349 208 4,751
228 Khetlal UHC 35,363 4,552 20,707 4,207 64,829 489 29 701 55 1,274
229 Khoksha UHC 11,555 2,428 11,251 1,806 27,040 1,659 311 1,713 171 3,854
230 Kishoreganj UHC, Nilphamari 4,130 6,775 3,728 6,280 20,913 1,346 3,898 1,149 2,890 9,283
231 Kotchandpur UHC 27,565 4,654 17,072 5,491 54,782 1,205 206 2,488 307 4,206
232 Kotwalipara UHC 27,405 14,736 17,305 11,812 71,258 3,798 994 2,570 879 8,241
233 Kownia UHC 19,759 10,356 21,219 9,882 61,216 1,412 394 1,652 406 3,864
234 Koyra UHC 1,328 4,939 1,049 3,889 11,205 2 388 3 275 668
235 Kulaura UHC 28,303 5,381 15,202 5,621 54,507 7,512 1,748 7,853 1,712 18,825
236 Kuliarchar UHC 41,220 8,564 288,140 8,108 346,032 2,244 220 2,561 232 5,257
237 Kumarkhali UHC 20,578 7,757 9,585 6,186 44,106 1,789 31 2,411 44 4,275
238 Kutubdia UHC 18,443 6,938 2,890 6,825 35,096 181 150 272 143 746
239 Lakhai UHC 26,131 6,888 21,754 4,747 59,520 1,343 204 1,723 299 3,569
240 Laksham UHC 10,816 2,830 7,511 2,635 23,792 1,377 119 2,105 75 3,676
241 Lakshmichhari UHC 5,245 2,514 3,685 2,040 13,484 320 53 468 58 899
242 Lalmohan UHC 15,207 11,022 14,872 10,101 51,202 1,098 276 1,105 312 2,791
243 Lalpur UHC 37,312 5,159 19,188 5,661 67,320 4,629 323 3,536 447 8,935
244 Lama UHC 22,238 11,601 12,683 10,755 57,277 1,644 456 1,622 422 4,144
245 Langadu UHC 16,780 2,879 12,739 2,354 34,752 93 49 77 23 242
246 Lohagara UHC, Chittagong 34,904 10,551 23,904 11,385 80,744 3,842 1,650 3,285 1,744 10,521
247 Lohagara UHC, Narail 44,234 5,843 30,774 4,500 85,351 3,767 279 2,907 387 7,340
248 Louhajang UHC 22,028 4,601 12,622 4,461 43,712 3,397 1,521 2,770 1,454 9,142
249 Madan UHC 6,441 1,210 5,557 1,117 14,325 2,630 510 2,267 456 5,863
250 Madarganj UHC 19,140 4,203 14,247 3,188 40,778 2,031 447 1,974 445 4,897
251 Madhabpur UHC 18,678 4,740 14,288 4,623 42,329 2,149 499 2,299 577 5,524
252 Manda UHC 39,762 10,411 22,396 7,645 80,214 2,588 587 2,568 498 6,241
253 Manikchhari UHC 31,202 614 18,671 298 50,785 1,515 365 1,712 224 3,816
254 Manpura UHC 23,112 8,080 14,780 7,175 53,147 412 656 1,077 513 2,658
Total Total
255 Mathbaria UHC 8,907 3,707 5,406 3,490 21,510 2,985 2,504 3,560 2,090 11,139
256 Matiranga UHC 24,164 17,022 43,889 15,689 100,764 812 544 732 425 2,513
257 Matlab(daxin) UHC 21,925 8,780 9,733 6,716 47,154 3,325 1,172 3,948 1,070 9,515
258 Matlab(uttar) UHC 18,670 2,220 16,665 2,425 39,980 1,215 285 1,120 215 2,835
259 Meghna UHC 3,615 1,082 3,506 939 9,142 251 11 435 9 706
260 Mehendiganj UHC 15,586 7,724 10,052 6,845 40,207 1,460 893 1,867 1,095 5,315
261 Melandaha UHC 52,179 7,931 35,177 5,840 101,127 5,057 756 5,112 702 11,627
262 Mirarsarai UHC 25,633 11,203 19,674 7,619 64,129 18,699 4,564 13,478 3,456 40,197
263 Mirpur UHC, Rajshahi 19,900 2,738 14,127 2,765 39,530 3,935 395 4,595 653 9,578
264 Mirzaganj UHC 10,325 1,498 12,932 1,558 26,313 1,845 264 1,374 404 3,887
265 Mirzapur UHC 30,344 8,906 16,848 6,948 63,046 2,309 1,013 1,245 1,008 5,575
266 Mithamoin UHC 34,345 6,116 21,839 5,320 67,620 1,684 329 1,846 267 4,126
267 Mithapukur UHC 28,386 5,542 15,335 3,946 53,209 3,367 322 4,380 450 8,519
268 Modhukhali UHC 26,735 10,432 14,250 8,022 59,439 12,460 943 5,620 650 19,673
269 Madhupur UHC 37,795 6,059 33,097 6,231 83,182 8,179 963 8,098 1,615 18,855
270 Mohadevpur UHC 22,153 7,164 18,102 7,341 54,760 3,683 228 3,702 247 7,860
271 Mohalchhari UHC 15,452 3,776 8,494 3,275 30,997 110 8 126 15 259
272 Mohammadpur UHC, Magura 36,941 7,114 24,188 5,276 73,519 2,308 806 2,019 755 5,888
273 Mohanganj UHC 18,650 3,110 19,703 3,891 45,354 2,254 318 2,774 437 5,783
274 Mohanpur UHC 37,808 5,702 17,769 5,517 66,796 1,897 198 2,564 254 4,913
275 Moheshkhali UHC 25,765 5,908 12,465 4,709 48,847 839 514 846 508 2,707
276 Moheshpur UHC 32,092 3,944 23,251 4,303 63,590 3,565 367 3,270 512 7,714
277 Mollahat UHC 29,435 5,164 13,030 5,765 53,394 2,618 529 2,522 435 6,104
278 Mongla UHC 22,439 3,016 10,972 2,676 39,103 3,369 235 2,586 298 6,488
279 Monirampur UHC 22,547 7,951 7,966 5,355 43,819 1,398 287 1,966 326 3,977
280 Monohardi UHC 32,723 5,534 14,016 6,240 58,513 1,866 165 3,097 232 5,360
281 Monoharganj UHC 5,912 1,927 5,132 1,435 14,406 0 0 0 0 0
282 Morrelganj UHC 17,038 5,808 6,626 5,840 35,312 1,635 153 1,361 173 3,322
283 Mujibnagar UHC 50,292 4,046 30,072 4,373 88,783 2,068 222 2,526 243 5,059
284 Mukshedpur UHC 39,106 12,542 28,869 13,210 93,727 3,275 817 4,032 904 9,028
285 Muktagacha UHC 65,845 2,393 46,931 2,605 117,774 4,892 929 5,562 1,154 12,537
286 Muladi UHC 6,880 3,213 4,855 3,165 18,113 1,074 167 1,344 309 2,894
287 Muradnagar UHC 35,683 6,386 19,439 5,856 67,364 3,796 1,038 5,336 1,219 11,389
ANNEX

Total Total
288 Nabiganj UHC 8,105 3,122 6,105 2,224 19,556 2,214 432 7,479 610 10,735
289 Nabinagar UHC 5,252 26,212 2,537 20,154 54,155 526 2,710 256 1,755 5,247

290 Nachol UHC 3,983 18,029 3,356 23,560 48,928 214 1,087 210 1,320 2,831
291 Nagarkanda UHC 14,221 1,449 12,805 1,401 29,876 1,420 1,257 2,259 1,125 6,061
292 Nagarpur UHC 16,801 7,285 10,540 5,285 39,911 1,273 223 487 115 2,098
293 Nageswari UHC 50,779 3,621 45,472 3,263 103,135 3,993 442 5,121 528 10,084
294 Naikhongchhari UHC 19,810 10,003 7,623 5,689 43,125 238 101 511 68 918
295 Nakhla UHC 25,211 3,230 25,614 7,927 61,982 4,299 1,236 4,511 1,354 11,400
296 Nalchithi UHC 18,174 8,205 15,885 5,275 47,539 4,744 428 6,703 350 12,225
297 Nalitabari UHC 46,966 2,096 31,002 2,191 82,255 2,496 251 3,182 289 6,218
298 Nandail UHC 23,066 4,754 1,790 6,062 35,672 4,610 936 4,532 1,098 11,176
299 Nandigram UHC 29,224 4,354 21,716 3,771 59,065 2,527 377 2,115 341 5,360
300 Nangolkot UHC 35,252 7,989 34,711 4,363 82,315 475 137 750 152 1,514
301 Naniarchar UHC 6,736 1,726 3,005 1,279 12,746 233 109 137 102 581
302 Naria UHC 19,391 4,964 12,410 3,576 40,341 1,075 1,036 4,312 1,183 7,606
303 Nasirnagar UHC 24,632 5,074 19,706 4,550 53,962 2,635 1,518 2,298 1,282 7,733
304 Nawabganj UHC, Dhaka 52,134 12,929 36,726 10,954 112,743 596 335 1,248 610 2,789
305 Nawabganj UHC, Dinajpur 32,896 11,110 27,189 8,649 79,844 1,763 298 2,201 412 4,674
306 Nazirpur UHC 15,272 1,606 9,022 2,041 27,941 454 60 534 28 1,076
307 Nesarabad UHC 23,827 2,878 14,025 2,919 43,649 5,125 748 3,310 1,127 10,310
308 Niamatpur UHC 17,093 2,639 25,904 2,630 48,266 317 28 641 20 1,006
309 Nikli UHC 44,984 4,092 36,724 5,264 91,064 2,333 1,347 1,996 1,009 6,685
310 Paba UHC 65,499 5,679 49,876 4,321 125,375 721 147 948 103 1,919
311 Paikgacha UHC 12,010 4,001 8,805 3,010 27,826 211 28 377 33 649
312 Pakundia UHC 33,366 5,119 19,856 7,533 65,874 1,109 1,047 2,924 1,109 6,189
313 Palash UHC 31,670 5,336 12,805 5,074 54,885 1,608 430 1,508 581 4,127
314 Palashbari UHC 34,327 2,582 23,278 2,833 63,020 2,960 162 2,631 261 6,014
315 Panchhari UHC 18,708 3,214 8,538 3,307 33,767 879 257 893 234 2,263
316 Panchbibi UHC 21,755 2,463 13,077 2,460 39,755 378 72 1,029 76 1,555
317 Pangsha UHC 17,840 3,819 13,334 4,522 39,515 446 51 875 68 1,440
318 Parbatipur UHC 14,199 3,007 13,455 3,359 34,020 3,970 558 3,978 464 8,970
319 Parsuram UHC 22,046 7,269 16,644 6,112 52,071 343 22 1,006 59 1,430
320 Patgram UHC 15,297 4,098 14,850 3,312 37,557 4,766 1,083 4,850 977 11,676
Total Total
321 Pathargatha UHC 11,159 1,727 8,051 2,043 22,980 395 162 936 190 1,683
322 Patiya UHC 21,528 7,150 20,215 7,753 56,646 10,893 3,122 14,141 3,520 31,676
323 Patnitala UHC 21,527 2,400 12,630 2,412 38,969 278 25 715 25 1,043
324 Pekua UHC 26,480 5,296 10,542 10,642 52,960 1,088 376 1,495 408 3,367
325 Pirgacha UHC 19,623 3,624 16,676 3,576 43,499 1,391 616 1,189 614 3,810
326 Pirganj UHC, Rangpur 48,052 27,721 32,354 21,321 129,448 10,225 5,422 6,996 5,040 27,683
327 Pirganj UHC, Thakurgaon 37,289 2,227 19,088 1,664 60,268 605 123 729 119 1,576
328 Porsha UHC 19,886 10,784 12,570 8,494 51,734 3,843 373 3,771 221 8,208
329 Purbadhala UHC 9,135 2,539 5,945 2,486 20,105 4,392 1,087 4,152 1,047 10,678
330 Puthia UHC 24,994 43,290 20,098 29,991 118,373 603 2,455 301 3,345 6,704
331 Raiganj UHC 28,597 1,737 23,303 1,589 55,226 1,382 327 1,343 287 3,339
332 Raipur UHC 48,790 11,946 2,739 8,043 71,518 886 63 1,600 84 2,633
333 Raipura UHC 13,345 817 14,876 8,024 37,062 4,007 530 3,687 458 8,682
334 Rajapur UHC 17,530 7,855 11,515 6,201 43,101 2,966 422 3,162 621 7,171
335 Rajarhat UHC 12,719 1,361 13,762 1,543 29,385 2,321 279 1,440 208 4,248
336 Rajibpur UHC 2,367 36,478 4,320 37,359 80,524 1,345 2,387 1,559 2,734 8,025
337 Rajnagar UHC 421,000 13,109 239,080 11,339 684,528 2,687 902 2,638 757 6,984
338 Rajoir UHC 24,980 5,585 17,394 6,657 54,616 4,426 1,109 4,112 988 10,635
339 Rajsthali UHC 6,078 916 6,032 1,114 14,140 237 34 394 60 725
340 Ramganj UHC 36,050 2,767 20,705 2,812 62,334 3,004 313 2,635 436 6,388
341 Ramgarh UHC 23,241 4,013 12,592 4,654 44,500 958 170 1,039 243 2,410
342 Ramgati UHC 28,035 3,664 19,909 3,793 55,401 1,544 789 1,518 1,280 5,131
343 Rampal UHC 6,839 10,167 4,212 5,475 26,693 532 3,371 319 2,384 6,606
344 Ramu UHC 26,824 14,191 15,607 9,048 65,670 4,576 717 3,773 1,187 10,253
345 Rangunia UHC 14,326 15,654 19,930 13,580 63,490 4,920 3,521 3,560 4,215 16,216
346 Raninagar UHC 24,177 8,762 15,728 11,893 60,560 4,938 629 3,045 504 9,116
347 Ranisankhail UHC 11,978 2,010 10,482 1,632 26,102 2,908 250 2,406 402 5,966
348 Roujan UHC 2,738 42,356 2,569 40,126 87,789 762 3,846 698 6,958 12,264
349 Rowangchhari UHC 4,468 590 5,217 724 10,999 86 13 229 10 338
350 Rowmari UHC 27,005 4,022 27,924 3,217 62,168 687 31 755 21 1,494
351 Ruma UHC 7,129 413 7,829 548 15,919 251 52 323 47 673
352 Rupganj UHC 18,370 5,905 18,370 5,100 47,745 2,010 101 2,820 89 5,020
353 Rupsha UHC 24,604 2,228 18,811 2,628 48,271 1,002 52 1,849 108 3,011
ANNEX

Total Total
354 Sadarpur UHC 11,250 4,046 3,756 4,020 23,072 2,322 450 2,302 420 5,494
355 Sadullapur UHC 31,520 7,848 23,760 5,230 68,358 755 280 629 237 1,901

356 Saharasthi UHC 24,563 3,202 12,047 3,744 43,556 4,918 608 4,776 7,720 18,022
357 Sailkupa UHC 18,167 9,167 18,165 9,000 54,499 1,300 1,876 2,000 1,475 6,651
358 Sakhipur UHC 26,850 6,334 15,243 7,429 55,856 5,224 786 3,916 830 10,756
359 Sandwip UHC 8,965 20,368 8,322 17,425 55,080 596 1,969 572 3,024 6,161
360 Santhia UHC 75,290 6,556 24,996 8,924 115,766 5,511 474 6,222 663 12,870
361 Sapahar UHC 16,938 3,788 12,657 3,102 36,485 2,883 662 3,460 771 7,776
362 Sarail UHC 22,282 9,111 19,639 6,840 57,872 5,281 1,686 4,120 1,466 12,553
363 Sarankhola UHC 9,350 1,865 8,192 1,674 21,081 6,609 257 3,219 223 10,308
364 Sariakandi UHC 32,048 4,992 22,770 3,713 63,523 2,084 475 2,437 512 5,508
365 Sarishabari UHC 19,103 3,092 11,856 3,746 37,797 2,596 489 4,367 731 8,183
366 Sarsa UHC 39,879 9,828 13,488 8,025 71,220 2,711 366 4,495 504 8,076
367 Satkania UHC 15,007 6,010 12,056 5,520 38,593 4,044 476 3,015 410 7,945
368 Saturia UHC 35,194 6,658 20,069 4,252 66,173 1,888 293 2,987 348 5,516
369 Savar UHC 59,730 10,407 42,303 11,275 123,715 2,887 327 4,587 510 8,311
370 Senbag UHC 12,941 4,961 15,802 7,512 41,216 1,490 1,290 1,720 1,580 6,080
371 Serajdikhan UHC 61,163 3,056 28,098 2,998 95,315 5,075 1,806 4,891 1,707 13,479
372 Shaghata UHC 39,262 4,750 31,902 4,300 80,214 1,610 310 2,200 390 4,510
373 Shahzadpur UHC 74,982 3,537 26,891 4,513 109,923 2,939 288 1,825 272 5,324
374 Shailkupa UHC 18,167 9,167 18,165 9,000 54,499 1,300 1,876 2,000 1,475 6,651
375 Shajahanpur UHC 37,803 2,437 12,447 2,057 54,744 1,320 179 1,078 132 2,709
376 Shalikha UHC 20,190 2,901 13,250 2,717 39,058 2,436 340 1,828 328 4,932
377 Sherpur UHC, Bogra 55,635 9,296 50,848 7,297 123,076 6,873 1,513 7,886 1,884 18,156
378 Shibalaya UHC 32,921 4,647 16,007 3,573 57,148 3,363 236 2,969 326 6,894
379 Shibchar UHC 8,010 23,461 5,608 16,305 53,384 647 1,110 1,671 3,249 6,677
380 Shibganj UHC, Bogra 29,895 5,093 13,962 4,356 53,306 2,659 485 2,196 427 5,767
381 Shibganj UHC, Chapainowabganj 25,856 11,316 19,648 10,173 66,993 1,165 235 1,931 315 3,646
382 Shibpur UHC 28,124 2,052 11,232 2,780 44,188 3,682 420 4,877 706 9,685
383 Shyamnagar UHC 15,857 9,570 13,225 8,173 46,825 4,667 2,285 4,314 2,300 13,566
384 Singair UHC 25,726 7,825 21,047 12,219 66,817 1,409 491 4,016 261 6,177
385 Singra UHC 41,849 3,006 37,587 3,199 85,641 6,801 1,671 6,539 1,487 16,498
386 Sitakunda UHC 38,457 15,847 29,358 14,582 98,244 6,324 1,125 5,635 1,095 14,179
387 Sonagazi UHC 28,768 11,337 24,580 11,148 75,833 1,374 418 2,918 401 5,111
Total Total
388 Sonaimuri UHC 30,793 2,892 15,678 2,750 52,113 2,977 865 2,123 903 6,868
389 Sonargaon UHC 78,312 9,856 25,341 10,230 123,739 2,039 784 2,217 965 6,005
390 Sonatala UHC 15,265 10,352 10,428 7,112 43,157 2,338 862 2,151 494 5,845
391 Sreemangal UHC 38,640 3,626 26,559 3,618 72,443 8,072 1,240 12,821 1,120 23,253
392 Sreenagar UHC 27,811 10,509 15,305 10,001 63,626 4,181 1,024 4,882 1,701 11,788
393 Sreepur UHC, Gazipur 43,696 9,428 24,641 9,921 87,686 3,842 390 4,638 540 9,410
394 Sreepur UHC, Magura 20,146 2,658 14,258 2,638 39,700 863 217 980 229 2,289
395 Sribordi UHC 48,441 8,271 33,597 8,521 98,830 3,082 899 3,041 981 8,003
396 Subarnachar UHC 4,244 8,704 2,830 5,962 21,740 405 1,477 417 1,220 3,519
397 Sujanagar UHC 7,963 13,875 7,402 11,960 41,200 1,922 4,366 2,013 4,472 12,773
398 Sulla UHC 7,466 1,713 7,914 1,667 18,760 72 53 102 37 264
399 Sundarganj UHC 23,935 249 20,512 257 44,953 1,871 432 2,108 384 4,795
400 Taherpur UHC 52,578 14,008 34,543 13,208 114,337 3,112 98 3,008 120 6,338
401 Tajumuddin UHC 31,981 10,045 33,141 10,422 85,589 876 83 1,077 92 2,128
402 Tala UHC 16,394 2,341 16,210 2,315 37,260 2,323 331 2,209 315 5,178
403 Tanore UHC 43,278 11,439 27,353 7,314 89,384 1,326 214 678 167 2,385
404 Taraganj UHC 36,557 1,121 23,946 1,333 62,957 1,362 537 1,732 423 4,054
405 Tarail UHC 39,428 5,460 37,898 6,365 89,151 1,642 195 1,901 201 3,939
406 Tarash UHC 33,996 9,960 25,674 7,140 76,770 544 231 567 156 1,498
407 Teknaf UHC 29,278 6,901 14,488 7,476 58,143 4,871 1,534 4,674 2,203 13,282
408 Terakhada UHC 31,512 3,228 26,939 3,009 64,688 516 200 577 250 1,543
409 Tetulia UHC 17,921 7,068 19,007 6,108 50,104 1,967 134 3,234 221 5,556
410 Thanchi UHC 3,456 543 2,784 387 7,170 44 6 92 9 151
411 Titas UHC 2,658 22,524 3,254 18,452 46,888 1,416 2,876 1,984 1,698 7,974
412 Trisal UHC 42,875 8,872 31,145 7,225 90,117 9,738 832 10,345 895 21,810
413 Tungibari UHC 49,063 12,617 26,279 11,764 99,723 1,402 781 1,672 675 4,530
414 Tungipara UHC 25,332 4,856 21,031 3,562 54,781 2,568 985 2,015 896 6,464
415 Ukhyia UHC 55,452 14,047 38,440 11,212 119,151 6,014 2,024 4,963 2,637 15,638
416 Ullapara UHC 35,511 5,094 22,617 5,003 68,225 1,207 380 1,476 421 3,484
417 Ullipur UHC 8,995 24,978 7,687 23,780 65,440 7,890 530 6,560 450 15,430
418 Wazirpur UHC 10,681 2,402 6,431 3,115 22,629 1,809 203 1,841 234 4,087
419 Zakiganj UHC 18,294 13,652 11,823 13,396 57,165 6,559 2,029 7,309 1,988 17,885
420 Zanjira UHC 41,503 8,301 19,641 7,436 76,881 3,570 1,516 1,761 835 7,682
ANNEX
421 Zianagar UHC 7,812 737 5,737 687 14,973 293 51 231 67 642

2.Total bed, average length of stay (ALS), and bed-occupancy ratio (BOR) in hospitals under DGHS in 2015
A.Tertiary hospitals
Type Name of facility Total bed ALS (Day) BOR (%)
Govt. Homeopathic Medical College Hospital, Dhaka 100 20.4 34.5

Hospitals of alternative medical colleges

Govt. Unani & Ayurvedic Medical College Hospital, Dhaka 100 18.4 44.4
Chittagong Medical College Hospital, Chittagong 1,313 5.0 168.0
Comilla Medical College Hospital, Comilla 500 2.9 149.0
Dhaka Medical College Hospital, Dhaka 2,600 8.4 131.4
Dinajpur Medical College Hospital, Dinajpur 500 4.6 102.7
Faridpur Medical College Hospital, Faridpur 500 4.6 103.3
Khulna Medical College Hospital, Khulna 500 4.4 129.3
Mymensingh Medical College Hospital, Mymensingh 1,000 4.9 199.6

Medical college hospitals
Rajshahi Medical College Hospital, Rajshahi 1,200 4.0 137.5
Rangpur Medical College Hospital, Rangpur 1,000 6.0 172.3
Shaheed Suhrawardy Medical College Hospital, Dhaka 850 4.8 118.3
Shahid Ziaur Rahman Medical College Hospital, Bogra 500 4.9 162.7
Sher-e-Bangla Medical College Hospital, Barisal 1,000 5.7 144.5
Sir Salimullah Medical College (Mitford) Hospital, Dhaka 600 4.9 131.6
Sylhet MAG Osmani Medical College Hospital 900 4.6 190.2
Bangladesh Institute of Tropical and Infectious Disease, Foujdarhat, Chittagong 120 2.2 29.6
Dhaka Dental College Hospital, Dhaka 200 29.8 76.3

Pabna Mental Hospital, Pabna 500 97.2 83.6
Shaheed Sheikh Abu Naser Specialized Hospital, Khulna 250 49.6 151.0
Institute of Child and Mother Health, Matuail, Dhaka - - -
National Center For Control Of Rheumatic Fever & Heart Disease 100 - -
National Institute of Cancer Research and Hospital (NICR&H), Mohakhali, Dhaka 200 4.9 96.9
National Institute of Cardiovascular Disease (NICVD), Sher-e-Bangla Nagar, Dhaka 300 11.1 74.1
National Institute of Diseases of the Chest and Hospital (NIDCH), Mohakhali, Dhaka 414 4.0 166.2
Specialty institute hospitals National Institute of ENT, Dhaka 600 16.5 103.8
National Institute of Kidney Disease and Urology (NIKDU), Sher-e-Bangla Nagar, Dhaka 150 8.6 90.7
National Institute of Mental Health & Research (NIMHR), Sher-e-Bangla Nagar, Dhaka 200 19.6 82.9
National Institute of Neurosciences and Hospital (NINH) , Dhaka 300 15.0 100.0
National Institute of Ophthalmology (NIO), Sher-e-Bangla Nagar, Dhaka 250 5.5 88.9
National Institute of Traumatology and Rehabilitation (NITOR), Sher-e-Bangla Nagar, Dhaka 500 9.5 96.9
TB Hospital, Khulna 100 1.0 1.0

TB hospitals
TB Hospital, Rajshahi 150 57.0 40.6
B. Secondary (district-level) hospitals
Division District Name of facility Total bed ALS (Day) BOR (%)
Barguna Barguna District Hospital 100 2.9 115.4
Barisal Barisal General Hospital 100 4.6 99.0
Bhola Bhola District Hospital 100 1.9 145.1

Barisal
Jhalokathi Jhalokathi District Hospital 100 3.1 124.4
Patuakhali Patuakhali 250-bed Sadar Hospital 250 3.8 139.5
Pirojpur Pirojpur District Hospital 100 2.4 101.7
Bandarban Bandarban District Hospital 100 3.2 59.8
Brahmanbaria Brahmanbaria 250-bed District Sadar Hospital 250 3.1 90.5
Chandpur Chandpur 250-bed General Hospital 250 2.9 103.5
Chittagong Chittagong General Hospital 250 5.4 70.0
Comilla Comilla General Hospital 100 3.7 80.6
Chittagong Coxs Bazar Coxs Bazar 250-bed District Sadar Hospital 250 2.8 153.4
Feni Feni 250-bed District Sadar Hospital 250 1.7 58.0
Khagrachhari Khagrachhari District Hospital 100 2.8 89.3
Lakshmipur Lakshmipur District Hospital 100 3.6 173.4
Noakhali Noakhali 250-bed General Hospital 250 3.4 174.3
Rangamati Rangamati General Hospital 100 2.8 82.0
Kurmitola 500-bed General Hospital 500 3.4 48.6

Dhaka
Mugda 500-bed Hospital 500 _ _
Faridpur Faridpur General Hospital 100 2.7 145.1
Gazipur Gazipur District Hospital 100 2.0 100.0
Gopalganj Gopalganj 250-bedded District Sadar Hospital 250 3.2 99.0
Kishoreganj Kishoreganj 250-bed District Sadar Hospital 250 2.4 157.7
Madaripur Madaripur District Hospital 100 2.5 145.1
Manikganj Manikganj District Hospital 100 2.5 157.8

Dhaka
Munshiganj Munshiganj District Hospital 100 2.6 111.0
Narayanganj 300-bedded Hospital 300 10.5 80.5

Narayanganj
Narayanganj General Hospital 100 2.5 121.3
Narsingdi 100-bed Zilla Hospital 100 4.9 145.1

Narsingdi
Sadar Hospital Narsingdi 100 3.1 73.5
Rajbari Rajbari District Hospital 100 2.4 131.5
Shariatpur Shariatpur District Hospital 100 1.0 116.4
Tangail Tangail 250-bed District Hospital 250 2.4 169.6

ANNEX

Division District Name of facility Total bed ALS (Day) BOR (%)
Bagerhat Bagerhat District Hospital 100 3.2 138.0
Chuadanga Chuadanga District Hospital 100 7.2 593.2
Jessore Jessore 250-bed General Hospital 278 2.7 155.6
Jhenaidah Jhenaidah District Hospital 100 2.4 192.8

Khulna Khulna General Hospital 150 6.1 96.7
Khulna
Kushtia Kushtia 250-bed General Hospital 250 3.0 181.8
Magura Magura District Hospital 100 3.3 264.9
Meherpur Meherpur District Hospital 100 2.4 184.3
Narail Narail District Hospital 100 2.9 154.9
Satkhira Satkhira District Hospital 100 3.4 220.3
Jamalpur Jamalpur 250-bed General Hospital 250 2.7 138.4
Mymensingh Netrakona Netrakona District Hospital 100 2.2 171.5
Sherpur Sherpur 100-bed District Sadar Hospital 100 2.7 214.5
Bogra Bogra 250-bed Mohammad Ali District Hospital 250 4.1 82.2
Chapainowabganj Chapainowabganj District Hospital 100 2.6 185.4
Joypurhat Joypurhat District Hospital 150 2.7 127.9
Rajshahi Naogaon Naogaon District Hospital 100 2.3 146.3
Natore Natore District Hospital 100 2.1 154.7
Pabna Pabna 250-bed General Hospital 250 2.2 176.6
Sirajganj Sirajganj General Hospital 250 1.0 93.7
Dinajpur Dinajpur General Hospital 250 2.4 64.0
Gaibandha Gaibandha District Hospital 100 2.3 141.6
Kurigram Kurigram District Hospital 100 2.7 185.8
Lalmonirhat Lalmonirhat District Hospital 100 3.3 94.0

Rangpur
Nilphamari District Hospital 100 3.0 169.1
Nilphamari
Saidpur 100-bed Hospital 100 2.9 101.7
Panchagarh Panchagarh 100-bed District Sadar Hospital 100 2.8 144.5
Thakurgaon Thakurgaon District Hospital 100 2.7 278.3
Habiganj Habiganj District Hospital 100 2.0 219.0
Maulvibazar Maulvibazar 250-bed District Sadar Hospital 250 2.3 98.0

Sylhet
Sunamganj Sunamganj 250-bed District Sadar Hospital 250 3.0 75.0
Sylhet Shahid Shamsuddin District Hospital 100 - -

ANNEX
C. Upazila health complex
Division District Name Total beds ALS (Days) BOR (%)
Amtali Upazila Health Complex 50 2.4 66.8
Bamna Upazila Health Complex 31 3.9 68.1
Betagi Upazila Health Complex 50 2.43 80.47
Pathargatha Upazila Health Complex 50 2.3 58.2
Agailjhara Upazila Health Complex 50 3 60.8
Babuganj Upazila Health Complex 31 5.4 57.4
Barguna Bakerganj Upazila Health Complex 31 2.5 103.2
Banaripara Upazila Health Complex 50 2.3 63.5
Gournadi Upazila Health Complex 50 2.7 81.3
Hijla Upazila Health Complex 31 3.5 70.5
Mehendiganj Upazila Health Complex 31 2.3 103.2
Muladi Upazila Health Complex 50 4 77.1
Wazirpur Upazila Health Complex 50 4.1 90.1
Borhanuddin Upazila Health Complex 50 1.8 92.6
Char Fasson Upazila Health Complex 50 2 146
Daulatkhan Upazila Health Complex 50 2.2 56.1

Bhola
Lalmohan Upazila Health Complex 50 2.1 105.7
Barisal
Manpura Upazila Health Complex 31 3.3 74.1
Tajumuddin Upazila Health Complex 31 4 101.3
Kathalia Upazila Health Complex 31 5.3 116.8
Jhalokathi Nalchithi Upazila Health Complex 50 2.8 55.7
Rajapur Upazila Health Complex 50 3.3 75.6
Bauphal Upazila Health Complex 50 4 95.6
Dashmina Upazila Health Complex 31 2.4 114.1
Dumki Upazila Health Complex 31 3.2 65.9

Patuakhali
Galachipa Upazila Health Complex 50 3.1 115.4
Kalapara Upazila Health Complex 50 2.5 120.8
Mirzaganj Upazila Health Complex 50 3.4 64.2
Bhandaria Upazila Health Complex 31 2.5 101.4
Kawkhali Upazila Health Complex 31 3.5 57.4
Mathbaria Upazila Health Complex 50 2.4 103.7

Pirojpur
Nazirpur Upazila Health Complex 50 4.1 57.4
Nesarabad Upazila Health Complex 50 1.9 84.2
Zianagar Upazila Health Complex 31 0 0
Alikadam Upazila Health Complex 31 1.9 64
Lama Upazila Health Complex 31 2.7 100.3
Naikhongchhari Upazila Health Complex 31 1 47.4

Bandarban
Rowangchhari Upazila Health Complex 10 2.8 58.2
Ruma Upazila Health Complex 10 2 65
Thanchi Upazila Health Complex 31 2 77.5
Chittagong Akhaura Upazila Health Complex 31 1.9 79
Ashuganj Upazila Health Complex 0 0 0
Bancharampur Upazila Health Complex 31 2.2 67.7

Brahman-
Kashba Upazila Health Complex 31 1.5 56.1
baria
Nabinagar Upazila Health Complex 31 1 84
Nasirnagar Upazila Health Complex 50 2.6 89.1
Sarail Upazila Health Complex 50 1.9 59.5

Faridganj Upazila Health Complex 31 2.2 69.9
Haimchar Upazila Health Complex 31 2.7 92.4
Haziganj Upazila Health Complex 50 2.6 59.7
Chandpur Kachua Upazila Health Complex 50 2.1 61.2
Matlab(daxin) Upazila Health Complex 50 2.4 82.8
Matlab(uttar) Upazila Health Complex 31 3.5 82.9
Saharasthi Upazila Health Complex 50 2.5 80
Anwara Upazila Health Complex 50 1.7 94.2
Banshkhali Upazila Health Complex 50 2 93.9
Boalkhali Upazila Health Complex 50 1.9 62.3
Chandanaish Upazila Health Complex 50 1.5 54.3
Fatikchhari Upazila Health Complex 50 1.5 73.4
Hathazari Upazila Health Complex 50 2 86.4
Lohagara Upazila Health Complex 50 2.2 80.8

Chittagong
Mirarsarai Upazila Health Complex 50 1.8 68.3
Patiya Upazila Health Complex 50 1.8 100.9
Rangunia Upazila Health Complex 50 1.9 72.7
Roujan Upazila Health Complex 50 1 73.9
Sandwip Upazila Health Complex 31 2 80.3
Satkania Upazila Health Complex 31 2.6 99
Sitakunda Upazila Health Complex 50 1.6 89.4
Barura Upazila Health Complex 31 2.7 88.9
Brahmmanpara Upazila Health Complex 31 2.8 70
Burichong Upazila Health Complex 31 1.9 80.7

Chittagong
Chauddagram Upazila Health Complex 50 1.6 81.6
Chandina Upazila Health Complex 31 1.6 123.9
Comilla Sadar Daxin Upazila Health Complex 31 0 0
Daudkandi Upazila Health Complex 31 1 59.7
Comilla Debidwar Upazila Health Complex 50 1 85.4
Homna Upazila Health Complex 50 1.7 65.4
Laksham Upazila Health Complex 50 1.8 54.5
Meghna Upazila Health Complex 31 6.4 34.9
Monoharganj Upazila Health Complex 31 0 0
Muradnagar Upazila Health Complex 50 2.3 87.2
Nangolkot Upazila Health Complex 50 2.2 68.6
Titas Upazila Health Complex 31 1.3 56.7
Chhagalnaya Upazila Health Complex 50 3 93.6
Daganbhuiya Upazila Health Complex 31 2.1 94.3
Feni Fulgazi Upazila Health Complex 31 1.9 76.1
Parsuram Upazila Health Complex 50 2.2 76.1
Sonagazi Upazila Health Complex 31 2.2 155.3
Dighinala Upazila Health Complex 10 1 150.1
Lakshmichhari Upazila Health Complex 31 2.8 24.6
Manikchhari Upazila Health Complex 10 2.5 206.7

Khagrach-
Matiranga Upazila Health Complex 31 4.6 69.7
hari
Mohalchhari Upazila Health Complex 31 2.1 31
Panchhari Upazila Health Complex 10 1.8 91.5
Ramgarh Upazila Health Complex 31 2.2 52.4

ANNEX
Kamolnagar Upazila Health Complex 31 2 175.2
Raipur Upazila Health Complex 50 2.8 87.1

Lakshmipur
Ramganj Upazila Health Complex 31 2.2 97
Ramgati Upazila Health Complex 31 2.2 83.8
Begumganj Upazila Health Complex 31 4 72.8
Chatkhil Upazila Health Complex 50 2.3 89.5
Companiganj Upazila Health Complex 50 3 110.3
Hatiya Upazila Health Complex 50 2.2 77.7

Noakhali
Kabirhat Upazila Health Complex 50 0 0
Senbag Upazila Health Complex 50 2.3 78.8
Sonaimuri Upazila Health Complex 31 2.4 99.7
Subarnachar Upazila Health Complex 31 2.6 103.1
Baghaichhari Upazila Health Complex 31 2.1 32.9
Barkol Upazila Health Complex 10 6.6 75.7

Chittagong
Belaichhari Upazila Health Complex 10 1.8 19.7
Juraichhari Upazila Health Complex 10 3.9 38.7
Rangamati Kaptai Upazila Health Complex 31 3.2 62.4
Kawkhali Upazila Health Complex 10 2.9 80.9
Langadu Upazila Health Complex 31 3.1 53.8
Naniarchar Upazila Health Complex 10 3 54.1
Rajsthali Upazila Health Complex 10 2.8 51.3
Chakaria Upazila Health Complex 50 1.6 141.7
Kutubdia Upazila Health Complex 50 1 36.5
Moheshkhali Upazila Health Complex 50 1 77.7
Coxs Bazar Pekua Upazila Health Complex 31 1 49.4
Ramu Upazila Health Complex 31 2 119.7
Teknaf Upazila Health Complex 50 1.2 47.6
Ukhyia Upazila Health Complex 50 1.5 66.6
Dhamrai Upazila Health Complex 50 2.4 85.4
Dohar Upazila Health Complex 50 2 75
Dhaka Keraniganj Upazila Health Complex 31 3.6 93.1
Nawabganj Upazila Health Complex 50 2.6 98.3
Savar Upazila Health Complex 50 3.9 92.7
Alfadanga Upazila Health Complex 50 2.3 64.5
Bhanga Upazila Health Complex 50 2.4 82.2
Boalmari Upazila Health Complex 50 1.8 83.4
Faridpur Charbhadrason Upazila Health Complex 31 2.9 57.2
Modhukhali Upazila Health Complex 31 0 0

Dhaka
Nagarkanda Upazila Health Complex 50 2.8 86.4
Sadarpur Upazila Health Complex 50 2.6 51.5
Kaliakair Upazila Health Complex 31 2.4 122.1
Kaliganj Upazila Health Complex 50 2.3 77.3

Gazipur
Kapasia Upazila Health Complex 50 2.5 82.3
Sreepur Upazila Health Complex 50 1.9 65.8
Kashiani Upazila Health Complex 31 2.1 77.5
Kotwalipara Upazila Health Complex 50 2.1 79.7

Gopalganj
Mukshedpur Upazila Health Complex 31 2.4 173.5
Tungipara Upazila Health Complex 50 3.5 103.7

Austagram Upazila Health Complex 50 2.4 34.5
Bajitpur Upazila Health Complex 31 2.5 95.2
Bhairab Upazila Health Complex 50 2.3 86.9
Hossainpur Upazila Health Complex 50 1.8 85
Itna Upazila Health Complex 31 2.7 58.4
Karimganj Upazila Health Complex 50 1.8 67.4

Kishorganj
Katiadi Upazila Health Complex 50 1.9 91.9
Kuliarchar Upazila Health Complex 31 2.3 64.8
Mithamoin Upazila Health Complex 31 2.6 46.7
Nikli Upazila Health Complex 31 2.1 67.7
Pakundia Upazila Health Complex 50 3.1 57.1
Tarail Upazila Health Complex 50 2.7 82.6
Kalkini Upazila Health Complex 50 2.8 61.8
Madaripur Shibchar Upazila Health Complex 50 3 83
Upazila Health Complex, Rajoir, Madaripur. 50 2.2 91.2
Daulatpur Upazila Health Complex 31 1.6 65.9
Ghior Upazila Health Complex 31 3.1 77.8
Harirampur Upazila Health Complex 31 1.8 43.3

Manikganj
Saturia Upazila Health Complex 50 2.6 70
Shibalaya Upazila Health Complex 31 1.8 92
Singair Upazila Health Complex 50 1.1 39.3
Gazaria Upazila Health Complex 50 2.2 70

Dhaka
Louhajang Upazila Health Complex 50 3.1 63.6
Munshiganj Serajdikhan Upazila Health Complex 50 3.4 71.3
Sreenagar Upazila Health Complex 50 2.2 50.2
Tungibari Upazila Health Complex 50 3.4 75.6
Araihazar Upazila Health Complex 31 2.7 66.9
Bandar Upazila Health Complex 31 8.2 62

Narayanganj
Rupganj Upazila Health Complex 50 4.8 65.4
Sonargaon Upazila Health Complex 31 2.4 77.4
Belabo Upazila Health Complex 31 2.6 88.5
Monohardi Upazila Health Complex 50 3.1 84.2
Narsingdi Palash Upazila Health Complex 31 2.6 57.9
Raipura Upazila Health Complex 31 1.8 64.4
Shibpur Upazila Health Complex 31 2.8 59.6
Baliakandi Upazila Health Complex 31 2.7 97.3
Goalanda Upazila Health Complex 50 2.1 85.6

Rajbari
Kalukhali Upazila Health Complex 0 0 0
Pangsha Upazila Health Complex 50 2.8 100.7
Bhedarganj Upazila Health Complex 31 1.8 86.7
Damudya Upazila Health Complex 31 2.1 85.6
Shariatpur Goshairhat Upazila Health Complex 31 2.2 80.1
Naria Upazila Health Complex 31 2.6 87.5
Zanjira Upazila Health Complex, Shariatpur 31 2 94.9

ANNEX
Basail Upazila Health Complex,Tangail. 31 2.6 59
Bhuapur Upazila Health Complex 50 2.4 88.8
Delduar Upazila Health Complex 31 1 59.3
Dhanbari Upazila Health Complex 0 0 0
Ghatail Upazila Health Complex 50 2.3 77
Dhaka Tangail Gopalpur Upazila Health Complex 50 2.1 46.2
Kalihati Upazila Health Complex 50 2.8 84.1
Mirzapur Upazila Health Complex 31 3.5 71.4
Madhupur Upazila Health Complex 50 2.1 99.4
Nagarpur Upazila Health Complex 50 2.6 78.3
Sakhipur Upazila Health Complex 50 2.3 115.6
Chitalmari Upazila Health Complex 31 2.5 86.6
Fakirhat Upazila Health Complex 31 2.2 188.5
Kachua Upazila Health Complex 50 4.6 93.9
Mollahat Upazila Health Complex 31 2.3 100.5

Bagerhat
Morrelganj Upazila Health Complex 31 3.6 117.5
Sarankhola Upazila Health Complex 31 2.6 110.9
Upazila Health Complex, Rampal, Bagerhat 50 3.6 101.4
Mongla Upazila Health Complex 50 3.1 91.4
Alamdanga Upazila Health Complex 31 2.6 161.7
Chuadanga Damurhuda Upazila Health Complex 31 1.9 72.7
Jibannagar Upazila Health Complex 31 1.6 123.1
Abhoynagar Upazila Health Complex 50 2.1 104.3
Bagerpara Upazila Health Complex 50 2.6 75.9
Chowgacha Upazila Health Complex 50 2.4 180
Jessore Jhikargacha Upazila Health Complex 50 2.4 55
Keshabpur Upazila Health Complex 50 2.4 89.1
Monirampur Upazila Health Complex 50 2.3 83.2
Sarsa Upazila Health Complex 31 1.5 80.8
Harinakunda Upazila Health Complex 50 1.9 85.6

Khulna
Jhenaidah Kotchandpur Upazila Health Complex 50 1.4 76.8
Moheshpur Upazila Health Complex 50 2.3 83.6
Sailkupa Upazila Health Complex 50 2.3 88.8
Batiaghata Upazila Health Complex 31 5.8 112.9
Dacope Upazila Health Complex 50 5.6 164.9
Dighalia Upazila Health Complex 31 3.3 78.1
Dumuria Upazila Health Complex 31 2 93.6
Khulna Fultala Upazila Health Complex 50 2.9 109.8
Koyra Upazila Health Complex 50 1 24.5
Paikgacha Upazila Health Complex 50 3.1 120.4
Rupsha Upazila Health Complex 31 3.4 119.4
Terakhada Upazila Health Complex 31 2.5 114.6
Bheramara Upazila Health Complex 50 1.7 67.1
Daulatpur Upazila Health Complex 50 1.8 89.6
Kushtia Khoksha Upazila Health Complex 50 3 77.5
Kumarkhali Upazila Health Complex 50 2.7 128.6
Mirpur Upazila Health Complex 50 2 66.8
Magura Shalikha Upazila Health Complex 31 2.6 83.9
Sreepur Upazila Health Complex 31 4.2 81.7

Magura
Mohammadpur Upazila Health Complex, Magura. 31 2.5 117.7

Gangni Upazila Health Complex 31 2 88.5

Meherpur
Mujibnagar Upazila Health Complex 31 2.8 93
Kalia Upazila Health Complex 50 2.2 64.1

Narail
Lohagara Upazila Health Complex 50 2.5 77.1
Assasuni Upazila Health Complex 31 3.6 81.9

Khulna
Debhata Upazila Health Complex 50 4.9 86.3
Kalaroa Upazila Health Complex 50 3.2 79.4

Satkhira
Kaliganj Upazila Health Complex 50 6 89.8
Shyamnagar Upazila Health Complex 50 3.2 194.5
Tala Upazila Health Complex 50 9.8 232.5
Bakshiganj Upazila Health Complex 31 3.3 116.3
Dewanganj Upazila Health Complex 50 3.6 73.3
Islampur Upazila Health Complex 50 2.2 52.5

Jamalpur
Madarganj Upazila Health Complex 31 3.2 66.4
Melandaha Upazila Health Complex 50 2.6 45.6
Sarishabari Upazila Health Complex 50 2.1 103.3
Bhaluka Upazila Health Complex 50 2.8 109.4
Dhubaura Upazila Health Complex 31 1.8 88
Fulbaria Upazila Health Complex 31 2.5 92.7
Fulpur Upazila Health Complex 50 1.7 87.1
Gofargaon Upazila Health Complex 50 7.4 77.6

Mymensin-
Gouripur Upazila Health Complex 31 1.6 91
gh
Haluaghat Upazila Health Complex 50 1 90.3
Iswarganj Upazila Health Complex 50 1.9 86
Mymensingh Muktagacha Upazila Health Complex 31 1 71.8
Nandail Upazila Health Complex 50 2.7 96.2
Trisal Upazila Health Complex 50 2.7 70.3
Atpara Upazila Health Complex 50
Barhatta Upazila Health Complex 31 1.6 41.9
Durgapur Upazila Health Complex 50 2.3 71.2
Kalmakanda Upazila Health Complex 50 2.7 74.6

Netrakona
Kendua Upazila Health Complex 50 1.6 42.7
Khaliajuri Upazila Health Complex 31 3.3 61.5
Madan Upazila Health Complex 50 3.5 84.3
Purbadhala Upazila Health Complex 50 3 127
Jhenaigati Upazila Health Complex 31 2 58.4
Nakhla Upazila Health Complex 50 2.3 72.5

Sherpur
Nalitabari Upazila Health Complex 31 3.3 111.9
Sribordi Upazila health Complex 31 4 81
Adamdighi Upazila Health Complex 50 2.2 55
Dhunat Upazila Health Complex 50 3.6 79.7
Dhupchachia Upazila Health Complex 50 1.9 87.6
Gabtali Upazila Health Complex 50 3.3 74.7
Kahaloo Upazila Health Complex 50 3.3 88.8
Rajshahi Bogra Nandigram Upazila Health Complex 31 2.6 100.2
Sariakandi Upazila Health Complex 50 4.1 104.6
Shajahanpur Upazila Health Complex 31 5.1 77.5
Sherpur Upazila Health Complex 31 1.6 87.9
Shibganj Upazila Health Complex 50 2.6 80.1
Sonatala Upazila Health Complex 50 3.3 74.3

ANNEX
Bholahat Upazila Health Complex 31 2.5 87
Chapai- Gomastapur Upazila Health Complex 31 1.9 97.9

nowabganj Nachol Upazila Health Complex 31 2.7 99.8
Shibganj Upazila Health Complex 50 1.7 72.7
Akkelpur Upazila Health Complex 50 3.1 59.3
Kalai Upazila Health Complex 50 2.5 101.2

Joypurhat
Khetlal Upazila Health Complex 50 2.7 66.9
Panchbibi Upazila Health Complex 50 2.6 58.9
Atrai Upazila Health Complex 31 2.2 93.3
Badalgachi Upazila Health Complex 50 2.4 46.3
Dhamairhat Upazila Health Complex 50 3.1 53.6
Manda Upazila Health Complex 50 2.3 70.9
Mohadevpur Upazila Health Complex 50 1.4 51.8

Naogaon
Niamatpur Upazila Health Complex 50 2.4 50.4
Patnitala Upazila Health Complex 50 2.3 57.2
Porsha Upazila Health Complex 31 3 76.8
Raninagar Upazila Health Complex 31 3.1 97.1
Sapahar Upazila Health Complex 50 2.4 70.3
Bagatipara Upazila Health Complex 31 2.3 70
Baraigram Upazila Health Complex 31 2.1 60.1
Natore Gurudashpur Upazila Health Complex 50 1.9 58.2
Lalpur Upazila Health Complex 50 2 90.2
Singra Upazila Health Complex 31 1.5 92.8
Atghoria Upazila Health Complex 31 2.4 89.8

Rajshahi
Bera Upazila Health Complex 50 1.1 66.7
Bhangura Upazila Health Complex 31 2 81.7
Chatmohar Upazila Health Complex 50 2 113.9

Pabna
Iswardi Upazila Health Complex 50 1.6 105.4
Santhia Upazila Health Complex 50 2.3 84.5
Sujanagar Upazila Health Complex 51 1.4 81.5
Upazila Health Complex, Faridpur, Pabna 50 3.5 87
Bagha Upazila Health Complex 50 2.9 65.1
Bagmara Upazila Health Complex 50 2.5 71.9
Charghat Upazila Health Complex 50 1 40.3
Durgapur Upazila Health Complex 50 1.7 62.3
Rajshahi Godagari Upazila Health Complex 31 2 55.2
Mohanpur Upazila Health Complex 50 1.8 44.6
Paba Upazila Health Complex 31 1 66.6
Puthia Upazila Health Complex 50 1.7 65.4
Tanore Upazila Health Complex 50 2.8 70.2
Belkuchi Upazila Health Complex 31 1.1 68.7
Chowhali Upazila Health Complex 31 0 0
Kamarkhanda Upazila Health Complex 31 2.6 70.2
Kazipur Upazila Health Complex 31 3.2 97.2

Sirajganj
Raiganj Upazila Health Complex 31 1 97.2
Shahzadpur Upazila Health Complex 31 1.8 56.6
Tarash Upazila Health Complex 31 1.5 60.4
Ullapara Upazila Health Complex 31 3.1 95.5

Birampur Upazila Health Complex 31 1.5 69.9
Birganj Upazila Health Complex 50 2.9 57.6
Birol Upazila Health Complex 50 2.6 42.3
Bochaganj Upazila Health Complex 50 2.3 54.3
Chirirbandar Upazila Health Complex 31 1 98
Fulbari Upazila Health Complex 31 1 101.5

Dinajpur
Ghoraghat Upazila Health Complex 31 2.8 78.5
Hakimpur Upazila Health Complex 31 2 68.9
Kaharol Upazila Health Complex 31 2.7 55.4
Khansama Upazila Health Complex 31 2.2 108.1
Nawabganj Upazila Health Complex 31 2.2 72.9
Parbatipur Upazila Health Complex 50 2.9 98.4
Fulchhari Upazila Health Complex 31 4.1 73
Gobindaganj Upazila Health Complex 50 1.5 97.4
Palashbari Upazila Health Complex 31 1.8 79.3

Gaibandha
Sadullapur Upazila Health Complex 31 2.2 115.2
Shaghata Upazila Health Complex 31 2.5 72.7
Sundarganj Upazila Health Complex 31 1 85.4
Bhurungamari Upazila Health Complex 31 2.2 91.3
Chilmari Upazila Health Complex 50 2.4 51.5
Fulbari Upazila Health Complex 31 3.8 98.8
Nageswari Upazila Health Complex 31 3.4 124.5

Kurigram
Rajarhat Upazila Health Complex 31 3.8 97.4
Rajibpur Upazila Health Complex 31 1 38
Rowmari Upazila Health Complex 31 1.4 84.7

Rangpur
Ullipur Upazila Health Complex 50 2 85.5
Aditmari Upazila Health Complex 50 3.4 41.2
Hatibandha Upazila Health Complex 50 1.5 68.9

Lalmonirhat
Patgram Upazila Health Complex 31 2.8 101
Dimla Upazila Health Complex 50 2 90.4
Domar Upazila Health Complex 50 1.7 79.4
Nilphamari Jaldhaka Upazila Health Complex 50 1 116.3
Kishoreganj Upazila Health Complex 50 1.5 86.8
Saidpur Upazila Health Complex 0 0 0
Atwari Upazila Health Complex 50 2.2 74.2
Boda Upazila Health Complex 50 2.9 78.2

Panchagarh
Debiganj Upazila Health Complex 50 2.2 71.4
Tetulia Upazila Health Complex 50 3.2 71.4
Badarganj Upazila Health Complex 31 1.9 130.9
Gangachara Upazila Health Complex 50 3 87.4
Kownia Upazila Health Complex 31 1.9 91
Rangpur Mithapukur Upazila Health Complex 50 1.8 99.3
Pirgacha Upazila Health Complex 31 2.9 87.7
Pirganj Upazila Health Complex 50 1 81
Taraganj Upazila Health Complex 31 2.6 74.6
Baliadangi Upazila Health Complex 50 2.4 80.4
Haripur Upazila Health Complex 50 2.5 52.5

Thakurgaon
Pirganj Upazila Health Complex 50 1.6 84.8
Ranisankhail Upazila Health Complex 50 2.5 79

ANNEX
Azmiriganj Upazila Health Complex 31 1.1 40.4
Bahubal Upazila Health Complex 31 1.9 114.3
Baniachong Upazila Health Complex 31 2 87.2
Habiganj Chunarughat Upazila Health Complex 31 1.6 97.8
Lakhai Upazila Health Complex 31 2.5 62.3
Madhabpur Upazila Health Complex 50 1.7 67.1
Sylhet Nabiganj Upazila Health Complex 31 1.5 70.6
Barlekha Upazila Health Complex 31 1.2 82.9
Juri Upazila Health Complex 0 0 0
Kamalganj Upazila Health Complex 31 1.3 82.7

Maulvibazar
Kulaura Upazila Health Complex 50 2.45 80.51
Rajnagar Upazila Health Complex 31 2.1 81.7
Sreemangal Upazila Health Complex 50 1.9 72

ANNEX TO CHAPTER 7
Admissions in hospitals under DGHS in 2015

Age and sex
Type Name of hospital >5 yrs 5 yrs >5 yrs 5 yrs

Total
Female Male
Govt. Homeopathic Medical College Hospital 327 26 255 10 618

Hospital of alternative medical college
Govt. Unani & Ayurvedic Medical College Hospital 415 36 390 40 881
Chittagong Medical College Hospital, Chittagong 61,538 7,067 84,979 8,986 162,570
Comilla Medical College Hospital, Comilla 38,768 5,795 42,364 8,007 94,934
Dhaka Medical College Hospital, Dhaka 42,407 11,948 75,969 18,798 149,122
Dinajpur Medical College Hospital, Dinajpur 18,103 2,756 17,578 2,609 41,046
Faridpur Medical College Hospital, Faridpur 1,399 19,700 1,907 18,100 41,106
Khulna Medical College Hospital, Khulna 25,540 2,492 23,718 1,702 53,452
Mymensingh Medical College Hospital, Mymensingh 56,717 15,390 56,146 21,479 149,732
Medical College hospitals
Rajshahi Medical College Hospital, Rajshahi 52,254 23,950 49,968 22,810 148,982
Rangpur Medical College Hospital, Rangpur 43,500 6,507 50,802 4,206 105,015
Shaheed Suhrawardy Medical College Hospital, Dhaka 25,024 8,356 32,823 10,368 76,571
Shahid Ziaur Rahman Medical College Hospital, Bogra 25,494 3,809 27,620 4,128 61,051
Sher-e-Bangla Medical College Hospital, Barisal 38,621 2,965 47,638 3,370 92,594
Sir Salimullah Medical College (Mitford) Hospital, Dhaka 27,512 1,794 26,850 2,131 58,287
Sylhet MAG Osmani Medical College Hospital 52,239 10,302 59,182 13,520 135,243
Bangladesh Institute of Tropical and Infectious Disease, Foujdarhat, Chittagong 2,824 73 2,965 124 5,986
Dhaka Dental College Hospital, Dhaka 956 26 858 28 1,868

Pabna Mental Hospital, Pabna 336 - 1,234 - 1,570
Shaheed Sheikh Abu Naser Specialized Hospital, Khulna 1,032 - 1,743 - 2,775
Age and sex
Type Name of hospital >5 yrs 5 yrs >5 yrs 5 yrs

Total
Female Male
Institute of Child and Mother Health, Matuail, Dhaka 6,933 3,028 694 3,852 14,507
National Institute of Cancer Research and Hospital (NICR&H), Mohakhali, Dhaka 2,830 193 4,040 222 7,285
National Institute of Cardiovascular Disease (NICVD), Sher-e-Bangla Nagar, Dhaka 18,694 432 43,598 666 63,390
National Institute of Diseases of the Chest and Hospital (NIDCH), Mohakhali, Dhaka 3,259 34 10,435 37 13,765
National Institute of ENT, Dhaka - - - - -
National Institute of Kidney Disease and Urology (NIKDU), Sher-e-Bangla Nagar,

Specialty institute hospitals 2,202 48 3,411 83 5,744
Dhaka
National Institute of Mental Health & Research (NIMHR), Sher-e-Bangla Nagar,

1,103 - 1,982 - 3,085
Dhaka
National Institute of Neurosciences and Hospital (NINH) , Dhaka 3,074 365 3,438 423 7,300
National Institute of Ophthalmology (NIO), Sher-e-Bangla Nagar, Dhaka 6,765 321 7,125 557 14,768
National Institute of Traumatology and Rehabilitation (NITOR), Sher-e-Bangla Nagar,

6,102 197 11,893 518 18,710
Dhaka
TB Hospital, Khulna 131 - 225 - 356

TB Hospitals
TB Hospital, Rajshahi 109 - 281 - 390
ANNEX

B. Secondary (district-level) hospital
Age and sex
Division Name of hospital >5 yrs 5 yrs >5 yrs 5 yrs

Total
Female Male
Barguna District Hospital 7,258 896 5,456 1,145 14,755
Barisal General Hospital 300 4,406 120 2,994 7,820

Barisal
Bhola District Hospital 10,860 3,752 9,525 3,143 27,280

Jhalokathi District Hospital 7,686 586 5,687 874 14,833

Patuakhali 250-bed Sadar Hospital 16,156 3,778 10,361 3,630 33,925
Pirojpur District Hospital, Pirojpur 7,337 1,564 4,660 1,801 15,362
Bandarban District Hospital 2,655 796 2,390 973 6,814
Brahmanbaria 250-bed District Sadar Hospital 10,954 2,026 10,021 3,289 26,290
Chandpur 250-bed General Hospital 14,132 3,424 9,601 5,098 32,255
Chittagong 250-bed General Hospital 1,576 4,502 1,444 4,375 11,897
Comilla General Hospital 2,713 897 3,139 1,248 7,997
Chittagong Coxs Bazar 250-bed District Sadar Hospital 11,540 16,055 10,034 12,543 50,172
Feni 250-bed District Sadar Hospital 11,940 4,980 9,730 4,865 31,515
Khagrachhari District Hospital 5,906 678 3,982 1,233 11,799
Lakshmipur District Hospital 7,745 1,148 6,659 1,878 17,430
Noakhali 250-bed General Hospital 15,459 8,526 16,114 6,684 46,783
Rangamati General Hospital 5,215 548 4,136 707 10,606
250-bed District Hospital, Manikganj 11,208 1,635 8,617 1,402 22,862
Faridpur General Hospital 9,330 1,259 7,970 1,384 19,943
Gazipur District Hospital 8,310 1,402 6,824 1,384 17,920
Gopalganj 250-bedded District Hospital 11,386 1,874 12,843 2,183 28,286
Kishoreganj 250-bed District Sadar Hospital 28,068 4,652 21,095 6,562 60,377
Kurmitola 500-bed General Hospital 9,600 2,865 10,054 3,246 25,765
Madaripur District Hospital 9,725 1,677 8,036 1,832 21,270
Mugda 500-bed General Hospital 3,875 920 2,584 790 8,169

Dhaka
Munshiganj District Hospital 7,845 1,376 5,538 970 15,729
Narayanganj 300-bed Hospital 4,226 352 3,458 353 8,389
Narayanganj General (Victoria) Hospital 7,270 1,646 7,075 1,395 17,386
Narsingdi 100-bed Zilla Hospital 3,669 1,714 3,429 2,051 10,863
Rajbari District Hospital 10,056 1,263 7,271 1,239 19,829
Sadar Hospital Narsingdi 3,326 918 3,511 993 8,748
Shariatpur District Hospital 23,329 3,403 13,200 2,560 42,492
Tangail 250-bed District Hospital 5,483 27,776 5,145 25,490 63,894
250-bedded General Hospital, Jessore 27,444 3,883 24,771 3,003 59,101
Bagerhat District Hospital 7,847 1,016 5,510 1,611 15,984
Chuadanga District Hospital 13,853 2,751 10,849 2,632 30,085
Jhenaidah District Hospital 18,693 1,665 6,943 2,261 29,562
Khulna 150-bed General Hospital 4,946 312 3,169 268 8,695

Khulna
Kushtia 250-bed General Hospital 23,344 3,653 22,046 5,395 54,438
Magura District Hospital 13,085 2,243 10,389 3,831 29,548
Meherpur 250-bed District Hospital 14,149 3,277 7,899 2,602 27,927
Narail District Hospital 8,954 1,570 6,438 2,472 19,434
Satkhira District Hospital 9,999 3,488 7,386 2,854 23,727
Jamalpur 250-beded General Hospital 21,466 4,212 13,875 7,378 46,931
Mymensingh Netrokona District Hospital 15,450 1,583 8,184 2,790 28,007
Sherpur District Hospital 10,682 4,081 9,213 4,539 28,515

ANNEX
Age and sex
Division Name of hospital >5 yrs 5 yrs >5 yrs 5 yrs

Total
Female Male
Bogra 250-bed Mohammad Ali District Hospital 8,477 1,083 6,721 1,827 18,108
Chapainowabganj District Hospital 10,584 2,531 9,649 3,143 25,907
Joypurhat District Hospital 13,229 952 10,131 1,320 25,632
Rajshahi Naogaon District Hospital 11,448 2,329 7,933 1,581 23,291
Natore District Hospital 10,197 3,612 10,409 3,321 27,539
Pabna 250-bed General Hospital 30,533 6,530 27,819 9,837 74,719
Sirajganj General Hospital 41,686 2,737 40,421 3,336 88,180
Dinajpur 250-bed General Hospital 8,263 1,702 12,336 1,932 24,233
Gaibandha District Hospital 10,039 1,839 7,720 3,025 22,623
Kurigram District Hospital 10,396 2,997 9,220 2,597 25,210
Lalmonirhat District Hospital 3,969 1,021 4,064 1,287 10,341

Rangpur
Nilphamari District Hospital 28,856 4,411 28,854 4,312 66,433
Panchagarh District Hospital 8,781 1,541 6,540 1,732 18,594
Saidpur 100-bed Hospital 7,074 889 3,798 880 12,641
Thakurgaon District Hospital 9,084 6,408 10,899 11,681 38,072
Habiganj District Hospital 5,820 16,350 5,505 13,100 40,775
Moulvibazar 250-bed District Sadar Hospital 17,686 3,077 12,467 4,914 38,144
Sylhet Sunamganj 250-bed District Sadar Hospital 10,377 1,765 9,175 1,685 23,002
Sylhet Shahid Shamsuddin Ahmed District

1,443 - 905 - 2,348
Hospital
Age and sex
Division Name of UHC >5 yrs 5 yrs >5 yrs 5 yrs

Total
F M
Agailjhara Upazila Health Complex 1,620 240 1,475 315 3,650
Amtali Upazila Health Complex 2,392 384 1,618 608 5,002
Babuganj Upazila Health Complex 599 88 470 54 1,211
Bakerganj Upazila Health Complex 2,212 242 1,925 212 4,591
Bamna Upazila Health Complex 895 151 799 146 1,991
Banaripara Upazila Health Complex 3,094 322 1,189 519 5,124
Bauphal Upazila Health Complex 1,713 435 1,563 614 4,325
Betagi Upazila Health Complex 1,474 144 1,088 218 2,924
Bhandaria Upazila Health Complex 2,493 186 1,681 320 4,680
Borhanuddin Upazila Health Complex 4,243 934 2,695 1,585 9,457
Char Fasson Upazila Health Complex 6,541 1,532 3,915 1,064 13,052
Dashmina Upazila Health Complex 2,543 406 1,744 656 5,349

Barisal
Daulatkhan Upazila Health Complex 2,005 571 1,325 775 4,676
Dumki Upazila Health Complex 720 303 958 357 2,338
Galachipa Upazila Health Complex 2,645 644 2,600 991 6,880
Gournadi Upazila Health Complex 2,002 1,017 1,617 791 5,427
Hijla Upazila Health Complex 1,042 83 1,027 139 2,291
Kalapara Upazila Health Complex 4,605 562 2,843 885 8,895
Kathalia Upazila Health Complex 1,102 277 905 227 2,511
Kawkhali Upazila Health Complex 962 56 722 103 1,843
Lalmohan Upazila Health Complex 4,458 703 3,040 1,133 9,334
Manpura Upazila Health Complex 888 521 711 443 2,563
Mathbaria Upazila Health Complex 3,024 1,187 2,638 1,008 7,857
Mehendiganj Upazila Health Complex 1,866 923 1,386 902 5,077

Age and sex

Total
F M
Mirzaganj Upazila Health Complex 1,460 285 1,246 452 3,443
Muladi Upazila Health Complex 1,719 170 1,472 125 3,486
Nalchithi Upazila Health Complex 1,629 305 1,390 285 3,609
Nazirpur Upazila Health Complex 1,554 63 907 49 2,573
Nesarabad Upazila Health Complex 4,277 686 2,167 1,015 8,145

Barisal
Pathargatha Upazila Health Complex 2,219 340 1,550 437 4,546
Rajapur Upazila Health Complex 1,986 304 1,463 471 4,224
Tajumuddin Upazila Health Complex 907 383 1,011 549 2,850
Wazirpur Upazila Health Complex 1,753 419 1,283 582 4,037
Zianagar Upazila Health Complex - - - - -
Akhaura Upazila Health Complex 2,140 198 2,224 227 4,789
Alikadam Upazila Health Complex 1,000 1,053 1,007 750 3,810
Anwara Upazila Health Complex 3,985 1,491 3,716 950 10,142
Ashuganj Upazila Health Complex - - - - -
Baghaichhari Upazila Health Complex 745 141 708 161 1,755
Bancharampur Upazila Health Complex 1,625 278 1,301 327 3,531
Banshkhali Upazila Health Complex 2,627 1,310 2,495 2,071 8,503
Barkol Upazila Health Complex 191 19 187 19 416
Barura Upazila Health Complex 1,840 317 1,229 374 3,760
Begumganj Upazila Health Complex 959 263 597 251 2,070
Belaichhari Upazila Health Complex 115 45 179 56 395
Boalkhali Upazila Health Complex 2,163 1,229 1,469 1,160 6,021
Brahmmanpara Upazila Health Complex 1,152 301 964 401 2,818
Burichong Upazila Health Complex 654 1,985 514 1,628 4,781
Chauddagram Upazila Health Complex 3,500 1,979 2,405 1,210 9,094
Chakaria Upazila Health Complex 3,820 3,248 4,509 4,447 16,024
Chandanaish Upazila Health Complex 1,827 1,781 1,254 1,587 6,449
Chandina Upazila Health Complex 3,972 780 2,717 1,294 8,763
Chatkhil Upazila Health Complex 3,982 532 1,605 860 6,979
Chittagong Chhagalnaya Upazila Health Complex 2,687 680 1,475 929 5,771
Comilla Sadar Daxin Upazila Health Complex - - - - -
Companiganj Upazila Health Complex 3,265 735 2,092 704 6,796
Daganbhuiya Upazila Health Complex 2,384 462 1,721 451 5,018
Daudkandi Upazila Health Complex 4,169 100 2,308 62 6,639
Debidwar Upazila Health Complex 2,801 2,812 5,390 4,578 15,581
Dighinala Upazila Health Complex 2,414 637 2,019 410 5,480
Faridganj Upazila Health Complex 1,812 206 1,310 256 3,584
Fatikchhari Upazila Health Complex 1,263 3,621 812 3,020 8,716
Fulgazi Upazila Health Complex 2,378 289 1,584 192 4,443
Haimchar Upazila Health Complex 1,746 619 1,113 410 3,888
Hathazari Upazila Health Complex 3,867 800 2,685 606 7,958
Hatiya Upazila Health Complex 2,167 955 1,720 1,460 6,302
Haziganj Upazila Health Complex 1,802 474 1,570 403 4,249
Homna Upazila Health Complex 3,416 398 2,685 656 7,155
Juraichhari Upazila Health Complex 139 26 157 39 361
Kabirhat Upazila Health Complex - - - - -
Kachua Upazila Health Complex 2,597 190 2,167 253 5,207
Kamolnagar Upazila Health Complex 5,864 914 1,612 1,599 9,989
Kaptai Upazila Health Complex 1,007 142 848 231 2,228

ANNEX
Age and sex

Total
F M
Kashba Upazila Health Complex 1,741 428 1,351 583 4,103
Kawkhali Upazila Health Complex 504 115 256 141 1,016
Kutubdia Upazila Health Complex 2,468 845 2,503 853 6,669
Laksham Upazila Health Complex 2,880 342 1,849 421 5,492
Lakshmichhari Upazila Health Complex 367 91 474 65 997
Lama Upazila Health Complex 1,727 360 1,766 318 4,171
Langadu Upazila Health Complex 948 193 699 143 1,983
Lohagara Upazila Health Complex 2,838 827 2,027 933 6,625
Manikchhari Upazila Health Complex 1,530 335 838 298 3,001
Matiranga Upazila Health Complex 459 438 511 320 1,728
Matlab(daxin) Upazila Health Complex 3,077 902 1,637 735 6,351
Matlab(uttar) Upazila Health Complex 1,172 265 1,056 185 2,678
Meghna Upazila Health Complex 299 4 308 3 614
Mirarsarai Upazila Health Complex 2,567 1,785 1,568 986 6,906
Mohalchhari Upazila Health Complex 734 224 581 131 1,670
Moheshkhali Upazila Health Complex 4,984 2,424 4,049 2,105 13,562
Monoharganj Upazila Health Complex - - - - -
Muradnagar Upazila Health Complex 2,310 721 3,451 532 7,014
Nabinagar Upazila Health Complex 2,195 3,722 1,096 2,497 9,510
Naikhongchhari Upazila Health Complex 2,025 920 1,833 580 5,358
Nangolkot Upazila Health Complex 2,492 432 1,931 761 5,616
Naniarchar Upazila Health Complex 312 42 248 52 654
Nasirnagar Upazila Health Complex 1,438 1,507 1,562 1,820 6,327
Panchhari Upazila Health Complex 841 162 707 186 1,896
Chittagong Parsuram Upazila Health Complex 3,666 955 1,271 307 6,199
Patiya Upazila Health Complex 5,470 1,178 2,090 1,384 10,122
Pekua Upazila Health Complex 3,427 400 1,573 188 5,588
Raipur Upazila Health Complex 3,249 240 1,772 401 5,662
Rajsthali Upazila Health Complex 270 52 273 77 672
Ramganj Upazila Health Complex 2,516 283 1,891 397 5,087
Ramgarh Upazila Health Complex 1,222 219 872 353 2,666
Ramgati Upazila Health Complex 1,300 780 1,024 1,284 4,388
Ramu Upazila Health Complex 3,326 698 1,641 1,081 6,746
Rangunia Upazila Health Complex 2,102 1,865 1,463 1,523 6,953
Roujan Upazila Health Complex 1,230 6,157 1,536 4,632 13,555
Rowangchhari Upazila Health Complex 334 62 285 67 748
Ruma Upazila Health Complex 485 65 521 73 1,144
Saharasthi Upazila Health Complex 2,925 541 1,649 688 5,803
Sandwip Upazila Health Complex 743 3,263 450 2,452 6,908
Sarail Upazila Health Complex 1,800 950 2,345 698 5,793
Satkania Upazila Health Complex 923 1,511 784 1,113 4,331
Senbag Upazila Health Complex 2,030 670 2,540 980 6,220
Sitakunda Upazila Health Complex 3,859 1,528 3,295 1,462 10,144
Sonagazi Upazila Health Complex 4,502 1,701 1,021 642 7,866
Sonaimuri Upazila Health Complex 1,988 660 1,608 523 4,779
Subarnachar Upazila Health Complex 449 2,325 800 1,000 4,574
Teknaf Upazila Health Complex 2,646 1,247 1,317 2,272 7,482
Thanchi Upazila Health Complex 65 16 53 12 146
Titas Upazila Health Complex 978 1,428 856 1,659 4,921

Age and sex

Total
F M
Ukhyia Upazila Health Complex 3,506 867 2,196 1,421 7,990
Alfadanga Upazila Health Complex 2,542 365 1,900 220 5,027
Araihazar Upazila Health Complex 10 1,658 15 1,093 2,776

Chittagong
Atpara Upazila Health Complex 840 20 826 31 1,717
Austagram Upazila Health Complex 1,142 156 1,082 262 2,642
Bajitpur Upazila Health Complex 1,865 394 1,595 532 4,386
Bakshiganj Upazila Health Complex 2,009 275 1,419 342 4,045
Baliakandi Upazila Health Complex 2,100 147 1,658 229 4,134
Bandar Upazila Health Complex 438 13 387 22 860
Barhatta Upazila Health Complex 1,296 261 1,202 277 3,036
Basail Upazila Health Complex,Tangail. 1,160 171 1,079 160 2,570
Belabo Upazila Health Complex 2,199 90 1,389 154 3,832
Bhairab Upazila Health Complex 3,467 754 1,390 1,152 6,763
Bhaluka Upazila Health Complex 2,958 1,596 1,621 918 7,093
Bhanga Upazila Health Complex 3,357 237 2,425 243 6,262
Bhedarganj Upazila Health Complex 2,188 972 1,110 1,211 5,481
Bhuapur Upazila Health Complex 3,378 768 2,001 736 6,883
Boalmari Upazila Health Complex 2,649 2,156 2,115 1,629 8,549
Charbhadrason Upazila Health Complex 923 238 836 230 2,227
Damudya Upazila Health Complex 2,257 480 1,515 350 4,602
Daulatpur Upazila Health Complex 1,787 607 1,784 518 4,696
Delduar Upazila Health Complex 1,964 1,142 2,027 1,577 6,710
Dewanganj Upazila Health Complex 1,718 256 1,421 358 3,753
Dhamrai Upazila Health Complex 3,623 221 2,263 376 6,483
Dhanbari Upazila Health Complex - - - - -
Dhubaura Upazila Health Complex 2,366 430 2,206 541 5,543
Dohar Upazila Health Complex 3,662 504 2,274 683 7,123

Dhaka and
Durgapur Upazila Health Complex 2,585 493 1,863 679 5,620
Mymensingh
Fulbaria Upazila Health Complex 1,950 242 1,551 416 4,159
Fulpur Upazila Health Complex 4,491 1,134 2,600 1,045 9,270
Gazaria Upazila Health Complex 2,872 618 1,888 475 5,853
Ghatail Upazila Health Complex 2,646 366 2,548 530 6,090
Ghior Upazila Health Complex 1,145 231 1,260 225 2,861
Goalanda Upazila Health Complex 3,509 441 2,610 741 7,301
Gofargaon Upazila Health Complex 700 400 500 300 1,900
Gopalpur Upazila Health Complex 2,170 213 1,294 385 4,062
Goshairhat Upazila Health Complex 1,814 522 1,430 417 4,183
Gouripur Upazila Health Complex 2,793 840 2,219 781 6,633
Haluaghat Upazila Health Complex 7,269 900 6,517 1,471 16,157
Harirampur Upazila Health Complex 1,778 129 691 90 2,688
Hossainpur Upazila Health Complex 3,961 754 3,261 818 8,794
Islampur Upazila Health Complex 2,086 302 1,670 391 4,449
Iswarganj Upazila Health Complex 5,132 436 2,417 211 8,196
Itna Upazila Health Complex 984 133 1,056 246 2,419
Jhenaigati Upazila Health Complex 1,419 250 1,372 242 3,283
Kaliakair Upazila Health Complex 3,205 89 2,304 203 5,801
Kaliganj Upazila Health Complex 2,999 474 1,664 874 6,011
Kalihati Upazila Health Complex 2,572 427 1,973 459 5,431
Kalkini Upazila Health Complex 1,993 228 1,636 204 4,061

ANNEX
Age and sex

Total
F M
Kalmakanda Upazila Health Complex 2,073 371 1,928 625 4,997
Kalukhali Upazila Health Complex - - - - -
Kapasia Upazila Health Complex 3,080 298 2,245 290 5,913
Karimganj Upazila Health Complex 2,870 463 2,573 765 6,671
Kashiani Upazila Health Complex 1,680 231 1,870 365 4,146
Katiadi Upazila Health Complex 4,876 446 2,911 440 8,673
Kendua Upazila Health Complex 2,320 550 1,464 507 4,841
Keraniganj Upazila Health Complex 1,515 195 997 184 2,891
Khaliajuri Upazila Health Complex 906 173 883 174 2,136
Kotwalipara Upazila Health Complex 3,226 911 2,207 462 6,806
Kuliarchar Upazila Health Complex 812 718 980 715 3,225
Louhajang Upazila Health Complex 1,537 697 1,016 495 3,745
Madan Upazila Health Complex 1,935 401 1,631 434 4,401
Madarganj Upazila Health Complex 1,047 178 938 161 2,324
Melandaha Upazila Health Complex 1,498 303 1,218 218 3,237
Mirzapur Upazila Health Complex 1,010 254 900 117 2,281
Mithamoin Upazila Health Complex 980 58 826 153 2,017
Modhukhali Upazila Health Complex 2,173 196 2,450 316 5,135
Madhupur Upazila Health Complex 4,740 462 2,886 748 8,836
Mohanganj Upazila Health Complex 3,667 181 2,764 218 6,830
Monohardi Upazila Health Complex 2,640 327 1,667 353 4,987
Mukshedpur Upazila Health Complex 2,718 1,287 2,937 1,326 8,268
Muktagacha Upazila Health Complex 5,164 261 1,987 336 7,748
Nagarkanda Upazila Health Complex 2,432 853 1,815 562 5,662

Dhaka and
Nagarpur Upazila Health Complex 3,727 120 1,641 96 5,584
Mymensingh
Nakhla Upazila Health Complex 1,510 588 3,000 612 5,710
Nalitabari Upazila Health Complex 1,577 198 1,829 214 3,818
Nandail Upazila Health Complex 2,901 637 1,833 1,120 6,491
Naria Upazila Health Complex 1,867 495 1,134 310 3,806
Nawabganj Upazila Health Complex 3,325 409 2,556 519 6,809
Nikli Upazila Health Complex 1,336 420 1,314 549 3,619
Pakundia Upazila Health Complex 1,454 266 1,322 310 3,352
Palash Upazila Health Complex 1,272 169 818 229 2,488
Pangsha Upazila Health Complex 2,805 458 2,545 789 6,597
Purbadhala Upazila Health Complex 3,509 923 2,422 824 7,678
Raipura Upazila Health Complex 2,550 271 962 197 3,980
Rajoir Upazila Health Complex 3,466 769 2,605 584 7,424
Rupganj Upazila Health Complex 1,260 21 1,165 17 2,463
Sadarpur Upazila Health Complex 1,842 134 1,477 101 3,554
Sakhipur Upazila Health Complex 4,830 699 2,831 751 9,111
Sarishabari Upazila Health Complex 4,252 1,069 2,303 1,174 8,798
Saturia Upazila Health Complex 2,609 116 1,992 145 4,862
Savar Upazila Health Complex 2,380 184 1,639 148 4,351
Serajdikhan Upazila Health Complex 2,148 204 1,284 198 3,834
Shibalaya Upazila Health Complex 2,846 198 2,333 249 5,626
Shibchar Upazila Health Complex 1,857 1,275 1,281 680 5,093
Shibpur Upazila Health Complex 1,182 84 970 143 2,379
Singair Upazila Health Complex 3,478 768 1,872 569 6,687
Sonargaon Upazila Health Complex 1,434 197 1,712 234 3,577

Age and sex

Total
F M
Sreenagar Upazila Health Complex 1,805 624 1,226 521 4,176
Sreepur Upazila Health Complex 3,351 195 2,464 295 6,305
Sribordi Upazila health Complex 935 146 1,045 165 2,291
Tarail Upazila Health Complex 1,773 595 2,277 974 5,619

Dhaka and
Tejgaon Health Complex - - - - -
Mymensingh
Trisal Upazila Health Complex 2,749 267 1,454 244 4,714
Tungibari Upazila Health Complex 1,583 671 1,293 546 4,093
Tungipara Upazila Health Complex 1,785 1,085 1,660 835 5,365
Zanjira Upazila Health Complex 2,123 1,015 1,580 625 5,343
Abhoynagar Upazila Health Complex 5,535 299 2,836 358 9,028
Alamdanga Upazila Health Complex 3,773 316 2,479 417 6,985
Assasuni Upazila Health Complex 1,517 109 865 103 2,594
Bagerpara Upazila Health Complex 1,741 1,402 1,160 935 5,238
Batiaghata Upazila Health Complex 1,226 54 873 50 2,203
Bheramara Upazila Health Complex 3,614 379 2,669 585 7,247
Chitalmari Upazila Health Complex 1,917 182 1,446 331 3,876
Chowgacha Upazila Health Complex 8,418 1,022 2,723 1,558 13,721
Dacope Upazila Health Complex 3,502 305 1,205 339 5,351
Damurhuda Upazila Health Complex 1,949 543 1,433 487 4,412
Daulatpur Upazila Health Complex 5,525 975 2,336 412 9,248
Debhata Upazila Health Complex 2,002 131 955 107 3,195
Dighalia Upazila Health Complex 1,544 25 1,067 35 2,671
Dumuria Upazila Health Complex 792 2,445 652 1,521 5,410
Fakirhat Upazila Health Complex 5,723 502 3,101 472 9,798
Fultala Upazila Health Complex 3,351 226 3,150 221 6,948
Gangni Upazila Health Complex 7,029 457 2,955 558 10,999
Harinakunda Upazila Health Complex 4,186 1,416 1,774 879 8,255
Jhikargacha Upazila Health Complex 2,426 395 1,135 249 4,205
Jibannagar Upazila Health Complex 3,883 1,210 2,621 970 8,684

Khulna
Kachua Upazila Health Complex 2,032 90 1,453 135 3,710
Kalaroa Upazila Health Complex 2,703 203 1,519 154 4,579
Kalia Upazila Health Complex 2,963 298 1,517 499 5,277
Kaliganj Upazila Health Complex 5,905 806 3,961 1,170 11,842
Keshabpur Upazila Health Complex 3,481 234 2,771 337 6,823
Khoksha Upazila Health Complex 2,602 561 1,020 459 4,642
Kotchandpur Upazila Health Complex 4,976 635 3,442 741 9,794
Koyra Upazila Health Complex 476 2,018 283 1,525 4,302
Kumarkhali Upazila Health Complex 4,219 613 2,984 937 8,753
Lohagara Upazila Health Complex 3,237 233 1,844 295 5,609
Mirpur Upazila Health Complex 3,300 627 1,993 144 6,064
Moheshpur Upazila Health Complex 2,942 262 3,163 402 6,769
Mollahat Upazila Health Complex 2,461 278 1,907 381 5,027
Mongla Upazila Health Complex 2,865 163 2,106 213 5,347
Monirampur Upazila Health Complex 3,825 325 1,999 317 6,466
Morrelganj Upazila Health Complex 2,066 387 880 362 3,695
Mujibnagar Upazila Health Complex 2,025 44 1,641 57 3,767
Paikgacha Upazila Health Complex 299 4,196 402 2,241 7,138
Rampal Upazila Health Complex 345 2,986 183 1,680 5,194
Rupsha Upazila Health Complex 2,364 119 1,364 167 4,014

ANNEX
Age and sex

Total
F M
Sailkupa Upazila Health Complex 1,950 1,630 1,550 1,870 7,000
Sarankhola Upazila Health Complex 2,278 189 2,140 154 4,761
Sarsa Upazila Health Complex 3,734 162 2,182 140 6,218
Shalikha Upazila Health Complex 1,823 236 1,314 231 3,604
Khulna Shyamnagar Upazila Health Complex 6,081 1,078 2,407 1,511 11,077
Sreepur Upazila Health Complex 1,075 109 854 166 2,204
Tala Upazila Health Complex 1,937 276 1,842 263 4,318
Terakhada Upazila Health Complex 2,747 407 1,680 301 5,135
Adamdighi Upazila Health Complex 2,355 174 1,691 250 4,470
Akkelpur Upazila Health Complex 1,957 120 1,228 169 3,474
Atghoria Upazila Health Complex 2,333 85 1,639 133 4,190
Atrai Upazila Health Complex 3,254 210 1,107 227 4,798
Badalgachi Upazila Health Complex 1,663 254 1,381 293 3,591
Bagatipara Upazila Health Complex 1,881 114 1,337 154 3,486
Bagha Upazila Health Complex 2,216 148 1,630 139 4,133
Bagmara Upazila Health Complex 2,510 380 1,968 310 5,168
Baraigram Upazila Health Complex 1,865 38 1,320 55 3,278
Belkuchi Upazila Health Complex 3,299 277 3,264 277 7,117
Bera Upazila Health Complex 5,322 690 3,833 898 10,743
Bhangura Upazila Health Complex 2,885 220 1,071 484 4,660
Bholahat Upazila Health Complex 2,174 140 1,434 246 3,994
Charghat Upazila Health Complex 2,507 274 2,026 2,555 7,362
Chatmohar Upazila Health Complex 4,966 1,239 3,230 980 10,415
Chowhali Upazila Health Complex - - - - -
Dhamairhat Upazila Health Complex 1,430 253 1,329 195 3,207
Dhunat Upazila Health Complex 1,651 479 1,482 378 3,990
Dhupchachia Upazila Health Complex 4,603 579 2,695 672 8,549
Durgapur Upazila Health Complex 3,777 263 2,281 250 6,571
Gabtali Upazila Health Complex 1,972 208 1,549 364 4,093

Rajshahi
Godagari Upazila Health Complex 1,668 202 1,047 161 3,078
Gomastapur Upazila Health Complex 2,808 429 1,908 543 5,688
Gurudashpur Upazila Health Complex 2,437 488 2,174 421 5,520
Iswardi Upazila Health Complex 7,920 304 3,240 298 11,762
Kahaloo Upazila Health Complex 2,748 154 1,786 171 4,859
Kalai Upazila Health Complex 4,243 281 2,474 407 7,405
Kamarkhanda Upazila Health Complex 1,562 78 1,337 74 3,051
Kazipur Upazila Health Complex 1,945 155 1,243 89 3,432
Khetlal Upazila Health Complex 3,007 69 1,397 105 4,578
Lalpur Upazila Health Complex 4,414 270 3,145 395 8,224
Manda Upazila Health Complex 2,851 205 2,215 300 5,571
Mohadevpur Upazila Health Complex 3,297 456 2,338 502 6,593
Mohanpur Upazila Health Complex 2,190 568 1,326 432 4,516
Nachol Upazila Health Complex 235 1,886 390 1,656 4,167
Nandigram Upazila Health Complex 2,240 137 1,806 180 4,363
Niamatpur Upazila Health Complex 1,768 354 1,384 320 3,826
Paba Upazila Health Complex 3,213 15 4,323 34 7,585
Panchbibi Upazila Health Complex 2,207 284 1,408 268 4,167
Patnitala Upazila Health Complex 2,489 228 1,524 287 4,528
Porsha Upazila Health Complex 1,363 388 847 254 2,852

Age and sex

Total
F M
Puthia Upazila Health Complex 371 3,071 354 3,405 7,201
Raiganj Upazila Health Complex 4,388 904 4,502 1,207 11,001
Raninagar Upazila Health Complex 1,597 266 1,277 398 3,538
Santhia Upazila Health Complex 3,748 215 2,589 286 6,838
Sapahar Upazila Health Complex 2,986 212 1,920 287 5,405
Sariakandi Upazila Health Complex 2,567 79 1,803 171 4,620
Shahzadpur Upazila Health Complex 1,920 121 1,345 197 3,583
Shajahanpur Upazila Health Complex 911 105 638 76 1,730
Rajshahi Sherpur Upazila Health Complex 2,887 457 2,408 601 6,353
Shibganj Upazila Health Complex 8,204 707 3,538 835 13,284
Singra Upazila Health Complex 3,712 461 2,648 404 7,225
Sonatala Upazila Health Complex 1,635 602 1,521 399 4,157
Sujanagar Upazila Health Complex 2,135 3,840 2,203 2,992 11,170
Tanore Upazila Health Complex 2,534 428 1,244 317 4,523
Tarash Upazila Health Complex 2,081 713 1,057 691 4,542
Ullapara Upazila Health Complex 1,535 421 1,111 443 3,510
Upazila Health Complex, Faridpur, Pabna 2,198 315 1,529 431 4,473
Aditmari Upazila Health Complex 1,069 298 642 175 2,184
Atwari Upazila Health Complex 2,768 574 2,007 688 6,037
Badarganj Upazila Health Complex 4,325 547 2,605 507 7,984
Baliadangi Upazila Health Complex 560 3,932 3,210 2,443 10,145
Bhurungamari Upazila Health Complex 1,967 407 1,706 571 4,651
Birampur Upazila Health Complex 3,041 151 1,893 205 5,290
Birganj Upazila Health Complex 1,814 173 1,464 225 3,676
Birol Upazila Health Complex 1,626 57 1,205 40 2,928
Bochaganj Upazila Health Complex 2,550 143 1,488 166 4,347
Boda Upazila Health Complex 1,554 1,128 1,236 1,016 4,934
Chilmari Upazila Health Complex 1,773 258 1,495 357 3,883
Chirirbandar Upazila Health Complex 3,673 1,985 3,721 1,712 11,091
Debiganj Upazila Health Complex 4,094 131 1,400 243 5,868
Dimla Upazila Health Complex 3,811 722 3,012 629 8,174
Domar Upazila Health Complex 4,620 303 3,462 228 8,613
Fulbari Upazila Health Complex 7,231 527 5,918 779 14,455

Rangpur
Fulchhari Upazila Health Complex 1,062 83 761 115 2,021
Gangachara Upazila Health Complex 3,508 286 1,253 251 5,298
Ghoraghat Upazila Health Complex 1,463 96 1,446 113 3,118
Gobindaganj Upazila Health Complex 6,025 1,308 3,504 1,233 12,070
Hakimpur Upazila Health Complex 2,157 97 1,526 195 3,975
Haripur Upazila Health Complex 2,055 289 1,295 235 3,874
Hatibandha Upazila Health Complex 3,650 1,057 2,693 910 8,310
Jaldhaka Upazila Health Complex 7,775 4,233 5,387 3,826 21,221
Kaharol Upazila Health Complex 1,261 48 981 53 2,343
Kaliganj Upazila Health Complex 1,949 232 1,388 265 3,834
Khansama Upazila Health Complex 3,702 217 1,364 182 5,465
Kishoreganj Upazila Health Complex 1,698 3,990 1,980 3,020 10,688
Kownia Upazila Health Complex 3,491 279 1,270 357 5,397
Mithapukur Upazila Health Complex 5,847 432 2,997 562 9,838
Nageswari Upazila Health Complex 1,768 288 1,635 512 4,203
Nawabganj Upazila Health Complex 1,756 405 1,136 526 3,823

ANNEX
Age and sex

Total
F M
Palashbari Upazila Health Complex 2,536 177 2,080 186 4,979
Parbatipur Upazila Health Complex 3,264 301 2,256 458 6,279
Patgram Upazila Health Complex 1,998 415 1,334 397 4,144
Pirgacha Upazila Health Complex 1,256 501 1,199 441 3,397
Pirganj Upazila Health Complex 11,566 2,419 7,973 2,397 24,355
Rajarhat Upazila Health Complex 1,708 154 933 130 2,925
Rajibpur Upazila Health Complex 1,612 409 1,720 555 4,296
Ranisankhail Upazila Health Complex 2,860 237 2,360 391 5,848

Rangpur
Rowmari Upazila Health Complex 2,526 1,008 2,272 1,193 6,999
Sadullapur Upazila Health Complex 2,966 466 2,126 402 5,960
Saidpur Upazila Health Complex - - - - -
Shaghata Upazila Health Complex 1,500 278 1,310 250 3,338
Sundarganj Upazila Health Complex 5,567 155 3,807 132 9,661
Taraganj Upazila Health Complex 1,412 452 1,097 327 3,288
Tetulia Upazila Health Complex 2,601 117 1,164 185 4,067
Ullipur Upazila Health Complex 1,990 2,230 1,560 2,009 7,789
Azmiriganj Upazila Health Complex 2,341 548 953 507 4,349
Bahubal Upazila Health Complex 2,472 882 1,983 1,438 6,775
Balaganj Upazila Health Complex 1,056 261 681 243 2,241
Baniachong Upazila Health Complex 1,989 826 1,441 630 4,886
Barlekha Upazila Health Complex 2,727 2,125 1,587 1,234 7,673
Beanibazar Upazila Health Complex 5,150 937 779 1,381 8,247
Biswambarpur Upazila Health Complex 523 598 423 987 2,531
Biswanath Upazila Health Complex 775 118 410 176 1,479
Chhatak Upazila Health Complex 2,825 478 1,849 822 5,974
Chunarughat Upazila Health Complex 3,512 152 2,921 133 6,718
Companyganj Upazila Health Complex 624 728 532 879 2,763
Dakhin Surma Upazila Health Complex - - - - -
Daxin Sunamganj Upazila Health Complex - - - - -
Derai Upazila Health Complex 5,397 1,197 3,093 1,478 11,165
Dharmapasha Upazila Health Complex 2,940 1,087 2,221 891 7,139
Doarabazar Upazila Health Complex 451 837 584 482 2,354
Fenchuganj Upazila Health Complex 2,428 161 1,484 301 4,374

Sylhet
Golapganj Upazila Health Complex 1,867 692 852 686 4,097
Gowainghat Upazila Health Complex 3,474 2,013 2,613 1,604 9,704
Jagannathpur Upazila Health Complex 2,182 1,127 1,389 1,115 5,813
Jamalganj Upazila Health Complex 2,525 446 2,105 373 5,449
Jointapur Upazila Health Complex 2,996 727 1,783 598 6,104
Juri Upazila Health Complex - - - - -
Kamalganj Upazila Health Complex 3,198 740 2,596 708 7,242
Kanaighat Upazila Health Complex 2,195 590 1,968 644 5,397
Kulaura Upazila Health Complex 3,905 1,632 3,026 1,657 10,220
Lakhai Upazila Health Complex 1,393 185 916 304 2,798
Madhabpur Upazila Health Complex 3,328 289 3,453 323 7,393
Nabiganj Upazila Health Complex 2,329 1,005 1,137 880 5,351
Rajnagar Upazila Health Complex 1,967 551 1,343 552 4,413
Sreemangal Upazila Health Complex 3,545 362 2,540 340 6,787
Sulla Upazila Health Complex 1,138 356 864 316 2,674
Taherpur Upazila Health Complex 1,360 140 1,715 120 3,335
Zakiganj Upazila Health Complex 3,202 1,245 1,459 1,231 7,137

ANNEX TO CHAPTER 8
Number of death and death rate (%) in hospitals under DGHS in 2015

Age and sex
Hospital
Type Name of hospital >5 yrs 5 yrs >5 yrs 5 yrs death rate
Total (%)
Female Male
Hospital of alternative medical Govt. Homeopathic Medical College Hospital - - 1 - 1 0.2

college Govt. Unani & Ayurvedic Medical College Hospital - - - - - -
Chittagong Medical College Hospital, Chittagong 2,490 806 4,159 1,397 8,852 5.45
Comilla Medical College Hospital, Comilla 411 270 594 393 1,668 1.76
Dhaka Medical College Hospital, Dhaka 5,811 180 7,516 358 13,865 9.30
Dinajpur Medical College Hospital, Dinajpur 497 181 763 242 1,683 4.10
Faridpur Medical College Hospital, Faridpur 307 918 285 810 2,320 5.64
Khulna Medical College Hospital, Khulna 1,210 132 1,312 180 2,834 5.30
Mymensingh Medical College Hospital, Mymensingh 2,119 1,234 2,282 1,412 7,047 4.71
Medical College hospitals
Rajshahi Medical College Hospital, Rajshahi 1,995 622 3,071 1,246 6,934 4.65
Rangpur Medical College Hospital, Rangpur 1,886 484 2,275 525 5,170 4.92
Shaheed Suhrawardy Medical College Hospital, Dhaka 414 95 503 156 1,168 1.53
Shahid Ziaur Rahman Medical College Hospital, Bogra 955 411 1,626 446 3,438 5.63
Sher-e-Bangla Medical College Hospital, Barisal 1,389 608 1,446 613 4,056 4.38
Sir Salimullah Medical College (Mitford) Hospital, Dhaka 709 67 919 108 1,803 3.09
Sylhet MAG Osmani Medical College Hospital 1,782 367 2,941 462 5,552 4.11
Bangladesh Institute of Tropical and Infectious Disease, Foujdarhat, Chittagong 5 1 23 1 30 0.50
Dhaka Dental College Hospital, Dhaka 1 - 1 - 2 0.1

Pabna Mental Hospital, Pabna 6 - 8 - 14 0.9
Shaheed Sheikh Abu Naser Specialized Hospital, Khulna 107 - 125 - 232 8.4
Institute of Child and Mother Health, Matuail, Dhaka 17 179 14 202 412 2.8
National Institute of Cancer Research and Hospital (NICR&H), Mohakhali, Dhaka 66 2 96 4 168 2.3
National Institute of Cardiovascular Disease (NICVD), Sher-e-Bangla Nagar, Dhaka 999 51 2,889 79 4,018 6.3
National Institute of Diseases of the Chest and Hospital (NIDCH), Mohakhali, Dhaka 215 - 757 - 972 7.1
National Institute of ENT, Dhaka - - - - - -

Specialty institute hospitals
National Institute of Kidney Disease and Urology (NIKDU), Sher-e-Bangla Nagar, Dhaka 71 - 114 4 189 3.3
National Institute of Mental Health & Research (NIMHR), Sher-e-Bangla Nagar, Dhaka 1 - 3 - 4 0.1
National Institute of Neurosciences and Hospital (NINH) , Dhaka 311 13 349 23 696 9.5
National Institute of Ophthalmology (NIO), Sher-e-Bangla Nagar, Dhaka - - - - - -
National Institute of Traumatology and Rehabilitation (NITOR), Sher-e-Bangla Nagar, Dhaka 23 - 121 - 144 0.8
TB Hospital, Khulna 1 - 5 - 6 1.7

TB Hospitals
TB Hospital, Rajshahi 6 - 18 - 24 6.2
B. Secondary (district-level) hospital
Age and sex

Hospital
Division Name of hospital >5 yrs 5 yrs >5 yrs 5 yrs death rate
Total (%)
Female Male
Barguna District Hospital - 3 - 13 16 0.2
Barisal General Hospital 120 120 196 98 534 2.0
Bhola District Hospital 33 3 25 3 64 0.4

Barisal
Jhalokathi District Hospital 135 63 185 94 477 1.4
Patuakhali 250-bed Sadar Hospital 38 20 77 23 158 1.0
Pirojpur District Hospital, Pirojpur 24 13 1 19 57 0.8
Bandarban District Hospital 169 44 199 44 456 1.7
Brahmanbaria 250-bed District Sadar Hospital 84 44 104 55 287 0.9
Chandpur 250-bed General Hospital 14 - 24 - 38 0.3
Chittagong 250-bed General Hospital 14 3 17 2 36 0.5
Comilla General Hospital 395 280 364 226 1,265 2.5
Chittagong Coxs Bazar 250-bed District Sadar Hospital 123 61 147 57 388 1.2
Feni 250-bed District Sadar Hospital 51 44 85 71 251 2.1
Khagrachhari District Hospital 64 9 106 23 202 1.2
Lakshmipur District Hospital 315 118 378 174 985 2.1
Noakhali 250-bed General Hospital 62 28 86 33 209 2.0
Rangamati General Hospital - 3 - 13 16 0.2
250-bed District Hospital, Manikganj 122 53 179 51 405 1.8
Faridpur General Hospital 37 78 44 72 231 1.2
Gazipur District Hospital 31 15 39 21 106 0.6
Gopalganj 250-bedded District Hospital 179 67 192 87 525 1.9
Kishoreganj 250-bed District Sadar Hospital 136 154 274 177 741 1.2
Kurmitola 500-bed General Hospital 35 - 55 1 91 0.4
Madaripur District Hospital 51 14 71 13 149 0.7
Mugda 500-bed General Hospital 14 3 12 5 34 0.4

Dhaka
Munshiganj District Hospital 25 6 48 8 87 0.6
Narayanganj 300-bed Hospital 12 - 18 - 30 0.4
Narayanganj General (Victoria) Hospital 13 - 21 - 34 0.2
Narsingdi 100-bed Zilla Hospital 60 52 89 54 255 2.3
Rajbari District Hospital 54 11 73 9 147 0.7
Sadar Hospital Narsingdi 38 50 46 41 175 2.0
Shariatpur District Hospital 71 23 86 22 202 0.5
Tangail 250-bed District Hospital 408 170 479 336 1,393 2.2
ANNEX

Age and sex
Hospital
Division Name of hospital >5 yrs 5 yrs >5 yrs 5 yrs death rate
Total (%)
Female Male
250-bedded General Hospital, Jessore 662 150 1,101 130 2,043 3.5
Bagerhat District Hospital 85 38 100 40 263 1.6

Chuadanga District Hospital 200 36 255 34 525 1.7
Jhenaidah District Hospital 158 48 142 37 385 1.3
Khulna 150-bed General Hospital 34 - 60 - 94 1.1

Khulna
Kushtia 250-bed General Hospital 527 13 788 17 1,345 2.5
Magura District Hospital 160 36 243 51 490 1.7
Meherpur 250-bed District Hospital 75 44 167 43 329 1.2
Narail District Hospital 59 30 101 23 213 1.1
Satkhira District Hospital 275 176 382 144 977 4.1
Jamalpur 250-beded General Hospital 113 132 157 233 635 1.4
Mymensingh Netrokona District Hospital 55 41 75 56 227 0.8
Sherpur District Hospital 74 21 127 33 255 0.9
Bogra 250-bed Mohammad Ali District Hospital 17 3 44 12 76 0.4
Chapainowabganj District Hospital 49 67 74 122 312 1.2
Joypurhat District Hospital 106 40 212 29 387 1.5
Rajshahi Naogaon District Hospital 241 17 212 11 481 2.1
Natore District Hospital 80 17 141 22 260 0.9
Pabna 250-bed General Hospital 361 166 488 233 1,248 1.7
Sirajganj General Hospital 103 119 134 244 600 0.7
Dinajpur 250-bed General Hospital 29 8 30 12 79 0.3
Gaibandha District Hospital 107 41 102 72 322 1.4
Kurigram District Hospital 101 116 130 138 485 1.9
Lalmonirhat District Hospital 21 39 33 31 124 1.2

Rangpur
Nilphamari District Hospital - 40 54 30 124 0.2
Panchagarh District Hospital 119 52 165 59 395 2.1
Saidpur 100-bed Hospital 27 3 38 5 73 0.6
Thakurgaon District Hospital 75 135 161 168 539 1.4
Habiganj District Hospital 371 140 290 120 921 2.3
Moulvibazar 250-bed District Sadar Hospital 116 48 140 53 357 0.9

Sylhet
Sunamganj 250-bed District Sadar Hospital 70 84 61 75 290 1.3
Sylhet Shahid Shamsuddin Ahmed District Hospital 1 - 2 - 3 0.1

Age and sex

Hospital
Division Name of UHC >5 yrs 5 yrs >5 yrs 5 yrs death rate
Total (%)
F M
Agailjhara Upazila Health Complex 12 1 10 - 23 0.6
Amtali Upazila Health Complex 9 2 7 - 18 0.4
Babuganj Upazila Health Complex - - 1 - 1 0.1
Bakerganj Upazila Health Complex 4 - 8 2 14 0.3
Bamna Upazila Health Complex 4 2 9 1 16 0.8
Banaripara Upazila Health Complex 6 - 8 - 14 0.3
Bauphal Upazila Health Complex 4 1 5 2 12 0.3
Betagi Upazila Health Complex 10 2 7 2 21 0.7
Bhandaria Upazila Health Complex 8 - 9 - 17 0.4
Borhanuddin Upazila Health Complex 10 2 16 2 30 0.3
Char Fasson Upazila Health Complex 21 31 30 4 86 0.7
Dashmina Upazila Health Complex 9 1 12 1 23 0.4
Daulatkhan Upazila Health Complex 2 2 2 3 9 0.2
Dumki Upazila Health Complex 2 - 4 - 6 0.3
Galachipa Upazila Health Complex 11 1 16 2 30 0.4
Gournadi Upazila Health Complex 6 - 9 1 16 0.3
Hijla Upazila Health Complex 2 1 6 2 11 0.5

Barisal
Kalapara Upazila Health Complex 17 2 23 3 45 0.5
Kathalia Upazila Health Complex 7 - 4 - 11 0.4
Kawkhali Upazila Health Complex 5 - 6 - 11 0.6
Lalmohan Upazila Health Complex 10 5 15 4 34 0.4
Manpura Upazila Health Complex 4 4 1 3 12 0.5
Mathbaria Upazila Health Complex 19 12 20 14 65 0.8
Mehendiganj Upazila Health Complex 5 4 3 3 15 0.3
Mirzaganj Upazila Health Complex 6 - 7 1 14 0.4
Muladi Upazila Health Complex 12 3 8 4 27 0.8
Nalchithi Upazila Health Complex 4 1 4 - 9 0.2
Nazirpur Upazila Health Complex 5 - 4 - 9 0.3
Nesarabad Upazila Health Complex 19 2 27 7 55 0.7
Pathargatha Upazila Health Complex 9 5 5 4 23 0.5
Rajapur Upazila Health Complex 2 - 10 - 12 0.3
Tajumuddin Upazila Health Complex 2 1 4 1 8 0.3
Wazirpur Upazila Health Complex 5 1 2 - 8 0.2
Zianagar Upazila Health Complex - - - - - -
Akhaura Upazila Health Complex 5 1 3 1 10 0.2

ANNEX

Age and sex
Hospital
Total (%)
F M
Alikadam Upazila Health Complex 7 2 4 6 19 0.5
Anwara Upazila Health Complex 1 - 3 - 4 0.0
Ashuganj Upazila Health Complex - - - - - -

Baghaichhari Upazila Health Complex 7 3 7 2 19 1.1
Bancharampur Upazila Health Complex 3 1 4 1 9 0.3
Banshkhali Upazila Health Complex 8 3 9 6 26 0.3
Barkol Upazila Health Complex - - - 1 1 0.2
Barura Upazila Health Complex 4 4 5 2 15 0.4
Begumganj Upazila Health Complex 1 - - - 1 0.0
Belaichhari Upazila Health Complex 1 - 1 - 2 0.5
Boalkhali Upazila Health Complex 1 5 1 3 10 0.2
Brahmmanpara Upazila Health Complex - - 1 1 2 0.1
Burichong Upazila Health Complex 5 1 8 2 16 0.3
Chauddagram Upazila Health Complex 2 1 1 2 6 0.1
Chakaria Upazila Health Complex 2 1 2 3 8 0.0
Chandanaish Upazila Health Complex 3 1 5 - 9 0.1
Chandina Upazila Health Complex 9 3 15 2 29 0.3
Chittagong Chatkhil Upazila Health Complex 4 1 8 1 14 0.2
Chhagalnaya Upazila Health Complex 2 - 2 - 4 0.1
Comilla Sadar Daxin Upazila Health Complex - - - - - -
Companiganj Upazila Health Complex 3 3 5 2 13 0.2
Daganbhuiya Upazila Health Complex 2 - 2 - 4 0.1
Daudkandi Upazila Health Complex 72 42 120 60 294 4.4
Debidwar Upazila Health Complex 5 5 9 4 23 0.1
Dighinala Upazila Health Complex - - 7 1 8 0.1
Faridganj Upazila Health Complex 1 - 2 - 3 0.1
Fatikchhari Upazila Health Complex - - - - - -
Fulgazi Upazila Health Complex 7 - 3 - 10 0.2
Haimchar Upazila Health Complex - - 1 - 1 0.0
Hathazari Upazila Health Complex 1 3 8 1 13 0.2
Hatiya Upazila Health Complex 24 31 42 55 152 2.4
Haziganj Upazila Health Complex 3 - 9 2 14 0.3
Homna Upazila Health Complex 11 2 20 1 34 0.5
Juraichhari Upazila Health Complex 2 1 1 1 5 1.4
Kabirhat Upazila Health Complex - - - - - -

Age and sex
Hospital
Total (%)
F M
Kachua Upazila Health Complex 5 1 9 - 15 0.3
Kamolnagar Upazila Health Complex 1 - - - 1 0.0
Kaptai Upazila Health Complex 1 1 1 - 3 0.1
Kashba Upazila Health Complex 2 - 3 - 5 0.1
Kawkhali Upazila Health Complex 2 - - - 2 0.2
Kutubdia Upazila Health Complex 4 4 4 2 14 0.2
Laksham Upazila Health Complex 2 2 4 1 9 0.2
Lakshmichhari Upazila Health Complex 3 - 2 1 6 0.6
Lama Upazila Health Complex 12 5 9 2 28 0.7
Langadu Upazila Health Complex 6 - 11 - 17 0.9
Lohagara Upazila Health Complex 3 - 1 - 4 0.1
Manikchhari Upazila Health Complex 2 2 8 - 12 0.4
Matiranga Upazila Health Complex 6 - 2 3 11 0.6
Matlab(daxin) Upazila Health Complex 3 1 7 - 11 0.2
Matlab(uttar) Upazila Health Complex - - 1 - 1 0.0
Meghna Upazila Health Complex - - - - - -
Mirarsarai Upazila Health Complex 4 - 5 1 10 0.1
Mohalchhari Upazila Health Complex - - 6 4 10 0.6

Chittagong
Moheshkhali Upazila Health Complex 9 6 5 3 23 0.2
Monoharganj Upazila Health Complex - - - - - -
Muradnagar Upazila Health Complex 9 6 15 3 33 0.5
Nabinagar Upazila Health Complex 4 12 3 8 27 0.3
Naikhongchhari Upazila Health Complex 2 2 3 2 9 0.2
Nangolkot Upazila Health Complex 3 1 8 2 14 0.2
Naniarchar Upazila Health Complex 4 - 4 - 8 1.2
Nasirnagar Upazila Health Complex 4 3 6 5 18 0.3
Panchhari Upazila Health Complex 1 - 5 - 6 0.3
Parsuram Upazila Health Complex 6 - 10 - 16 0.3
Patiya Upazila Health Complex 8 3 10 3 24 0.2
Pekua Upazila Health Complex - - - 1 1 0.0
Raipur Upazila Health Complex 6 4 3 1 14 0.2
Rajsthali Upazila Health Complex 2 - 1 - 3 0.4
Ramganj Upazila Health Complex 5 1 12 1 19 0.4
Ramgarh Upazila Health Complex 10 3 10 4 27 1.0
Ramgati Upazila Health Complex 2 - 4 - 6 0.1
Ramu Upazila Health Complex 5 3 3 2 13 0.2

ANNEX

Age and sex
Hospital
Total (%)
F M
Rangunia Upazila Health Complex 7 4 6 3 20 0.3
Roujan Upazila Health Complex 7 8 9 10 34 0.3
Rowangchhari Upazila Health Complex - 1 1 2 4 0.5

Ruma Upazila Health Complex 2 1 - 1 4 0.3
Saharasthi Upazila Health Complex 23 5 14 3 45 0.8
Sandwip Upazila Health Complex 1 12 2 10 25 0.4
Sarail Upazila Health Complex 5 - 4 - 9 0.2
Satkania Upazila Health Complex 2 3 1 3 9 0.2
Chittagong Senbag Upazila Health Complex 3 - 3 - 6 0.1
Sitakunda Upazila Health Complex 9 1 6 2 18 0.2
Sonagazi Upazila Health Complex 6 2 12 - 20 0.3
Sonaimuri Upazila Health Complex 1 - 2 - 3 0.1
Subarnachar Upazila Health Complex 2 1 6 1 10 0.2
Teknaf Upazila Health Complex - 3 1 4 8 0.1
Thanchi Upazila Health Complex - - 1 - 1 0.7
Titas Upazila Health Complex 1 1 2 - 4 0.1
Ukhyia Upazila Health Complex 5 1 2 4 12 0.2
Alfadanga Upazila Health Complex 6 - 9 - 15 0.3
Araihazar Upazila Health Complex - - - 2 2 0.1
Atpara Upazila Health Complex 3 - 5 - 8 0.5
Austagram Upazila Health Complex 3 5 9 4 21 0.8
Bajitpur Upazila Health Complex 5 - 6 2 13 0.3
Bakshiganj Upazila Health Complex 2 - 7 - 9 0.2
Baliakandi Upazila Health Complex 1 1 - - 2 0.0
Bandar Upazila Health Complex - - 3 - 3 0.3
Barhatta Upazila Health Complex 1 1 10 1 13 0.4

Dhaka and
Basail Upazila Health Complex,Tangail. 1 - - - 1 0.0
Mymensingh
Belabo Upazila Health Complex 3 1 5 - 9 0.2
Bhairab Upazila Health Complex 9 4 23 3 39 0.6
Bhaluka Upazila Health Complex 7 - 3 - 10 0.1
Bhanga Upazila Health Complex 8 - 1 - 9 0.1
Bhedarganj Upazila Health Complex 6 2 2 4 14 0.3
Bhuapur Upazila Health Complex 6 - 13 - 19 0.3
Boalmari Upazila Health Complex 17 5 21 21 64 0.7
Charbhadrason Upazila Health Complex - - 3 - 3 0.1
Damudya Upazila Health Complex 10 5 8 4 27 0.6

Age and sex
Hospital
Total (%)
F M
Daulatpur Upazila Health Complex 7 1 7 1 16 0.3
Delduar Upazila Health Complex - - 1 - 1 0.0
Dewanganj Upazila Health Complex 5 3 9 4 21 0.6
Dhamrai Upazila Health Complex 5 - 7 - 12 0.2
Dhanbari Upazila Health Complex - - - - - -
Dhubaura Upazila Health Complex 6 7 13 6 32 0.6
Dohar Upazila Health Complex 6 3 13 - 22 0.3
Durgapur Upazila Health Complex 14 13 15 6 48 0.9
Fulbaria Upazila Health Complex 3 3 3 - 9 0.2
Fulpur Upazila Health Complex 1 1 12 4 18 0.2
Gazaria Upazila Health Complex 3 1 9 1 14 0.2
Ghatail Upazila Health Complex 4 1 10 - 15 0.2
Ghior Upazila Health Complex - - 4 1 5 0.2
Goalanda Upazila Health Complex 2 - 4 1 7 0.1
Gofargaon Upazila Health Complex 6 2 10 1 19 1.0
Gopalpur Upazila Health Complex 3 - 13 - 16 0.4
Goshairhat Upazila Health Complex 5 6 13 12 36 0.9
Dhaka and Gouripur Upazila Health Complex 1 2 13 1 17 0.3

Mymensingh Haluaghat Upazila Health Complex 4 2 6 2 14 0.1
Harirampur Upazila Health Complex 4 - 5 - 9 0.3
Hossainpur Upazila Health Complex 4 - 6 - 10 0.1
Islampur Upazila Health Complex 6 1 6 1 14 0.3
Iswarganj Upazila Health Complex 5 1 2 - 8 0.1
Itna Upazila Health Complex 4 2 1 1 8 0.3
Jhenaigati Upazila Health Complex - - 1 - 1 0.0
Kaliakair Upazila Health Complex 4 1 11 4 20 0.3
Kaliganj Upazila Health Complex 9 1 14 - 24 0.4
Kalihati Upazila Health Complex 5 - 12 - 17 0.3
Kalkini Upazila Health Complex 7 - 3 - 10 0.2
Kalmakanda Upazila Health Complex 15 3 12 4 34 0.7
Kalukhali Upazila Health Complex - - - - - -
Kapasia Upazila Health Complex - - 6 1 7 0.1
Karimganj Upazila Health Complex 6 - 7 - 13 0.2
Kashiani Upazila Health Complex 6 - 9 - 15 0.4
Katiadi Upazila Health Complex 3 - 4 1 8 0.1
Kendua Upazila Health Complex 3 2 14 9 28 0.6

ANNEX

Age and sex
Hospital
Total (%)
F M
Keraniganj Upazila Health Complex 1 - 4 - 5 0.2
Khaliajuri Upazila Health Complex 3 4 7 2 16 0.7
Kotwalipara Upazila Health Complex 19 3 16 2 40 0.6

Kuliarchar Upazila Health Complex 1 1 9 - 11 0.3
Louhajang Upazila Health Complex 3 1 2 1 7 0.2
Madan Upazila Health Complex 3 1 6 3 13 0.3
Madarganj Upazila Health Complex 1 - 1 - 2 0.1
Melandaha Upazila Health Complex 1 - 2 - 3 0.1
Mirzapur Upazila Health Complex 1 - 1 - 2 0.1
Mithamoin Upazila Health Complex 8 - 17 - 25 1.2
Modhukhali Upazila Health Complex 7 - 9 - 16 0.3
Madhupur Upazila Health Complex 8 1 8 2 19 0.2
Mohanganj Upazila Health Complex 56 12 78 14 160 2.3
Monohardi Upazila Health Complex 3 - 6 - 9 0.2
Mukshedpur Upazila Health Complex 12 23 18 28 81 1.0
Muktagacha Upazila Health Complex 3 - 3 - 6 0.1
Nagarkanda Upazila Health Complex - - 2 - 2 0.0
Dhaka and Nagarpur Upazila Health Complex - - 8 - 8 0.1

Mymensingh Nakhla Upazila Health Complex 4 1 7 4 16 0.3
Nalitabari Upazila Health Complex 6 2 7 2 17 0.4
Nandail Upazila Health Complex 4 4 5 5 18 0.3
Naria Upazila Health Complex 2 1 3 1 7 0.2
Nawabganj Upazila Health Complex 11 1 35 1 48 0.7
Nikli Upazila Health Complex 2 4 7 2 15 0.4
Pakundia Upazila Health Complex - - - - - -
Palash Upazila Health Complex 7 - 3 1 11 0.4
Pangsha Upazila Health Complex 16 7 18 7 48 0.7
Purbadhala Upazila Health Complex 2 1 12 3 18 0.2
Raipura Upazila Health Complex - - 1 - 1 0.0
Rajoir Upazila Health Complex 12 3 21 2 38 1.5
Rupganj Upazila Health Complex 3 - 6 - 9 0.3
Sadarpur Upazila Health Complex 3 3 8 1 15 0.2
Sakhipur Upazila Health Complex 8 1 13 3 25 0.3
Sarishabari Upazila Health Complex 2 - 8 - 10 0.2
Saturia Upazila Health Complex 1 1 3 - 5 0.1
Savar Upazila Health Complex 7 - 8 - 15 0.4

Age and sex
Hospital
Total (%)
F M
Serajdikhan Upazila Health Complex 3 - 8 - 11 0.2
Shibalaya Upazila Health Complex 2 1 4 3 10 0.2
Shibchar Upazila Health Complex 1 - 1 - 2 0.1
Shibpur Upazila Health Complex 8 - 14 - 22 0.3
Singair Upazila Health Complex 3 1 5 2 11 0.3
Sonargaon Upazila Health Complex 2 3 4 2 11 0.3
Sreenagar Upazila Health Complex 7 - 7 - 14 0.2

Dhaka and
Sreepur Upazila Health Complex - - 4 1 5 0.2
Mymensingh
Sribordi Upazila health Complex 8 3 14 4 29 0.5
Tarail Upazila Health Complex - - - - - -
Tejgaon Health Complex - - - 1 1 0.0
Trisal Upazila Health Complex 1 - 8 - 9 0.2
Tungibari Upazila Health Complex 3 2 7 - 12 0.2
Tungipara Upazila Health Complex 10 - 13 1 24 0.3
Zanjira Upazila Health Complex 11 1 18 2 32 0.6
Abhoynagar Upazila Health Complex 21 - 25 2 48 0.9
Alamdanga Upazila Health Complex 23 1 22 1 47 0.5
Assasuni Upazila Health Complex 7 - 12 - 19 0.3
Bagerpara Upazila Health Complex 3 - 2 - 5 0.2
Batiaghata Upazila Health Complex 6 1 6 2 15 0.3
Bheramara Upazila Health Complex 3 - 1 - 4 0.2
Chitalmari Upazila Health Complex 3 - 9 2 14 0.2
Chowgacha Upazila Health Complex 9 2 18 1 30 0.8
Dacope Upazila Health Complex 6 1 6 2 15 0.1
Damurhuda Upazila Health Complex 11 3 24 8 46 0.9
Khulna Daulatpur Upazila Health Complex - - 4 - 4 0.1
Debhata Upazila Health Complex 5 - 7 - 12 0.1
Dighalia Upazila Health Complex 5 - 6 1 12 0.4
Dumuria Upazila Health Complex 4 - 7 - 11 0.4
Fakirhat Upazila Health Complex 2 12 3 20 37 0.7
Fultala Upazila Health Complex 13 - 18 - 31 0.3
Gangni Upazila Health Complex 35 - 48 - 83 1.2
Harinakunda Upazila Health Complex 6 - 6 - 12 0.1
Jhikargacha Upazila Health Complex 22 1 12 3 38 0.5
Jibannagar Upazila Health Complex 1 - 1 - 2 0.0
Kachua Upazila Health Complex 10 - 26 - 36 0.4

ANNEX

Age and sex
Hospital
Total (%)
F M
Kalaroa Upazila Health Complex 7 - 5 - 12 0.3
Kalia Upazila Health Complex 11 - 12 - 23 0.5
Kaliganj Upazila Health Complex 3 2 4 - 9 0.2

Keshabpur Upazila Health Complex 26 8 34 3 71 0.6
Khoksha Upazila Health Complex 16 2 39 1 58 0.9
Kotchandpur Upazila Health Complex 13 5 10 4 32 0.7
Koyra Upazila Health Complex 14 - 36 1 51 0.5
Kumarkhali Upazila Health Complex 1 12 2 17 32 0.7
Lohagara Upazila Health Complex 5 1 19 1 26 0.3
Mirpur Upazila Health Complex 7 - 14 1 22 0.4
Moheshpur Upazila Health Complex 5 - 6 1 12 0.2
Mollahat Upazila Health Complex 19 - 13 1 33 0.5
Mongla Upazila Health Complex 13 2 14 1 30 0.6
Khulna Monirampur Upazila Health Complex 6 - 11 - 17 0.3
Morrelganj Upazila Health Complex 8 - 15 - 23 0.4
Mujibnagar Upazila Health Complex - - - - - -
Paikgacha Upazila Health Complex 2 - 3 - 5 0.1
Rampal Upazila Health Complex 3 - 7 - 10 0.2
Rupsha Upazila Health Complex 12 2 35 3 52 0.7
Sailkupa Upazila Health Complex 5 - 4 - 9 0.2
Sarankhola Upazila Health Complex 3 - - - 3 0.0
Sarsa Upazila Health Complex 11 4 14 5 34 0.7
Shalikha Upazila Health Complex 5 - 7 - 12 0.2
Shyamnagar Upazila Health Complex 5 - 4 - 9 0.2
Sreepur Upazila Health Complex 38 8 56 10 112 1.0
Tala Upazila Health Complex 1 1 7 - 9 0.4
Terakhada Upazila Health Complex 24 25 25 29 103 2.4
Adamdighi Upazila Health Complex - 10 - 13 23 0.4
Akkelpur Upazila Health Complex - - 5 - 5 0.1
Atghoria Upazila Health Complex 5 - 8 1 14 0.4
Atrai Upazila Health Complex 1 - 6 - 7 0.2
Rajshahi Badalgachi Upazila Health Complex 3 - 4 - 7 0.1
Bagatipara Upazila Health Complex 1 - 1 - 2 0.1
Bagha Upazila Health Complex 4 - 3 - 7 0.2
Bagmara Upazila Health Complex 1 - 2 - 3 0.1
Baraigram Upazila Health Complex 4 1 5 - 10 0.2

Age and sex
Hospital
Total (%)
F M
Belkuchi Upazila Health Complex 3 - - - 3 0.1
Bera Upazila Health Complex 1 1 2 - 4 0.1
Bhangura Upazila Health Complex 8 1 10 3 22 0.2
Bholahat Upazila Health Complex 7 - 9 - 16 0.3
Charghat Upazila Health Complex 4 - 8 1 13 0.3
Chatmohar Upazila Health Complex 2 - 2 - 4 0.1
Chowhali Upazila Health Complex 11 7 20 3 41 0.4
Dhamairhat Upazila Health Complex - - - - - -
Dhunat Upazila Health Complex 4 - 8 - 12 0.4
Dhupchachia Upazila Health Complex 1 - 3 2 6 0.2
Durgapur Upazila Health Complex 5 - 9 - 14 0.2
Gabtali Upazila Health Complex 3 - 3 - 6 0.1
Godagari Upazila Health Complex - - 2 - 2 0.0
Gomastapur Upazila Health Complex 6 - 4 - 10 0.3
Gurudashpur Upazila Health Complex 5 2 10 1 18 0.3
Iswardi Upazila Health Complex 9 1 14 - 24 0.4
Kahaloo Upazila Health Complex 22 - 32 1 55 0.5
Kalai Upazila Health Complex 3 - 3 - 6 0.1

Rajshahi
Kamarkhanda Upazila Health Complex 8 - 9 - 17 0.2
Kazipur Upazila Health Complex 1 2 4 2 9 0.3
Khetlal Upazila Health Complex 4 - 5 - 9 0.3
Lalpur Upazila Health Complex 4 - 3 - 7 0.2
Manda Upazila Health Complex 10 - 12 - 22 0.3
Mohadevpur Upazila Health Complex 5 1 14 - 20 0.4
Mohanpur Upazila Health Complex 19 6 45 3 73 1.1
Nachol Upazila Health Complex 3 - - - 3 0.1
Nandigram Upazila Health Complex 1 3 4 4 12 0.3
Niamatpur Upazila Health Complex - - 3 - 3 0.1
Paba Upazila Health Complex 7 - 8 2 17 0.4
Panchbibi Upazila Health Complex 1 - 1 - 2 0.0
Patnitala Upazila Health Complex 3 1 1 1 6 0.1
Porsha Upazila Health Complex 17 2 17 1 37 0.8
Puthia Upazila Health Complex 5 4 10 2 21 0.7
Raiganj Upazila Health Complex 2 3 1 2 8 0.1
Raninagar Upazila Health Complex 1 - 3 1 5 0.0
Santhia Upazila Health Complex 2 - 7 - 9 0.3

ANNEX

Age and sex
Hospital
Total (%)
F M
Sapahar Upazila Health Complex 14 - 7 - 21 0.3
Sariakandi Upazila Health Complex 10 2 15 1 28 0.5
Shahzadpur Upazila Health Complex 2 - 4 - 6 0.1

Shajahanpur Upazila Health Complex 1 - 5 - 6 0.2
Sherpur Upazila Health Complex - - 1 - 1 0.1
Shibganj Upazila Health Complex 4 - 5 1 10 0.2
Rajshahi Singra Upazila Health Complex 5 1 7 1 14 0.1
Sonatala Upazila Health Complex 12 2 13 5 32 0.4
Sujanagar Upazila Health Complex 1 2 2 2 7 0.2
Tanore Upazila Health Complex 3 - 2 - 5 0.0
Tarash Upazila Health Complex 4 - 3 1 8 0.2
Ullapara Upazila Health Complex - 1 2 1 4 0.1
Upazila Health Complex, Faridpur, Pabna 2 - 10 5 17 0.5
Aditmari Upazila Health Complex 6 3 8 2 19 0.4
Atwari Upazila Health Complex 1 - 2 - 3 0.1
Badarganj Upazila Health Complex 4 1 1 - 6 0.1
Baliadangi Upazila Health Complex 8 - 11 2 21 0.3
Bhurungamari Upazila Health Complex 1 11 1 10 23 0.2
Birampur Upazila Health Complex 3 1 4 2 10 0.2
Birganj Upazila Health Complex 5 3 10 2 20 0.4
Birol Upazila Health Complex 4 - 1 - 5 0.1
Bochaganj Upazila Health Complex 4 - - - 4 0.1
Boda Upazila Health Complex 12 - 8 - 20 0.5
Chilmari Upazila Health Complex 6 - 5 - 11 0.2
Rangpur Chirirbandar Upazila Health Complex 3 2 4 3 12 0.3
Debiganj Upazila Health Complex - 2 - - 2 0.0
Dimla Upazila Health Complex 10 4 16 3 33 0.6
Domar Upazila Health Complex 23 4 16 3 46 0.6
Fulbari Upazila Health Complex 20 6 13 3 42 0.5
Fulchhari Upazila Health Complex 9 - 8 1 18 0.1
Gangachara Upazila Health Complex 1 - 1 - 2 0.1
Ghoraghat Upazila Health Complex 2 1 2 - 5 0.1
Gobindaganj Upazila Health Complex - - 4 - 4 0.1
Hakimpur Upazila Health Complex 7 2 6 - 15 0.1
Haripur Upazila Health Complex 4 1 6 1 12 0.3
Hatibandha Upazila Health Complex 7 - 4 - 11 0.3

Age and sex
Hospital
Total (%)
F M
Jaldhaka Upazila Health Complex 10 5 14 6 35 0.4
Kaharol Upazila Health Complex 8 3 15 3 29 0.1
Kaliganj Upazila Health Complex - - 2 - 2 0.1
Khansama Upazila Health Complex 10 1 13 2 26 0.7
Kishoreganj Upazila Health Complex - - 3 - 3 0.1
Kownia Upazila Health Complex 2 4 2 8 16 0.1
Mithapukur Upazila Health Complex 2 2 5 4 13 0.2
Nageswari Upazila Health Complex 7 1 3 - 11 0.1
Nawabganj Upazila Health Complex 5 - 7 - 12 0.3
Palashbari Upazila Health Complex 9 1 4 1 15 0.4
Parbatipur Upazila Health Complex - 1 1 2 4 0.1
Patgram Upazila Health Complex 1 - 2 - 3 0.0
Rangpur Pirgacha Upazila Health Complex 2 3 - 1 6 0.1
Pirganj Upazila Health Complex 1 - 6 - 7 0.2
Rajarhat Upazila Health Complex 27 2 39 1 69 0.3
Rajibpur Upazila Health Complex 1 1 3 - 5 0.2
Ranisankhail Upazila Health Complex 5 2 3 1 11 0.3
Rowmari Upazila Health Complex 6 - 10 - 16 0.3
Sadullapur Upazila Health Complex 8 8 13 22 51 0.7
Saidpur Upazila Health Complex 3 1 12 1 17 0.3
Shaghata Upazila Health Complex - - - - - -
Sundarganj Upazila Health Complex 2 - 1 - 3 0.1
Taraganj Upazila Health Complex 9 1 12 2 24 0.2
Tetulia Upazila Health Complex 2 - 2 - 4 0.1
Ullipur Upazila Health Complex 12 1 7 - 20 0.5
Azmiriganj Upazila Health Complex 2 4 2 3 11 0.1
Bahubal Upazila Health Complex 7 13 6 7 33 0.8
Balaganj Upazila Health Complex 1 - 1 1 3 0.0
Baniachong Upazila Health Complex 1 - - 1 2 0.1
Barlekha Upazila Health Complex 4 - 3 1 8 0.2
Sylhet Beanibazar Upazila Health Complex 11 6 4 5 26 0.3
Biswambarpur Upazila Health Complex 5 14 3 8 30 0.4
Biswanath Upazila Health Complex 4 4 5 5 18 0.7
Chhatak Upazila Health Complex - - - - - -
Chunarughat Upazila Health Complex 3 1 5 - 9 0.2
Companyganj Upazila Health Complex 9 5 9 1 24 0.4

ANNEX

Age and sex
Hospital
Total (%)
F M
Dakhin Surma Upazila Health Complex 1 1 - 1 3 0.1
Daxin Sunamganj Upazila Health Complex - - - - - -
Derai Upazila Health Complex - - - - - -

Dharmapasha Upazila Health Complex 10 18 2 15 45 0.4
Doarabazar Upazila Health Complex 11 7 8 9 35 0.5
Fenchuganj Upazila Health Complex 10 - 10 1 21 0.9
Golapganj Upazila Health Complex - 3 3 1 7 0.2
Gowainghat Upazila Health Complex 2 2 - - 4 0.1
Jagannathpur Upazila Health Complex 2 1 2 1 6 0.1
Jamalganj Upazila Health Complex 4 8 9 12 33 0.6
Jointapur Upazila Health Complex 6 1 6 3 16 0.3
Sylhet Juri Upazila Health Complex 3 3 2 2 10 0.2
Kamalganj Upazila Health Complex - - - - - -
Kanaighat Upazila Health Complex 1 4 3 2 10 0.1
Kulaura Upazila Health Complex 2 1 4 6 13 0.2
Lakhai Upazila Health Complex 7 3 3 1 14 0.1
Madhabpur Upazila Health Complex 1 2 3 1 7 0.3
Nabiganj Upazila Health Complex 8 3 9 2 22 0.3
Rajnagar Upazila Health Complex 2 - 4 1 7 0.1
Sreemangal Upazila Health Complex - - - - - -
Sulla Upazila Health Complex 3 - 7 1 11 0.2
Taherpur Upazila Health Complex 7 6 8 5 26 1.0
Zakiganj Upazila Health Complex 7 7 5 5 24 0.7

ANNEX TO CHAPTER 16
Division-wise distribution of sanctioned, filled-up and vacant posts under the DGHS (May 2015)
Filled-up Vacant
Filled-up Vacant
Division Class Sanctioned
as % of as % of
Male Female Total No.
sanctioned sanctioned
posts posts
Doctors 1543 995 324 1319 85 224 15

Class I
Non-doctors 25 6 1 7 28 18 72
Class II 1614 76 1441 1517 94 97 6

Barisal
Class III 4043 2288 1167 3455 85 628 15
Class IV 1912 1136 381 1517 79 395 21
Total 9177 4501 3314 7815 85 1362 15
Doctors 3911 2550 1110 3660 94 251 6

Class I
Non-doctors 61 12 0 12 20 49 80
Class II 3128 197 2546 2543 81 585 19

Chittagong
Class III 10092 5790 2084 7874 78 2218 22
Class IV 4515 2613 841 3454 77 1061 23
Total 21707 11162 6381 17543 81 4164 19
Doctors 9435 6163 2944 9107 97 328 3

Class I
Non-doctors 280 93 32 125 45 155 55
Class II 8316 644 6773 7417 89 899 11

Dhaka
Class III 16658 10066 4138 14204 85 2454 15
Class IV 11733 6456 2395 8851 75 2882 25
Total 46422 23422 16282 39704 86 6718 14
Doctors 2333 1479 542 2021 87 312 13

Class I
Non-doctors 46 12 5 17 37 29 63
Class II 1937 68 1703 1771 91 166 9

Khulna
Class III 5945 3185 1357 4542 76 1403 24
Class IV 2629 1408 586 1994 76 635 24
Total 12890 4193 3941 10345 80 2545 20
Doctors 2731 1789 667 2456 90 275 10

Class I
Non-doctors 54 13 6 19 35 35 65
Class II 2703 169 2235 2404 89 299 11

Rajshahi
Class III 6770 4623 1297 5920 87 850 13
Class IV 3762 2157 791 2948 78 814 22
Total 16020 8751 4996 13747 86 2273 14
Doctors 2270 1466 558 2024 89 246 11

Class I
Non-doctors 37 3 2 5 14 32 86
Class II 1922 99 1482 1581 82 341 18

Rangpur
Class III 5584 3741 1065 4797 86 787 14
Class IV 2568 1511 520 2031 79 537 21
Total 12381 6820 3618 10438 84 1943 16

Filled-up Vacant
Filled-up Vacant
Division Class Sanctioned
as % of as % of
Male Female Total No.
sanctioned sanctioned
posts posts
Doctors 1413 945 308 1253 89 160 11

Class I
Non-doctors 22 3 0 3 14 19 86
Class II 1263 76 906 982 78 281 22

Sylhet
Class III 3623 2183 674 2857 79 766 21
Class IV 1809 1055 420 1475 82 334 18
Total 8130 4262 2308 6570 81 1560 19
Grand total 126727 65070 41092 106162 84 20565 16
Doctors 22632 15387 6453 21440 92 1796 8

Class I
Non-doctors 525 142 46 188 36 337 64
Class II 20883 1329 16886 18215 87 2668 13

All divisions
Class III 52755 31876 11773 43649 83 9106 17
Class IV 28928 16336 5934 22270 77 6658 23
Total 126727 65070 41092 106162 84 20565 16

ANNEX
Institutions offering postgraduate medical courses and titles of courses, with the number of seats in
each course (December 2015)
Name of institution MS MD M. Phil Diploma MPH MTM MMED Total
Autonomous (No. of institutions: 1)
Bangabandhu Sheikh Mujib Medical University, Dhaka 140 150 70 106 0 10 0 476
Total 140 150 70 106 0 10 0 476
Government (No. of institutions: 22)
Centre for Medical Education (CME), Dhaka 0 0 0 0 0 0 15 15
Chittagong Medical College 37 48 29 48 03 0 0 165
Dhaka Dental College 22 0 0 0 0 0 0 22
Dhaka Medical College 70 110 86 82 06 0 0 354
Institute of Child & Mother Health (ICMH), Dhaka 10 10 0 30 0 0 0 50
Institute of Nuclear Medicine and Ultrasound, Dhaka 0 0 0 10 0 0 0 10
Mymensingh Medical College 22 40 33 59 0 0 0 154
National Institute of Cancer Research and Hospital Dhaka 06 12 0 0 0 0 0 18
National Institute of Cardiovascular Diseases (NICVD), Dhaka 20 20 0 14 0 0 0 54
National Institute of Chest Diseases and Hospital (NIDCH),

06 15 0 20 0 0 0 41
Dhaka
National Institute of Child Health, Dhaka 10 15 0 15 0 0 0 40
National Institute of Kidney Diseases and Urology, Dhaka 06 09 0 0 0 0 0 15
National Institute of Mental Health, Dhaka 0 06 0 0 0 0 0 06
National Institute of Ophthalmology, Dhaka 10 0 0 10 0 0 0 20
National Institute of Preventive and Social Medicine, Dhaka 0 0 07 0 166 0 0 173
National Institute of Traumatology and Orthopedic

30 0 0 15 0 0 0 45
Rehabilitation, Dhaka
Rajshahi Medical College 10 19 25 41 05 0 0 100
Rangpur Medical College 08 08 08 22 0 0 0 46
Shaheed Ziaur Rahman Medical College, Bogra 0 0 0 10 0 0 0 10
Sher-e-Bangla Medical College, Barisal 04 0 08 22 0 0 0 34
Sir Salimullah Medical College, Dhaka 21 36 18 40 05 0 0 120
MAG Osmani Medical College, Sylhet 20 12 28 40 0 0 0 100
Total 312 360 242 478 185 0 15 1592
Private (No. of institutions: 10)
Bangladesh College of Physicians and Surgeons, Mohakhali,

- - - - - - - -
Dhaka*
Bangladesh Institute of Research and Rehabilitation in

Diabetes, Endocrine and Metabolic Disorders (BIRDEM), 10 22 15 14 0 0 0 61
Shahbag, Dhaka
Chittagong Maa O Shishu & General Hospital. Agrabad,

0 0 0 06 0 0 0 06
Chittagong
Institute of Child Health and Shishu (Children) Hospital,

0 0 0 06 0 0 0 06
ShishuShasthya Foundation, Bangladesh , Mirpur 2, Dhaka
Institute of Community Ophthalmology, Chittagong 0 0 0 08 0 0 0 08
Institute of Health Sciences (under USTC), Foys Lake,

0 05 0 45 0 0 0 50
Chittagong
Lions Eye Institute and Hospital, Lions Bhaban, Rokeya Sarani,

0 0 0 06 0 0 0 06
Agargaon, Dhaka
Mirza Ahmed Ispahani Institute of Ophthalmology and Islamia

0 0 0 10 0 0 0 10
Hospital, Sher-e-Bangla Nagar, Dhaka
National Heart Foundation, Mirpur 2, Dhaka 05 05 0 0 0 0 0 10
United Hospital Ltd. Gulshan 2, Dhaka 06 06 0 0 0 0 0 12
Total 21 38 15 95 0 0 0 169
Grand total (No. of institutions: 33)
Grand total (no. of seats) 473 548 327 679 185 25 2,237
*Offers FCPS and MCPS courses. Number of seats are not fixed and not included in this count

Number of fellowships and memberships offered by Bangladesh College of Physicians and Surgeons in
various disciplines fromJuly 2015 to July 2016
Discipline FCPS MCPS
Anesthesiology 16 7
Biochemistry 0 0
Cardiology 4 0
Clinical Pathology 0 16
Conservative Dentistry 6 0
Dental Surgery 0 5
Dermatology & Venereology 14 10
Family Medicine 0 2
Forensic Medicine 0 5
Gastroenterology 1 0
Hematology 5 0
Histopathology 1 0
Medicine 117 31
Microbiology 1 0
Neonatology 0 0
Obstetrics & Gynecology 168 21
Ophthalmology 33 13
Oral & Maxilla-Facial Surgery 16 0
Orthodontics & dentofacial Orthopedic 12 0
Otolaryngology 24 7
Pediatric Surgery 0 0
Pediatrics 108 3
Physical Medicine & Rehabilitation 10 0
Prosthodontics 6 0
Psychiatry 4 5
Pulmonology 0 0
Radiology & Imaging 11 11
Radiotherapy 10 3
Surgery 84 10
Thoracic Surgery 1 0
Urology 3 0
Plastic and Reconstructive Surgery 6 0
Gynaecological Oncology 1 0
Nephrology 0 0
Pediatric Nephrology 1 0
Neurology 0 0
Neuro-surgery 3 0
Orthopedic Suegery 2 0
Rheumatology 1 0
Family Medicine 0 0
Insfectious Disease and Tropical Medicine 0 0
Cardiovascular Surgery 4 0
Peaditric Haematology & Oncology 1 0
Endocrinology and Metbolism 1 0
Feoto-maternal Medicine 1 0
Paediatric Neurology & Development 1 0
Transfusion Medicie 0 0
Hepatology 0 0
Paediatric Gastroentology and Nutrition 0 0
Reproductive Endocrinology and Infertility 0 0
Total 677 149

ANNEX
Government institutions offering MBBS degree, with number of seats (December 2015)
Serial no Name of college Year of establishment No. of seats as of 2015
1 Dhaka Medical College, Dhaka 1948 197
2 Mymensingh Medical College, Mymensingh 1962 197
3 Chittagong Medical College, Chittagong 1962 197
4 Rajshahi Medical College, Rajshahi 1962 197
5 MAG Osmani Medical College, Sylhet 1966 197
6 Sher-e-Bangla Medical College, Barisal 1968 197
7 Rangpur Medical College, Rangpur 1972 197
8 Sir Salimullah Medical College, Mitford, Dhaka 1972 197
9 Comilla Medical College, Comilla 1992 113
10 Khulna Medical College, Khulna 1992 141
11 Shaheed Ziaur Rahman Medical College, Bogra 1992 141
12 Faridpur Medical College, Faridpur 1992 113
13 Dinajpur Medical College, Dinajpur 1992 142
14 Shaheed Suhrawardy Medical College, Sher-e-Bangla Nagar, Dhaka 2005 142
15 Pabna Medical College, Pabna 2008 57
16 Abdul Malek Ukil Medical College, Noakhali 2008 57
17 Coxs Bazar Medical College, Coxs Bazar 2008 57
18 Jessore Medical College, Jessore 2010 57
19. Satkhira Medical College, Satkhira 2011 52
20 Shaheed Syed Nazrul Islam Medical College Kishoreganj 2011 52
21 Kushtia Medical College. Kushtia 2011 52
22 Sheikh Shahera Khatun Medical College. Gopalganj 2011 52
23 Shaheed Taj Uddin Ahmed Medical College. Gazipur 2013 52
24 Tangail Medical College. Tangail 2014 51
25 Shaheed M Monsur Ali Medical College, Shirgajganj. 2014 51
26 Manikganj Medical College, Manikganj 2014 51
27 Jamalpur Medical College, Jamalpur 2014 51
28 Patuakhali Medical College, Patuakhali 2014 51
29 Rangamati Medical College, Rangamati 2014 51
30 Mugda Medical College, Dhaka 2015 50
31 Armed Forces Medical College, Dhaka 1999 100
32 Army Medical College, Chittagong 2014 100
33 Army Medical College, Jessore 2014 100
34 Army Medical College, Comilla 2014 100
35 Army Medical College, Rangpur 2014 100
36 Army Medical College, Bogra 2014 100
Total 3812
Private institutions offering MBBS degree, with the number of seats (December 2015)
Sl. Code
Name of college No. of seats Year of establishment
no. no.
01 41 Bangladesh Medical College, Road # 14/A, Dhanmondi, Dhaka 120 1985
02 42 SamajVittic Medical College, Mirza Nagar, Via Savar Cant., Dhaka 150 1989
03 43 Institute of Applied Health Sciences, Foys lake, Chittagong 75 1990
04 44 Jahurul Islam Medical College, Bajitpur, Kishoreganj 100 1992
05 45 Medical College for Women and Hospital, Rd # 8-9 Set-1, Uttara Model Town, Dhaka 90 1992
06 46 Z.H Sikder, Women Medical College, Monica Estate, Western Dhanmondi, Dhaka 100 1992
07 47 Dhaka National Medical College, 53/1 Jonson Road, Dhaka 125 1995
08 48 Community-based Medical College, 161 K.B. Ismail Road, Mymensingh 125 1995
09 49 Jalalabad Ragib-Rabeya Medical College, Pathantola, Sylhet 175 1996

Sl. Code
no. no.
10 50 Shaheed Monsur Ali Medical College, Plot # 26, Rd# 10, St-11, Uttara, Dhaka 130 1998
11 51 North East Medical College, South Surma, Sylhet 120 1998
12 52 Holy Family Red Crescent Medical College, 1 Eskaton Garden Road, Dhaka 130 2000
13 53 International Medical College, Sataish Bazar, Gushuli,Tongi, Gazipur 120 2000
14 54 North Bengal Medical College, JC Road, Dhanbandi, Sirajganj 85 2000
15 55 East West Medical College, Aichi Nagar, JBCS Sarani, Horirampur, Turag, Dhaka 120 2000
16 56 Kumudini Medical College, Mirzapur, Tangail 110 2001
17 57 Tairunnessa Medical College, Targas, Kunia, Board Bazar, Gazipur 100 2001
18 58 Ibrahim Medical College, Ibrahim Sarani, Segun Bagicha, Dhaka 110 2002
19 59 BGC Trust Medical College, Kanchannagar, Chandanaish, Chittagong 75 2002
20 60 Shahabuddin Medical College, Rd # 113/A, Plot # 12,Gulshan Model Town, Dhaka 90 2003
21 61 Enam Medical College, Parbatinagar, Thana Road, Savar, Dhaka 145 2003
22 62 Islami Bank Medical College, Nowdapara, Safura, Airport Road, Rajshahi 85 2004
23 63 IBN Sina Medical College, H # 48, Rd # 9/A, Satmoshjid Rd, Dhanmondi, Dhaka 50 2005
24 64 Central Medical College, Comilla Tower, Laksham Road, Comilla 75 2005
25 65 Eastern Medical College, Race Course, Comilla 105 2005
26 66 Khawja Eunus Medical College, Enayetpur, Sirajganj 100 2005
27 67 Chottogram Ma O Shishu Medical College, Agrabad, Chittagong 4100 100 2006
28 68 Sylhet Women Medical College, Mirbox Tolla, Sylhet 100 2006
29 69 Nightingale Medical College, Ashulia, Sarker Market, Dhaka 85 2006
30 70 Southern Medical College, Mozaffor Ahmed Chy Rd., East Nasirabad, Chittagong 95 2006
31 71 Northern International Medical College, House # 81, Rd # 7, Dhanmondi, Dhaka 75 2006
32 72 Uttara Adhunik Medical College, Uttara, Dhaka 90 2007
33 73 Delta Medical College, Mirpur, Dhaka 90 2008
34 74 Ad-Din Women Medical College, 2 Boro Mogbazar, Dhaka 90 2008
35 75 Dhaka Community Medical College, 190 Boro Mogbazar, Dhaka 100 2008
36 76 TMSS Medical College. Bogra 130 2008
37 77 Anwer Khan Modern Medical College, Dhanmondi, Dhaka 120 2008
38 78 Prime Medical College, Pirjabad, Rangpur 125 2008
39 79 Rangpur Community Hospital Medical College, Medical East Gate, Rangpur 125 2008
40 80 Northern Private Medical College, Dhap, Chiklibata Burirhat Road, Rangpur 70 2006
41 81 Faridpur Diabetic Association Medical College, Jhiltuli, Faridpur 90 2010
42 82 Green Life Medical College, Dhanmondi, Dhaka 110 2010
43 83 Popular Medical College, Road # 02, House # 25, Dhanmondi, Dhaka 100 2010
44 84 MH Shamarita Medical College, 13/A and 89/1 PanthaPath, Dhaka 1215 110 2011
45 85 Moonno Medical College, Manikganj 80 2011
46 86 Central International Medical College, 2/1 Ring Road, Shyamoli, Dhaka 90 2011
47 87 Dr. Sirajul Islam Medical College, Mogbazar, Dhaka 95 2011
48 88 Marks Medical College, Mirpur, Dhaka 70 2011
49 89 Mainamoti Medical College, Baro Para, Comilla 100 2012
50 90 Ad-Din-Sakina Medical College, 15, Rail Road, Jessore 65 2012
51 91 Gazi Medical College, Sonadanga, Khulna 100 2012
52 92 Barind Medical College, Shershah Road, Laksmipur, Rajshahi 90 2012
53 93 City Medical College, Eta Hata, Block-B, Tangail Road, Gazipur 80 2012
54 94 Ashiyan Medical College, Unicon Plaza (4-6th Floor) 4212 North Avenue, Gulshan 2 50 2013
55 95 Aichi Medical College, Plot-35 and 37, Sector 8, Abdullahpur, Uttara, Dhaka 50 2013
56 96 Bashundhara Ad-Din Medical College, Karaniganj 50 2013
57 97 Abdul Hamid Medical College & Hospital, Kishoreganj 60 2014-15
58 98 Bikrampur Bhuiyans Medical College & Hospital, Srinagar, Munshiganj 50 2014-15
59 99 Universal Medical College, 74G/75 Peacock Square, New Airport Road, Dhaka 50 2014-15
60 100 Care Medical College, 2/1-A Iqbal Road, Mohammadpur, Dhaka 50 2014-15

ANNEX
Sl. Code
no. no.
61 101 Brahmanbaria Medical College, Ghatura, Brahmanbaria 50 2014-15
62 102 Parkview Medical College & Hospital, Taltola, Telirhat, VIP Road, Sylhet 50 2014-15
63 103 Marine City Medical College & Hospital, Chittagong 50 2014-15
64 104 Shah Makhdum Medical College, Boalia, Rajshahi 50 2014-15
65 105 US Bangla Medical College, Rupganj, Narayanganj 50 2014-15
66 106 Chattagram International Medical College, Chittagong 50 2015
67 107 Ad-Din Akij Medical College, Khulna 50 2015
68 108 Monowara Medical College, Patuakhali 50 2015
Total 6145
Government institutions offering BDS degree, with the number of seats (Jun 2016)
Sl. no. Name of college Established in Seats
01 Dhaka Dental College, Mirpur 14, Dhaka 1960 97
02 Chittagong Medical College Dental Unit, Chittagong 1990 60
03 Rajshahi Medical College Dental Unit, Rajshahi 1989 59
05 Shahid Suhrawardy Medical College Dental Unit, Dhaka 2012 56
04 Sir Salimullah Medical College Dental Unit, Dhaka 2012 52
06 Mymensingh Medical College Dental Unit, Mymensingh 2012 52
07 MAG Osmani Medical College Dental Unit, Sylhet 2012 52
08 Sher-e-Bangla Medical College Dental Unit, Barisal 2012 52
09 Rangpur Medical College Dental Unit, Rangpur 2012 52
Total 532
Private institutions offering BDS degree, with the number of seats (May 2016)
Sl. no. Code no. Name of college Seats Established in
01 21 Pioneer Dental College, 111 Malibag, D I T Road, Dhaka 100 1995
02 22 City Dental College, 1085/1 Malibag Chowdhury Para, Dhaka 75 1998
03 23 University Dental College, 120 Siddeswari Outer Circular Road, Century Arcade, Mogbazar, Dhaka 100 1996
04 24 Bangladesh Dental College, Road # 14/A, Dhanmondi, Dhaka 70 1997
05 25 Sapporo Dental College, Plot 12, Road 1/B, Sector 9, Uttara Model Town, Dhaka 90 2000
06 26 Rangpur Dental College, Medical East Gate, Rangpur 100 2008
07 27 Chittagong International Dental College, 206/1 Hazi Chandmia Road, Samsherpara, Chandgaon, Chittagong 65 2005
08 28 SamajVittik Dental College, Miza Nagar, Via Savar Cant., Dhaka 50 1997
09 29 Marks Dental College, A/3 Main Road, Section 14, Mirpur, Dhaka 50 2008
10 30 Update Dental College, 162 Atish Dipankar Road, West Mugdha, Dhaka 90 2008
11 31 Udayan Dental College, Rajshahi 50 2008
12 32 Shaphena Dental College, Boro Mogbazar, Dhaka 95 2010
13 33 Mandi Dental College, 295/Jha/14 Sikdar Real Estate, Dhanmondi (West), P.S: Hazaribag, Dhaka 1209 65 2010
14 34 MH Shamarita Medical College Dental Unit. 13/A and 89/1 PanthaPath, Dhaka 1215 45 2010
15 35 Kumudini Medical College Dental Unit, Mirzapur, Tangail 40 2011
16 36 Holy Family Red Crescent Medical College, 1 Eskaton Garden Road, Dhaka 30 2012
17 36 TMSS-Bogra Medical College Dental Unit, Bogra 50 2011
18 37 Community Medical College Dental Unit, 190 Boro Mogbazar, Dhaka 30 2012
19 38 Green Life Medical College Dental Unit, Dhanmondi, Dhaka 30 2013
20 39 Community-based Medical College Dental Unit, Mymensingh 30 2014
21 40 Dhaka National Medical College Dental Unit, 53/1 Jonson Road, Dhaka 20 2014
22 41 Delta Medical College Dental Unit, Mirpur, Dhaka 25 2014
23 42 Islami Bank Medical College Dental Unit, Rajshahi 20 2014
24 43 Al-Amin Dental College, Sylhet 40 2015
25 44 Ibrahim Medical College, Dental Unit, Dhaka 25 2016
Total 1385

Government nursing colleges offering four-year Basic BSc Nursing course (December 2014)
Division Name of nursing college Degree No. of seats
Under the Ministry of Health and Family Welfare
Chittagong College of Nursing, Chittagong Medical College, Chittagong BSc Nursing 100
College of Nursing, Dhaka Medical College, Dhaka BSc 100

Dhaka
College of Nursing, Mymensingh Medical College, Mymensingh BSc 100
Rajshahi College of Nursing, Rajshahi Medical College, Rajshahi BSc 100
Rangpur College of Nursing, Rangpur Medical College, Rangpur BSc 100
Sylhet College of Nursing, MAG Osmani Medical College, Sylhet BSc 100
Barisal College of Nursing, Sher-e-Bangla Medical College, Barisal BSc 100
Total no. of nursing colleges under MOHFW=7 Total seats 700
Armed Forces Medical Institute, Dhaka Cantonment, Dhaka BSc 60

Dhaka
Faculty of Nursing, BSMMU, Dhaka BSc 25
Rangpur Army Nursing College, Rangpur Cantonment, Rangpur BSc 50
Army Nursing College, Chittagong Cantonment, Chittagong BSc 50

Chittagong
Army Nursing College Comilla Cantonment, Comilla BSc 50
Army Nursing College, Jessore Cantonment, Jessore BSc 50
Army Nursing College, Bogra Cantonment, Bogra BSc 50
Total no. of nursing colleges under the Ministry of Defense=6; under BSMMU=1 Total seats 60
Total no. of nursing colleges in the government sector=14 (including autonomous BSMMU) Grand total 1035
Government nursing colleges offering Post-basic BSc courses (December 2015)
Division Name of institution Degree No. of seats
Under the Ministry of Health and Family Welfare
Dhaka Nursing College, Mohakhali, Dhaka Post- basic BSc 125
Chittagong Foujderhat Nursing College, Chittagong Post- basic BSc 125
Rajshahi Bogra Nursing College, Bogra Post- basic BSc 125
Khulna Khulna Nursing College, Khulna Post-basic BSc 125
Total no. of nursing colleges offering Post-basic BSc =4 Total seats 500
Under the Ministry of Defence
Armed Forces Medical Institute, Dhaka Cantonment, Dhaka Post- basic BSc 25
Total no. of nursing colleges offering Post-basic BSc courses=4+1=5 Total seats 525

ANNEX
Private nursing colleges offering Post-basic BSc Nursing degree (December 2015)
Division Name of nursing college Post-basic (no. of seats)
East West Nursing College, Turag, Dhaka 50
Kumudini Nursing College, Kumudini Hospital, Tangail 25
State College of Health Sciences, Dhanmondi, Dhaka 30
International Nursing College, Tongi, Gazipur 30
Anwer Khan Modern Nursing College, Dhanmondi, Dhaka 30
United College of Nursing, Gulshan, Dhaka 20
BIRDEM Nursing College, 122 Kazi Nazrul Islam Avenue, Shahbag, Dhaka 50
Dhaka
TMMC Nursing College, Targas, Board Bazar, Gazipur 30
Sheikh Fazilatunnesa Mujib Memorial KPJ Specialized Hospital and Nursing College, Gazipur 40
Prime Bank Nursing College, Kuril Bishwa Road, Dhaka 20
Grameen Caledonian College of Nursing, Dhaka 30
Dhaka Central International Nursing College & Institute, Shyamoli, Dhaka 30
Dhaka Community Nursing College, Wireless Gate, Mogbazar, Dhaka 30
Green life Nursing College, Green Road, Dhaka 30
TMSS Nursing College, Thengamara, Bogra 30

Rajshahi
Khaza Younus Ali Nursing College, Enaetpur, Sirajganj 30
North East Nursing College, Telihaor, Sylhet 60

Sylhet
Begum Rabeya Khatun Chowdhury Nursing College, Sylhet 50
Prime Nursing College, Rangpur 70
Rangpur Rangpur Community Nursing College, Rangpur 30
College of Nursing Science, Zia-HFH Upashohor, Dinajpur 30
Total no. of colleges=19 Total seats 745
Private nursing colleges offering Basic BSc Nursing degree (December 2015)
Division Name of nursing college Basic BSc (no. of seats)
East West Nursing College, Turag, Dhaka 50
Kumudini Nursing College, Kumudini Hospital, Tangail 25
Square Nursing College, Square Hospital, Dhaka 50
State College of Health Sciences, Dhanmondi, Dhaka 20
International Nursing College, Tongi, Gazipur 40
Anwer Khan Modern Nursing College, Dhanmondi, Dhaka 40
United College of Nursing, Gulshan, Dhaka 40
BIRDEM Nursing College, 122 Kazi Nazrul Islam Avenue, Shahbag, Dhaka 50
TMMC Nursing College, Targas, Board Bazar, Gazipur 25

Dhaka
Sheikh Fazilatunnesa Mujib Memorial KPJ Specialized Hospital and Nursing College, Gazipur 50
CRP Nursing College, Savar, Dhaka 40
Prime Bank Nursing College, Kuril Bishwa Road, Dhaka 30
Dhaka Central International Nursing College & Institute, Shyamoli, Dhaka 50
IUBAT, Uttara, Dhaka 125
Jahurul Islam Nursing College, Bajitpur, Kishoreganj 30
Dhaka Community Nursing College, Wireless Gate, Mogbazar, Dhaka 40
Green Life Nursing College, Green Road, Dhaka 40

Rajshahi
Khaza Younus Ali Nursing College, Enaetpur, Sirajganj 0
North East Nursing College, Telihaor, Sylhet 70

Sylhet
Begum Rabeya Khatun Chowdhury Nursing College, Sylhet 60
Rangpur Rangpur Community Nursing College, Rangpur 30
Total no. of colleges=24 Total seats 1060

Private institutions offering specialized nursing courses (December 2014)
Division Name of institution No. of seats
Diploma-in-Cardiac Nursing, National Heart Foundation Hospital & Research Institute, Mirpur, Dhaka 20
Dhaka Diploma-in-Cardiac Nursing, Ibrahim Cardiac Hospital, Shahbag, Dhaka 20
Pediatric Nursing, Dhaka Shishu Hospital, Dhaka 20
Rangpur Diploma-in-Cardiac Nursing, Institute of Nursing Science, Dinajpur (Zia Heart Foundation) 20
Total no. of institutions in the private sector offering specialized nursing courses =4 Total seats 80
Government nursing institutions, with number of seats (December 2014)
Nursing institutions attached with medical college hospitals
Nursing institutions attached with Comilla Medical College Hospital, Comilla 80

Chittagong
Nursing institutions attached with Noakhali Medical College Hospital 80
Nursing institutions attached with Faridpur Medical College Hospital, Faridpur 80

Dhaka
Nursing institutions attached with SSMC Hospital, Mitford, Dhaka 80
Khulna Nursing institutions attached with Khulna Medical College 80
Rangpur Nursing institutions attached with Dinajpur Medical College 80
Total 480
Nursing institutions attached with general hospitals
Barisal Nursing institutions attached with Patuakhali General Hospital 80
Chittagong Nursing institutions attached with Rangamati General Hospital 80
Dhaka Nursing institutions attached with Tangail General Hospital 80
Nursing institutions attached with Jessore General Hospital 80

Khulna
Nursing institutions attached with Kushtia General Hospital 80
Nursing institutions attached with Mohammad Ali Hospital, Bogra 80
Rajshahi Nursing Institutions attached with Pabna General Hospital 80
Nursing institutions attached with Sirajganj General Hospital 50
Total 610
Nursing institutions attached with district hospitals
Nursing institutions attached with Bhola District Hospital 50
Barisal Nursing institutions attached with Pirojpuri District Hospital 50
Nursing institutions attached with Barguna District Hospital 50
Nursing institutions attached with Brahmanbaria District Hospital 70
Nursing institutions attached with Coxs Bazar District Hospital 50

Chittagong
Nursing institutions attached with Feni District Hospital 50
Nursing institutions attached with Chandpur District Hospital 50
Nursing institutions attached with Munshiganj District Hospital 50
Nursing institutions attached with Netrakona District Hospital 50
Nursing institutions attached with Rajbari District Hospital 50
Nursing institutions attached with Gopalganj District Hospital 50

Dhaka
Nursing institutions attached with Madaripur District Hospital 50
Nursing institutions attached with Jamalpur District Hospital 50
Nursing institutions attached with Kishoreganj District Hospital 50
Nursing institutions attached with Sherpur District Hospital 50
Nursing institutions attached with Bagerhat District Hospital 50
Nursing institutions attached with Chuadanga District Hospital 50
Khulna Nursing institutions attached with Magura District Hospital 50
Nursing institutions attached with Satkhira District Hospital 50
Nursing institutions attached with Jhenaidah District Hospital 50

ANNEX
Nursing institutions attached with Chapainowabganj District Hospital 50
Rajshahi Nursing institutions attached with Joypurhat District Hospital 50
Nursing institutions attached with Naogaon District Hospital 50
Nursing institutions attached with Maulvibazar District Hospital 50

Sylhet
Nursing institutions attached with Habiganj District Hospital 50
Nursing institutions attached with Kurigram District Hospital 50
Nursing institutions attached with Thakurgaon District Hospital 50

Rangpur
Nursing institutions attached with Nilphamari District Hospital 50
Nursing institutions attached with Panchagarh District Hospital 50
Total 1470
Grand total 2560
Government-run junior midwifery institutions, with the number of seats in each (December 2015)
Junior midwifery institutions attached with medical college hospitals
Nursing institutions attached with Comilla Medical College Hospital, Comilla 25
Chittagong Nursing institutions attached with Noakhali Medical College Hospital 25
Chittagong Nursing College, Chittagong Medical College Hospital 25
Nursing institutions attached with Faridpur Medical College Hospital, Faridpur 25
Dhaka Nursing College, Dhaka Medical College Hospital, Dhaka 50

Dhaka
Mymensingh Nursing College, Mymensingh Medical College Hospital 25
Nursing institutions attached with SSMC Hospital, Mitford, Dhaka 25
Khulna Nursing institutions attached with Khulna Medical College 25
Nursing institutions attached with Dinajpur Medical College 25

Rangpur
Rangpur Nursing College, Rangpur Medical College Hospital 25
Barisal Barisal Nursing College, Barisal Sher-e-Bangla Medical College Hospital 25
Sylhet Sylhet Nursing College, MAG Osmani Medical College Hospital, Sylhet 25
Rajshahi Nursing College, Rajshahi Medical College Hospital 25

Rajshahi
Bogra Nursing College, Shaheed Ziaur Rahman Medical College Hospital 25
Total 375
Junior midwifery institutions attached with general hospitals
Dhaka Nursing institutions attached with Tangail General Hospital 25
Nursing institutions attached with Jessore General Hospital 25

Khulna
Nursing institutions attached with Kushtia General Hospital 25
Nursing institutions attached with Mohammad Ali Hospital, Bogra 25
Rajshahi Nursing Institutions attached with Pabna General Hospital 25
Nursing institutions attached with Sirajganj General Hospital 25
Total 150
Junior midwifery institutions attached with district hospitals
Nursing institutions attached with Brahmanbaria District Hospital 25

Chittagong
Foujderhat Nursing College, Chittagong 25
Nursing institutions attached with Munshiganj District Hospital 25
Nursing institutions attached with Rajbari District Hospital 25
Dhaka Nursing Institute, Manikganj 25
Nursing institutions attached with Gopalganj District Hospital 25
Nursing institutions attached with Kishoreganj District Hospital 25
Nursing institutions attached with Satkhira District Hospital 25

Khulna
Nursing institutions attached with Jhenaidah District Hospital 25
Sylhet Nursing institutions attached with Habiganj District Hospital 25
Rajshahi Nursing institutions attached with Joypurhat District Hospital 25
Total 275
Grand total 800

Private nursing institutions, with the number of seats (December 2015)
Division Name of nursing institution No. of seats
Nursing Institute, Christian Hospital, Chandroghona, Chittagong 30
Jemison Red Crescent Nursing Institute, 395 Andorkillah, Chittagong 50
Comilla Diabetic Hospital Nursing Institute, Comilla 40

Chittagong
Mahbubur Rahman Memorial Hospital & Nursing Institute, Bancharampur, Brahmanbaria 40
Begum Osman Ara College of Nursing, (BGC Trust), Chandanaish, Chittagong 50
Chittagong Ma O Shishu Hospital Nursing Institute, Agrabad, Chittagong 25
Fatima Nursing Institute, Ad-Din Hospital, Mogbazar, Dhaka 50
Kumudini Nursing School, Mirzapur, Tangail 50
Christian Health Project Nursing Institute, Joyramkura, Haluaghat, Mymensingh 30
CRP Nursing Institute, Savar, Dhaka 50
Diabetic Association Nursing Institute, Jhiltuli, Faridpur 40
BA Siddiqui Nursing Institute, Holy Family Red Crescent Medical College Hospital, Mogbazar, Dhaka 50
AL Helal Nursing Institute, Mirpur, Dhaka 30
Jahurul Islam Nursing Institute, Bajitpur, Kishoreganj 60
Munnu Nursing Institute, Manikganj 40
Prime Bank Nursing Institute, Kuril Bishwa Road, Dhaka 50
Japan-Bangladesh Friendship Nursing Institute, Mirpur, Dhaka 60
Central Hospital Nursing Institute, Green Road, Dhanmondi, Dhaka 50
Nursing Institute, ShishuShasthya Foundation Hospital, Mirpur, Dhaka 20
Nursing Institute, Medical College for Women and Hospital, Uttara, Dhaka 25
TMMC Nursing Institute, Targas, Board Bazar, Gazipur 50
Green Life Nursing College, Dhanmondi, Dhaka 40

Dhaka
NIMDT Nursing Institute, Mohammadpur, Dhaka 30
Shaheed Monsur Ali Nursing Institute, Uttara, Dhaka 40
Dhaka Community Nursing Institute, Wireless Gate, Mogbazar, Dhaka 30
Community-based Nursing Institute, Mymensingh 50
East West Nursing Institute, Turag, Dhaka 50
MH Shamarita Nursing Institute, Tejgaon, Dhaka 40
IBN Sina Nursing Institute , Kallyanpur, Dhaka 70
Anower Khan Modrern College, Road 8, Dhanmondi, Dhaka 50
Universal Nursing Institute, Mohakhali, Dhaka 50
Kalihati Nursing Institute, Kalihati, Tangail 50
Hamida Nursing Institute, Mirpur, Dhaka 30
Scholars Nursing Institute, Mymensingh 30
Dhaka Central International Nursing College & Institute , Shyamoli, Dhaka 50
Pollobi Nursing Institute, Mirpur, Dhaka 50
Skabo Nursing Institute, Mymensingh 40
Ad-Din Nursing Institute, Jessore 30
GMR Nursing Institute, Sonadanga, Khulna 70

Khulna
Safina Nursing Institute, Kushtia 30
Impact Nursing Institute, Amihupi, Meherpur 20

ANNEX
Division Name of nursing institution No. of seats
Nursing Institute attached with KhajaYunus Ali Medical College Hospital, Enayetpur, Sirajganj 50
Nursing Institute, Christian Mission Hospital 50
Pabna Community Nursing Institute, Sathia, Pabna 40
Islami Bank Medical College Hospital Nursing Institute, Rajshahi 100
Shah Makhdum Nursing Institute, Boalia, Rajshahi 30
Rajshahi Mojibur Rahman Foundation Nursing Institute, Joypurhat 40
Diabetic Association Nursing Institute, Rajshahi 60
Uttarbango Nursing Institute, Bogra 30
Ideal Nursing Institute, Sherpur Road, Bogra 50
Safa-Macca Nursing Institute, Sirajganj 40
BADS Nursing Institute, Naruli, Bogra 40
Udayon Nursing College, Rajshahi 50
North East Nursing Institute, Sylhet 120
Sylhet Sylhet Red Crescent Nursing Institute, Sylhet 40
Begum Rabeya Khatun Chowdhury Nursing Institute, Sylhet 70
Rangpur Community Nursing Institute, Rangpur 50
Lamb Nursing Institute, Parbotipur, Dinajpur 50
Saint Vincent Nursing Institute, Dinajpur 40

Rangpur
Northern Institute of Nursing Science, Dhap, Rangpur 40
Anwara Nursing Institute, Dinajpur 30
The Green Life Nursing Institute, Dinajpur 40
DWF Nursing Institute, Barisal 30

Barisal
Gazi M. Rahman Nursing Institute, Patuakhali 40
Total 3169
Privately-run junior midwifery institutions, with the number of seats in each (December 2015)
Division Name of junior midwifery institution No. of seats
Junior Midwifery Institute, Red Crescent Matrisadan Hospital, Chandpur 20
Jemison Red Crescent Midwifery Institute, Agrabad, Chittagong 50

Chittagong
Christian Hospital, Chandroghona, Rangamati 20
Junior Midwifery Institute, Memon Hospital, City Corporation, Chittagong 30
Junior Midwifery Institute, Holy Family Red Crescent Hospital, Dhaka 60
Dhaka Junior Midwifery Institute, Shaheed Moyez Uddin Memorial Red Crescent Matrisadan Hospital, Bangla Bazar, Dhaka 20
Junior Midwifery Institute, Kumudini Hospital, Mirzapur, Tangail 20
Central Hospital Nursing Institute, Green Road, Dhanmondi, Dhaka 20
Junior Midwifery Institute Ad-Din Matrisadan Hospital, Jessore 20

Khulna
Junior Midwifery Institute, Fatema Hospital, Jessore 20
Rajshahi Junior Midwifery Institute, Christian Hospital, Bogra 20
Rangpur Prime Nursing College, Rangpur 20
Total 320

Government Medical Assistant Training Schools (MATS), with the number of seats (June 2015)
Division Name of MATS No. of seats
Medical Assistant Training School, Comilla 52

Chittagong
Medical Assistant Training School, Noakhali 102
Medical Assistant Training School, Faridpur 52

Dhaka
Medical Assistant Training School, Tangail 102
Medical Assistant Training School, Bagerhat 152
Khulna Medical Assistant Training School, Kushtia 102
Medical Assistant Training School, Jhenaidah 52
Rajshahi Medical Assistant Training School, Sirajganj 102
Total 716
Private Medical Assistant Training Schools (MATS), with the number of seats (May 2015)
Division Name of institution Year of establishment No. of seats
Comilla Institute of Technology and MATS, Thakurpara, Comilla 2008 75
Chittagong Institute of Medical Technology, Chittagong 2011 50
Moinamoti Medical Assistant Training School, Comilla 2011 50

Chittagong
Noakhali Paramedical Centre (NPCMATS) 2011 50
Brahmanbaria Medical Assistant Training School, Brahmanbaria 2011 50
Chandpur Medical Assistant Training School, Chandpur 2011 50
AR Medical Assistant Training School, Mohammadpur, Dhaka 2008 75
Advance Medical Assistant Training School, Green Road, Dhaka 2010 100
Bangladesh Medical Assistant Training School, Uttara, Dhaka 2009 50
Dhaka Medical Assistant Training School, Mirpur, Dhaka 2009 100
New Pilot Medical Assistant Training School, Tangail Sadar 2008 50
Rabeya Medical Assistant Training School, Savar, Dhaka 2009 75
Rampura Medical Assistant Training School, Rampura, Dhaka 2008 80
Rumdo Medical Assistant Training School, Mymensingh 2008 75
SAIC Institute of Medical Assistant, Mirpur, Dhaka 2008 80
SIMT Medical Assistant Training School, Kalabagan, Dhaka 2008 100
Spark SIMT Medical Assistant Training Academy, Mirpur, Dhaka 2008 60
SPKS Medical Assistant Training School, Mirpur, Dhaka 2008 100
Sumona Medical Assistant Training School, Sadarghat, Dhaka 2008 60
The Medical Assistant Training School, Mirpur, Dhaka 2007 175
Trauma Medical Assistant Training School, Mohammadpur, Dhaka 2008 200

Dhaka
Institute of Medical Assistants, Faridpur 2010 50
Eden Medical Assistant Training School, Mirpur, Dhaka 2010 50
Tangail Medical Assistant Training School, Sabalia, Tangail 2010 180
Shyamoli Medical Assistant Training School, Mohammadpur, Dhaka 2010 200
Taleb Ali Medical Assistant Training School, Natun Bazar, Mymensingh 2010 50
Rajbari Community Medical Assistant Training School, Rajbari 2010 100
National Institute of Medical and Dental Technologist & MATS, Mohammadpur, Dhaka 2010 50
Prince Medical Assistant Training School, Savar, Dhaka 2010 75
Khondoker Abdul Mannan Medical Institute (MATS), Kishoreganj 2010 50
Reliable Medical Assistant Training School, Mirpur, Dhaka 2011 50
Dr. Halima Khatun Medical Assistant Training School, Mymensingh 2011 50
Jashimuddin Medical Assistant Training School, New College Road, Jamalpur 2011 50
Shahid SA Memorial Medical Institute, Uttara, Dhaka 2011 50
Paramedical Institute & MATS, Chandona, Gazipur 2011 50
Institute of Medical Technology & MATS, Jalkuri, Siddirganj, Narayanganj 2011 50

ANNEX
Fortune Institute of Medical Technology, Kamarpara Road, Turag Thana, Dhaka 2011 50
New Turag General Hospital Private Limited, Station Road, Tongi, Gazipur 2011 50
Rajdhani Medical Assistant Training School (Rajdhani MATS), Mirpur, Dhaka 2011 100
Dhaka Microlab Institute of Medical Technology (IST, MATS) 2011 50
Nidasa Medical Assistant Training School, 20/24 North South Road, Siddik Bazar, Dhaka 2011 50
Bibartan Medical Assistant Training School, Mirpur, Dhaka 2011 30
Matri Sheba Medical Training School (MATS), Kona Bari, Gazipur 2012 25
Ideal Medical Training Institute & Health Technology, Mymensingh Road, Sabalia, Tangail 2012 50
Jefri Institute of Health Science & Technology & MATS Dhanmondi, Rayer Bazar, Dhaka. 2013 50
JMATS & Medical Institute, College Road, Jamalpur 2013 50
D-Medical Assistant Training School, Mirpur Bus Stand, Dhaka 2013 50
Atik Medical Assistant Training School, Brammondi, Narsingdi 2013 50
Ma Medical Assistant Training School, Itahat, Gazipur 2013 50
Mawna Medical Assistant Training School, Mawna Chourasta, Gazipur 2013 50
Shyamoli Ideal Medical Assistant Training School, Mohammadpur, Dhaka 2014 75
The Radium MATS & Technology Institute, Ghiur, Manikganj 2014 50
Jonoseba Medical Assistant Training School, Arambag, Chapainowabganj 2014 50

Dhaka
Uttara Adhunik Medical Institute MATS, Abdullahpur, Uttara, Dhaka 2014 50
Dhaka City Medical Assistant Training School, Swamibag, Dhaka 2014 50
Bangladesh Cancer Society Medical Assistant Training School, Darussalam, Mirpur, Dhaka 2014 50
Momotaj Medical Assistant Training School, Dhanshiri, Dhamrai, Dhaka 2014 50
Byte Medical Assistant Training School & Health Technology Institute, Uthuli, Shibaloy,
2014 50
Manikganj
Central Institute of Health Science & MATS , Mirpur 14, Dhaka 2015 50
Eastern Medical Assistant Training School, Tikatuli, Dhaka 2015 50
Ekhlas Uddin Khan Medical Assistant Training School, Ghiur, Manikganj 2015 50
Gurukul Medical Assistant Training School, Dhokhin Bhabanipur, Rajbari 2015 50
Tongi Medical Assistant Training School, Road No 10, Uttara, Dhaka 2015 50
Dr. Rubi Medical Assistant Training School, Shyamoli, Dhaka 2011 50
Scholar Medical Assistant Training School (MATS), Maskanda, Mymensingh 2011 50
AITAM Welfare Organization, Mohammadpur, Dhaka 2012 50
Firoza Medical Assistant Training School, Sholakia, Kishoreganj 2012 50
Jamuna Medical Assistant Training School, Tangail Sadar 2012 75
Gazipur Pharmaceutical Institute, Chandra, Gazipur Sadar 2011 50
Rajshahi Medical Assistant Training School, Rajshahi 2008 100
Health Ways Medical Assistant Training School, Santahar, Bogra 2013 60
SIMT Medical Assistant Training School, Nishindho, Bogra 2011 30
TMSS Medical Assistant Training School, Thengamara, Bogra 2008 150
Udayan Medical Assistant Training School, Rajshahi 2008 180
Medical Assistant Training School, Joypurhat 2008 50
Ideal Medical Technology, Sherpur Road Colony, Bogra 2008 80
Peoples International Medical Assistant Training School, Airport Sarak, Sapura, Rajshahi 2008 50
Rajshahi Galaxy Medical Assistant Training School, Sapura, Rajshahi 2010 100
Pabna Community Medical Assistant Training School, Bishnupur, Sathia, Pabna 2011 50
Bangladesh Institute of Medical Technology, Hatem Kha, Boalia, Rajshahi 2011 50
PIMT Medical Assistant Training School, (MATS), Bogra 2011 100
Natore Medical Assistant Training School , Natore 2011 50
ASI Medical Assistant Training School, (MATS), Sirajganj 2011 50
NDC Medical Assistant Training School, (NDC MATS), Paharpur Road, Joypurhat 2011 75
Pabna Medical Assistant Training School, Mujib Palace, PP Road, Singa, Pabna 2011 50
Joypurhat Medical Assistant Training School, Joypurhat 50

RadiumMedical Training School, Talainari, Boalia, Rajshahi 2012 50
Sirajganj Modern Medical Training School, Coddarmore, Sirajganj 2011 25
Anwara Medical Assistant Training School, Dinajpur 2011 75
TS Medical Assistant Training School, New Bagura Road, Sirajganj 2011 80
Morning Glory Medical Assistant Training School, Shibtola, Chapainowabganj 2012 80
SDDL Medical Assistant Training School (MATS), Bogra 2012 80
Prime Medical Assistant Training School, Talaimari, Rajshahi 2011 100
State Medical Assistant Training Academy, Mill Gate Sarak, Kaliganj, Jhenaidah 2011 50
Ideal Medical Assistant Training School (MATS), Poura College Para, Chuadanga 2012 25
Uttar Banga Medical Assistant Training School, Uttar Banga MATS 2011 50
Mohasthan Medical Assistant Training School, Gokul, Bogra 2013 100
Rubi Medical Assistant Training School, Naogoan 2013 50
Doctors Medical Assistant Training school, Rajpara, Rajshahi 2013 50
DAF Bangladesh Medical Training School, Rajshahi 2013 50
Mahi Sawar Medical Assistant Training School, Bogra 2013 50
Afford Medical Assistant Training School, Boalia, Rajshahi 2013 75
Bright Nation Medical Assistant Training School, Pabna Sadar, Pabna 2013 50
Rajshahi
Padma Medical Assistant Training School, Kashiadanga, Rajshahi 2013 50
BIMT Medical Assistant Training School, Shajahanpur, Bogra 2013 75
Combined Medical Assistant Training School, Bogra 2013 50
Peerless Medical Assistant Training School, Puthia, Rajshahi 2013 50
Amena Medical Assistant Training School, Talaimari Bazar, Rajshahi 2013 50
NIAK Medical Assistant Training School, College Road, Shibbari, Bogra 2014 75
Royal Medical Assistant Training School, Sherpur Road, Bogra 2014 50
Jonoseba Medical Assistant Training School, Arambag, Chapainowabganj 2014 50
SM Institute of Medical Technology & MATS, Sirajganj 2014 50
Saleha Medical Assistant Training School, Boro Bonogram, Rajshahi 2014 50
Labcare Medical Assistant Training School, Munshi Meherullah Sorok, Sirajganj 2014 50
Al Amana Medical Assistant Training School, Loskorpur, Pabna 2014 50
The Green Medical Assistant Training School, Dhaka Bypass Road, Pabna 2015 50
Pabna Ideal Medical Assistant Training School, Salgaria, Pabna 2015 50
Asian Medical Assistant Training School, Sreerampur, Sherpur, Bogra 2015 50
Neuron Medical Assistant Training School, Boalia, Rajshahi 2015 50
Ullapara Medical Assistant Training School, Ullaoara, Sirajganj 2012 25
State Medical Assistant Training Academy, Mill Gate Sarak, Kaliganj, Jhenaidah 2011 50
Ideal Medical Assistant Training School (MATS),Poura College Para, Chuadanga 2012 50
Khulna Medical Assistant Training School (MATS), Khulna 2011 60
Dr. Liza Raton Medical Assistant Training School, 42/1 NS Road, Kushtia 2011 75
Alo Medical Assistant Training School, Alobhaban, NS Road, Kushtia 2011 80
Chuadanga Ideal Medical Assistant Training School (MATS), Alamdanga Road, Poura
2012 25
College Para, Chuadanga
Unilab Medical Assistant Training School, Magura 2011 100
Brick Medical Assistant Training School, Daulatpur, Kushtia 2014 50

Khulna
Dr. Taher, Dr. Lina Medical Assistant Training School, College Road, Meherpur 2014 50
Rupsha Medical Assistant Training School, Fulbari Gate, Khulna 2014 50
Oxford Medical Assistant Training School, Stadium More, Magura 2014 50
Bushra Medical Assistant Training School, Khulna Road More, Satkhira 2014 50
Lalonshah Medical Assistant Training, School & Medical Technology Institute, Kumarkhali, Kushtia 2014 50
Muktijudda Tofazzal Hossen Medical College, Hamdaha, Jhenaidah 2015 50
Dr. Mezbah-ur-Rahman Medical Assistant Training School, Jessore 2015 50
Padma Gorai Medical Assistant Training School, Kushtia Sadar, Kushtia 2015 50
Specialised Medical Assistant Training School, Hospital Road, Kushtia 2015 50

ANNEX
Morning Sun Assistant Training School (MATS), Nobogram Road, Barisal 2012 25
Disable Welfare Foundation Medical Assistant Training School, Sabujbagh, Patuakhali 2012 50
Jomjom Medical Assistant Training School, Kazipara, C&B Road, Barisal 2012 100
Barisal
DWF Medical Assistant Training School, Himel Cottage, C&B Road, Barisal 2014 50
Advance Institute of Medical & Dental Technology with MATS, Chandmari, Barisal 2014 50
Progressive Medical Assistant Training School, Bauphol, Patuakhali 2014 50
Rangpur Medical Assistant Training School, Islambag, RK Road, Rangpur 2010 105
Anwara Medical Assistant Training School, Mirzapur, Suihari, Dinajpur 2011 100
Renin Medical Assistant Training School, Lalmonirhat 2011 50
Central Medical Assistant Training School (MATS), Rangpur 2011 50
Green International Medical Assistant Training School, Rangpur 150
Prime Medical Assistant Training School, Rangpur 2012 80
Rangpur CT MATS, Kelabond C O Bazar, Rangpur 2012 80
Birampur Medical Assistant Training School, Birampur, Dinajpur 2012 50

Rangpur Janata Medical Assistant Training School, Nageshwori, Kurigram 2011 50
Creative Medical Assistant Training School, Hospital Road, Nilphamari 2012 50
North Bengal Medical Assistant Training School, College Road, Gaibandha 2013 50
Oriental Medical Assistant Training School, Gobindanagar, Thakurgoan 2013 50
Institute of Health Technology, MATS, Paharpur, Dinajpur 2013 50
Green Life Medical Assistant Training School, New Town, Dinajpur 2014 50
M.A. Medical Assistant Training School, Halpara, Thakurgoan 2015 50
Abul Hossain Medical Assistant Training School, Suihari, Dinajpur 2015 50
Panchagarh Medical Assistant Training School, Tetulia, Panchagarh 2015 50
Rangpur Delta Medical Assistant Training School, RK Road, Rangpur 2015 50
Jalalabad Medical Assistant Training School, Sylhet 2011 50
Maulvibazar Medical Assistant Training School, Kushumbag, Maulvibazar 2011 80
Sylhet Medical Assistant Training School, South Surma, Sylhet 2012 70

Sylhet
RTM International Medical Assistant Training School, Sylhet Sadar 2013 100
Symantik Medical Assistant Training School, Shahjalal Upashohor, Sylhet 2013 100
National Life Care Medical Assistant Training School, Upashohor Road, Sonarpar, Sylhet 2013 50
Asha Medical Assistant Training School, Chunarughat, Habiganj 2013 50
Total 12335
List of government institutes of health technology, with number of seats by discipline (June 2015)
Discipline with number of seats Quota for

Division Name of institute with location Estd. Total
LAB RDL PTY SI DENT PHAR RTY FF&TR
Dhaka Institute of Health Technology, Mohakhali, Dhaka 1962 50 50 50 50 50 50 20 5+2 327
Institute of Health Technology, Rajshahi 1976 50 50 50 50 50 50 20 5+1 327

Rajshahi
Institute of Health Technology, Bogra 2006 65 55 50 50 55 55 20 5+2 357
Chittagong Institute of Health Technology, Chittagong 2011 50 50 50 50 50 50 20 5+2 327
Barisal Institute of Health Technology, Barisal 2011 50 50 50 50 50 50 20 5+2 327
Rangpur Institute of Health Technology, Rangpur 2011 50 50 50 50 50 50 20 5+2 327
Khulna Institute of Health Technology, Jhenaidah 2011 50 50 50 50 50 50 20 5+2 327
Sylhet Institute of Health Technology, Sylhet 2011 50 50 20 50 50 50 0 5+2 277
Total
Total institutes=8 415 405 370 400 405 405 140 56 2596
seats
LAB= Laboratory; RDL=Radiology; PTY=Physiotherapy; SI=Sanitary inspection; DENT=Dentistry; PHAR=Pharmacy; RTY=Radiotherapy; FF&TR=Children of
freedom fighters and tribal students

List of private institutes of health technology, with the number of seats by discipline (December 2015)
Discipline
Division Name of institute with location Estd. RDL/ Total
LAB PTY DENT PHAR Other1 Other2
RDT
CSCR Institute of Medical Technology, Golpahar,

2008 35 0 25 25 30 0 0 115
Chittagong
Chittagong Institute of Medical Technology

2005 50 0 0 50 50 0 0 150
Halishahar, Chittagong
Comilla Institute of Medical Technology, Thakurpara,

2007 25 50 0 25 50 0 0 150
Comilla
Ilah College of Medical Technology, Nahar Kutir,

2005 25 0 0 0 25 0 0 50
Comilla
Chittagong
Institute of Health Technology, 180 Firingibazar, City
2003 25 25 0 25 0 0 0 75
Corporation, Chittagong
Coxs Bazar Institute of Medical Technology, Coxs Bazar 2011 30 30 0 30 0 0 0 90
Maizdi Institute of Health Technology, Noakhali 2013 30 0 0 0 30 0 0 60
United Care Institute of Medical Technology,

2010 25 0 0 15 0 0 0 40
Madhyapara, Brahmanbaria
Compact Medical Institute, Hazari Road, Feni 2011 25 0 0 50 25 0 0 100
SRB Diploma in Health Technology, Zindabazar, Sylhet 2013 25 0 0 0 0 25 0 50

Sylhet North East Institute of Health Technology South
2014 25 25 0 0 0 0 0 50
Surma, Sylhet
AR Institute of Medical Technology, Mohammadpur, Dhaka 2008 50 25 50 50 50 0 0 225
Ahsania Mission Institute of Health Technology,

2008 25 25 25 0 0 0 0 75
Mirpur, Dhaka
Armed Forces Institute of Medical Technology, Dhaka 2010 25 25+25 25 25 25 10 (OTA) 15 (ICA) 175
50 (Oc-
Bangladesh Health Profession Institute, Mirpur, Dhaka 1996 50 50 50 0 0 200
cupational)
25 25
Bangladesh Institute of Medical & Dental Technology,
1997 85 20 20 25 0 (BSc in (BSc in 200
Iqbal Road, Mohammadpur, Dhaka
Lab) Dentistry)
Bangladesh Medical College, Dhaka 0 0 25 0 0 0 0 25
Center for Rehabilitation of the Paralyzed, Savar, Occupa-

1999 50 50 50 0 0 0 200
Dhaka tional 50
Dhaka Institute of Health Technology, Humayun

2008 50 0 25 30 40 0 0 145
Road, College Gate, Mohammadpur, Dhaka
Fortune Institute of Medical Technology, Jasimuddin

2007 50 25 0 50 50 0 0 175
Road, Uttara, Dhaka
GonoShasthya Institute of Health Sciences, Tengra,

2006 50 0 25 50 0 0 0 150
Sreepur, Gazipur
Green View Institute of Health Technology, Green 50 (BSc

Dhaka 2002 50 0 0 40 25 0 165
Road, Dhanmondi, Dhaka in Lab)
Institute of Medical Technology, Rajbari 2010 50 0 0 0 50 0 0 100
Institute of British Colombia Medical Technology,

2008 40 0 25 25 35 0 0 125
Uttara, Dhaka
Institute of Community Health Bangladesh, Mogbazar,

2005 50 0 25 25 25 0 0 125
Dhaka
Institute of Medical Technology, Mirpur,

2000 100 0 0 50 50 0 0 200
Dhaka
Institute of Medical & Dental Technology, Tangail 2007 50 25 0 25 50 0 0 150
International Institute of Health Sciences, Shewrapara,

2006 70 25 25 50 40 0 0 210
Mirpur, Dhaka
Institute of Medical Technology, Tamizuddin Road,

2005 50 0 0 50 25 0 0 125
Jhiltuli, Faridpur
Jefri Institute of Health Sciences & Technology,

2009 50 50 50 50 50 0 0 250
Dhanmondi, Dhaka
Marks Institute of Medical Technology,

2002 50 25 0 50 50 0 0 175
Mirpur, Dhaka
Millennium Institute of Medical Technology,

2007 25 25 0 25 0 0 0 75
Bacharam Dewry, Dhaka
National Institute of Medical & Dental Technology,

2005 34 0 0 0 31 0 0 65
Mohammadpur, Dhaka

ANNEX
Discipline
RDT
National Institute of Medical Technology,

2003 50 0 0 50 50 0 0 150
Uttara Model Town, Dhaka
New Lab Institute of Medical Tech, Asad Gate, 130

2005 70 0 0 30 30 0 0
Mohammadpur, Dhaka
Prince Institute of Medical Technology, Savar, Dhaka 2008 45 0 0 30 40 0 0 115
75
25+25 45
(BSc
Prof. Suhrabuddin Institute of Medical Technology, (BSc (BSc 50 (BSc 25 (BSc
2007 In 0 70 315
Sabalia, Tangail in In Lab in Lab) in Dent)
Lab
PTY) 25)
50)
Radiant College of Medical Technology Green Road,

2003 40 0 0 40 0 0 0 80
Dhaka
Rumdo Institute of Medical Technology, Boundary

2007 60 0 0 0 25 0 0 85
Road, Mymensingh
2005&
SAIC Institute of Medical Technology Mirpur, Dhaka 70 10 25 40 40 0 0 185
2008
Shahid SA Memorial Institute of Medical Technology,

2007 40 0 0 25 25 0 0 90
Uttara, Dhaka
Shyamoli Ideal Institute of Medical Technology, Dhaka 2010 50 0 50 50 50 0 0 200
State University of Bangladesh, Iqbal Road, 50 (Op-

2008 0 0 0 0 0 0 50
Mohammadpur, Dhaka tometry)
Sumona Institute of Medical Technology, Sadarghat,

2007 50 0 0 30 50 0 0 130
Dhaka
Trauma Institute of Medical Technology, Shyamoli,

2008 75 50 0 25 50 75 50 325
Dhaka
Christian Institute of Medical Technology, West Tejturi

2010 30 0 0 0 30 0 0 60
Bazar, Tejgaon, Dhaka
Rampura Institute of Medical Technology, Rampura,

2010 60 0 0 0 50 0 0 110
Dhaka
Central Institute of Health Science (Diploma Course), 25 (B.Sc. 25 (B. Sc.

2012 25 25 0 0 0 100
Mirpur, Dhaka in Lab) In PTY)
Dhaka
Dhaka Microlab Institute of Medical Technology, 40 (B.Sc. 30 (B.Sc.
2010 30 0 0 15 30 145
Shahjadpur, Gulshan, Dhaka in Lab) in Lab)
MT
National Heart Foundation Hospital & Research MT(OTA)
2013 0 0 0 0 0 (Cardiol- 10
Institute, Mirpur, Dhaka 5
ogy) 5
J-MATS & Medical Institute, College Road, Jamalpur 2013 40 0 25 25 0 0 0 90
Ghurukul Medical Institute, Dokhhin Bhabanipur,

2014 25 0 25 25 0 0 0 75
Rajbari
East West Institute of Medical Technology, Turag,

2014 50 50 25 25 50 0 0 150
Dhaka
Fulpur Institute of Medical Technology, Fulpur,

2014 30 0 0 30 30 0 0 90
Mymensingh
Akonda Institute of Medical Technology, Chorpara,

2014 25 0 25 25 0 0 0 75
Mymensingh
Army Medical Core Center & School, Ghatail, Tangail 2013 1500
Rabeya MATS Technology, Savar, Dhaka 2014 25 0 0 25 0 0 0 50
Ghatail Medical Assistant Training School, Tangail 2013 75 0 0 0 75 0 0 150
International Institute of Medical Technology, Sataish BSc (MT

2013 0 0 0 0 0 0 40
Tongi, Gazipur LAB) 40
Lake View Institute of Medical Technology, Faridpur 2013 30 0 0 30 30 0 0 90
Institute of Medical Technology, Jalkuri, Narayanganj 2010 25 0 0 15 25 0 0 65
Diploma
in pros-
Bangladesh Health Professional Institute, CRP,
2013 0 0 0 0 0 thetics & 0 10
Chapain, Savar, Dhaka
Orthopa-
dics 10
Bhairab Institute of Medical Technology, Kishoreganj 2010 25 0 0 15 25 0 0 65
Uttara Crescent Institute of Medical Technology,

2011 25 25 25 25 25 0 0 125
Dhaka
Dialab Institute of Medical Technology, Lalbag, Dhaka 2011 25 25 25 0 25 0 0 100

Discipline
RDT
Mymensingh BNSB Institute of Community MLOP

2011 0 0 0 0 0 0 20
Ophthalmology, Mymensingh Asstt.20
SPKS Medical Assistant Training School, Mirpur, Dhaka 2011 25 0 0 0 25 0 0 50

Dhaka Florence Institute of Medical Technology, Maskanda,
2012 40 0 0 40 0 0 0 80
Mymensingh
Genemi Institute of Health Technology, Paik Kandi,

2012 30 30+30 0 0 0 0 0 90
Gopalganj
Ad-Din Womens Institute of Health Technology,

2007 25 25 0 25 25 0 0 100
Jessore
Khulna Specialised Medical Institute, 3 MU Bhuiya Sorok,

2015 25 0 25 25 0 0 0 75
Hospital Road, Kushtia
SAIC Institute of Medical Technology, Khulna 2010 50 0 30 50 50 0 0 180
Advance Institute of Medical & Dental Technology,

2010 50 25 25 25 50 0 0 175
Barisal
Disable Welfare Foundation Science and MT Institute,

2012 25 0 0 25 0 0 0 50
Sabujbag, Patuakhali
Barisal
Progressive Institute of Dental Technology, College
2014 25 0 0 25 0 0 0 50
Road, Bauphol, Patuakhali
Jamjam Institute of Health Technology, Kajipara, C&B

2012 25 25 0 25 0 0 0 75
Road, Barisal
25
Bangladesh Institute of Medical Technology Haji
2007 30 0 30 30 30 BSc in 0 145
Mohsin Road, Dilalpur, Pabna
(Lab)
Health Ways Institute of Medical Technology, Bogra 2002 100 0 0 31 50 0 0 181
Islami Bank Institute of Medical Technology, Rajshahi 2007 50 25 0 25 50 0 0 150
Janata Institute of Medical Technology, Bogra 2002 50 40 0 40 25 0 0 155
Joypurhat Institute of Medical Technology, Joypurhat 2010 50 0 0 0 50 0 0 100
Prime Institute of Medical Technology, 213/A

2006 100 0 0 50 50 0 0 200
Talaimari, Rajshahi
B-Baria Institute of Medical Technology, Baharampur,

2010 25 0 0 0 25 0 0 50
Rajshahi
Naogaon Institute of Medical Science & Technology,

2011 25 0 0 25 25 0 0 75
Kazirmoor, Naogaon
Rajshahi Institute of Medical Technology, Laxmipur,

2002 50 0 0 50 70 0 0 170
Rajshahi
Shah Makhdum Institute of Medical Technology,

2011 30 20 20 70
Boalia, Rajshahi
SAIC Institute of Medical Technology, Bogra 2008 50 0 0 25 50 0 0 125
TMSS Institute of Medical Technology, Thengamara,

2007 100 40 0 30 50 0 0 220
Rajshahi Bogra
City Institute of Medical Technology, Rajshahi 2010 25 0 0 0 25 0 0 50
Bangladesh Institute of Medical Technology, Boalia,

2010 25 0 0 0 25 0 0 50
Rajshahi
NDC Institute of Medical Technology, Joypurhat 2010 50 0 0 0 50 0 0 100
Sirajganj Institute of Medical Technology, Sirajganj 2010 25 0 0 15 25 0 0 65
Birampur Institute of Medical Technology, (IHT),

2012 50 0 0 0 50 0 0 100
Birampur, Rajshahi
SM Institute of Medical Technology & MATS, Ullapara,

2014 50 0 0 0 50 0 0 100
Sirajganj
Saleha Medical Assistant Training Institute, Boro

2014 50 0 50 0 50 0 0 150
Bonogram, Rajshahi
Pabna Ideal Institute of Medical Technology 2014 0 0 0 25 0 0 50

25
Ideal Institute of Health Technology, Chakfaridpur

2013 40 0 20 20 0 0 0 80
Colony, Bogra
Bright Nation Health & Technology Institute, Pabna 2013 50 25 0 25 0 0 0 100
Sailor Institute of Medical Technology Sapura, Boalia,

2013 30 0 0 0 0 0 0 30
Rajshahi

ANNEX
Discipline
RDT
Morning Glory Medical Assistant Training School,

2011 25 0 0 0 25 0 0 50
Shibtola, Chapainowabganj
Prime Institute of Science & Medical Technology,

2007 100 0 0 25 50 0 0 175
Rangpur
DAD Institute of Medical Technology, Dinajpur 2010 50 50 0 0 0 0 0 100
Rajshahi Birampur Institute of Medical Technology, Shimultoly,

2012 50 0 0 50 0 0 0 100
Dinajpur
40 (Di-
ploma
Rangpur CT IMT, Kelabond CO Bazar, Rangpur 2012 40 0 0 30 0 95
in
Lab)
Rangpur CT Institute of Medical Technology. Rangpur 2011 40 30 25 25 25 0 0 145
Total
Total no. of institutions=104 13266
seats
LAB= Laboratory; RDL=Radiology; PTY=Physiotherapy; SI=Sanitary inspection; DENT=Dentistry; PHAR=Pharmacy; RTY=Radiotherapy
List of government and private institutions offering certificate courses in medical technology, with
number of seats by discipline (June 2015)
Ophthalmic Ophthalmic Cath-lab

Division Name of institution with location Estd. Optometrist Refraction Total
assistant nursing assistant tech.
Bangladesh Jatiyo Andho Kallyan

Chittagong 2008 25 0 25 0 0 50
Samity, Comilla
Bangladesh Islamia Eye Hospital, Dhaka 2008 25 25 25 25 0 100

Dhaka
Fashion Eye Hospital Limited, Fashion
2008 0 10 10 0 0 20
Tower, 98/60A Boro Mogbazar, Dhaka
NICVD&H 2010 0 0 0 0 10 10
Total no. of institutions=4 Total seats 50 35 60 25 10 180
Government institutions offering BSc courses in Medical Technology, with name of discipline and the
number of seats (June 2015)
Division Name of institution with location Estd. RDL Physiotherapy Laboratory Medicine Dental Total
NITOR, Sher-e-Bangla Nagar, Dhaka 1993 0 25 0 0 25

Dhaka
Institute of Health Technology, Mohakhali, Dhaka 2007 40 55 55 60 210
Rajshahi Institute of Health Technology, Rajshahi 2007 0 30 30 60 120
No. of institutions=3 Total seats 0 85 60 120 265

Private institutions offering BSc and MSc courses in Medical Technology (June 2015)
Occu-
Physio- Lab Denti-
Division Name of institution with location Estd. pational Others Total
therapy Medicine stry
therapy
Bangladesh Health Professionals Institute, Savar, Dhaka 15 (Speech

2007 20 0 0 10 45
(BSc) therapy)
Bangladesh Medical College, Dhanmondi, Dhaka (BSc)

2008 0 0 0 0 0 0
Bangladesh ShishuShasthya Institute, Sher-e-Bangla Nagar,

2008 0 25 0 0 0 25
Dhaka (BSc)
GonoShasthya University, Savar, Dhaka (BSc)

2005 20 0 0 0 0 20
Institute of Medical Technology, Mirpur, Dhaka (BSc) 2007 0 30 30 0 0 60
International Institute of Health Science, Shewrapara,

2010 30 30 30 0 0 90
Dhaka (BSc)
Dhaka Marks Institute of Medical Technology, Mirpur, Dhaka (BSc) 2008 0 50 50 0 0 100
New Lab Institute of Medical Technology, Iqbal Road,

2010 0 30 30 0 0 60
Mohammadpur, Dhaka (BSc)
SAIC Institute of Medical Technology, Dhaka (BSc) 2007 50 50 50 0 0 150
50
State University, Mohammadpur, Dhaka (BSc) 2006 50 30 30 0 160
(Optometry)
The Peoples University, Dhanmondi, Dhaka (BSc) 2007 25 0 0 0 0 25
GonoSyastha University, Savar, Dhaka (MSc) 2005 60 0 0 0 0 60
Bangladesh Health Professionals Institute, Savar, Dhaka (MSc) 2007 15 0 0 0 0 15
Chittagong Institute of Medical Technology, Halishahar,

Chittagong 2008 0 50 50 0 50 (Ph) 150
Chittagong
Rangpur Prime Institute of Science & Technology, Islambag, Rangpur 75 0 0 0 0 75
Institute of Health Technology, Tuni Bhaban, Rajshahi 2007 0 25 0 0 0 25
Rajshahi Prime Institute of Health Technology, Talaimari, Rajshahi 2007 50 0 50 0 0 100
Prime Institute of Science & Technology, Rangpur 2008 0 75 0 0 0 75
Total
Total no. of institutions=18 320 395 320 10 115 1235
seats
Training/workshop/seminar (FY 2014-2015)
Topic/subject of the training/workshop/seminar Duration No. of batches No. of participants
Local Training
Short-term
Essential Service Delivery (ESD)
ESD Basic Training for Field Service Providers 21 days 24 600
ESD RefresherTraining for Field Service Providers 6 days 50 1250
Training on Nutrition for Field Service Providers 6 days 47 1175
Training on Emergency Medical and Surgical Care for Doctors 7 days 18 450
Training on Medical and Surgical Emergency Management for Support Staff 7 days 28 700
Training on Primary Management of Burn for Nurses and Paramedics 14 days 7 175
Training on Primary Management & Prevention of Kidney & Urological Diseases for Physicians 6 days 08 200
Training on Kidney & Urological Diseases for Nurses 6 days 15 375
Orientation Training on Kidney & Urological Diseases for Health Workers 3 days 50 1250
Training Program for Doctors on Mental Health 6 days 18 450
Training Program for Health Workers on Mental Health 14 days 17 425
Training on Cancer Awareness, Screening and Primary Detection for Doctors 5 days 11 275
Orientation on Early Detection of Breast and Cervical Cancer for Doctors and Nurses 2 days 17 425
Orientation on Cervical and Breast Cancer Awareness for Opinion Leaders 1 day 14 350
Training on Primary Eye Care for Doctors 6 days 16 400
Training on Primary Eye Care for Nurses and Paramedics 6 days 18 450
Training for Doctors on Violence against Women and Girls 6 days 13 325
Orientation for Awareness-building on Violence against Women for Health Workers (HA, AHI, HI, SI, etc.) 1 day 12 300

ANNEX
Training on Asthma Prevention and Management for Doctors 5 days 14 350
Training for Healthcare Providers (Doctors and Nurses) on Youth-friendly Health Services 3 days 18 450
Training on Basic Dental Healthcare for Primary Healthcare Providers 5 days 13 325
Training on Recent Advances in Dentistry for Dental Surgeons 6 days 06 150
Orientation on Autism Awareness for Health Personnel and Opinion Leaders at Upazila Level 1 day 115 2875
Basic Training (Management & Clinical) for Medical Assistants 6 days 19 475
Training for Doctors on Rational Use of Antimicrobials 3 days 10 250
Orientation for Awareness-building on Fistula Prevention and Care for Field Service Providers and
1 day 25 625
Social Representatives
Training on Primary Management of Burn for Nurses and Paramedics 14 days 7 175
Training on Cancer Awareness, Screening and Primary Detection for Doctors 5 days 11 275
Workshop on Medical Biotechnology 2 days 32 640
Training on Rational/Proper Use of Blood and Blood Product Transfusion for Doctors and Technologists 2 days 8 184
Training of Doctors on Rational Use of Antimicrobials 3 days 10 250
Training on Food Adulteration for UHFPO, RMO, MO, SI, HI, DHI etc. 5 days 14 350
Orientation for Awareness-building on Fistula Prevention and Care for Field Service Providers and
1 day 25 625
Social Representatives
Total for Essential Service Delivery (ESD) Training 710 17574
Management Training
Basic Service Management Training for Newly-recruited Doctors 7 days 23 483
Management Training on Cardiac Emergency for Health Personnel at Division, District and UZ Levels 7 days 13 325
Training on Improved Financial Management for Personnel Working at Division, District, Upazila
6 days 13 325
Levels, and Specialized Institutions, TTU, and Others
Training on Office Management for Office Staff 5 days 18 450
Laboratory Management Training for Laboratory Technicians 7 days 13 312
English Language Course for Nurses 28 days 28 420
Arabic Language Course (Training) for Nurses 28 days 27 405
Basic Computer Training for Health Personnel 28 days 15 255
Refresher Computer Training on Operating System, Installation, Internet, etc. for the Personnel of
14 days 25 435
MOHFW, DGHS, and Autonomous Institutions
Training on Epidemiology, Clinical Management and Prevention of Diarrheal Diseases and

5 days 14 350
Malnutrition for Doctors and Paramedics
Training for SSN, SNs, ASN, MTs, and others on Proper Use and Preventive Maintenance of Medical
3 days 20 560
Equipment
Training on Standard Operating Procedures (SOPs) regarding IPD, OPD, OT, Emergency, House-keeping,
Record-keeping, Nursing Services, Diagnostic Services, etc. for Service Providers of Primary, Secondary 5 days 17 425
and Tertiary Hospitals
Basic Training on Hospital Waste Management for Support Staff 3 days 20 500
Training on Store Management for Store-keepers 5 days 06 150
Training on Gender Issue for Field Staff (HA, AHI, HI, SI, etc.) 3 days 49 1225
Orientation on Joint Simulation Exercise with BDRCS at the Most Cyclone-prone Districts (Multi-
2 days 17 425
sectoral Approach) on Emergency Preparedness and Response)
Training for MOs and Field Staff on Disaster Mitigation/Post-disaster Hazards 2 days 20 500
Training Course on Mass Casualty Management for Hospital-level Staff 2 days 17 425
Basic Training on Patient-care and Hospital Management for Nurses, MTs 15 days 11 253
Training on Health Statistics for Statistical Personnel Working at Different Levels of Health Services 7 days 6 144
Training for Medical Technologists (Radiology) on CT MR and CR 14 days 10 250
Total of management training sessions 382 8617
Orientation for the Members of DTCC and DUTT 1 day 41 1025
Development and Review of Curriculum and Training Policy 3 days 6 120
Upgrading Training Management Information System (TMIS) 1 5 5
Total: 52 1150
(a) Sub-total of local training sessions 1144 27341
Subject-wise Specialized Training to be Implemented by ICMH, IPH, NIPSOM, IEDCR, BCPS, CME

TOT for Doctors on Advanced ESD Clinical Skills Training Course on Reproductive Health under
6 days 1 14
HPNSDP
TOT for Doctors on Advanced ESD Clinical Skills Training Course on Reproductive Child Healthcare
6 days 1 18
under HPNSDP
Research Methodology under HPNSDP 2 38
TOT on Nutrition Program, Planning & Management under HPNSDP 6 days 2 39
Training on Complementary Feeding under HPNSDP 6 days 3 59
Breastfeeding Counseling Training for the Healthcare Providers 6 days 4 76
Refresher Course on Computer Training 6 days 2 30
Training on HIV/AIDS 6 days 1 15
Training on GLP and Lab Management for Health Personnel 10/5 27 520
Training on Occupational Safety 6 days 1 30
Training on Research Methodology 6 days 1 33
Nutritional Anthropometrical Study 6 days 1 30
Epidemiological Survey of Health Status 6 days 1 30
Faculty Development 2 63
Seminar on Emerging Issues 1 days 8 224
Certificate Course on Clinical Epidemiology 3 month 1 12
Training on Disease Surveillance 3 days 2 44
Training on Outbreak Investigation 3 days 4 63
Training on Communication Skill Development and IT 5 days 4 64
Orientation Training on Basic Surgical Skill Development 3 days 12 224
Training of Teachers of Postgraduate Medical Institutes, Medical Colleges, Nursing Colleges,

3-7 days 2 44
Paramedical Institutes, and MATS
Training on Educational Management 3-7 days 2 38
Total 84 1708
Overseas Training
Different Clinical Specialties
Short-term (4 weeks or less) Clinical Training for Health Service Providers 1- 4 weeks 4 35
Short-term (4 weeks or less) Training for Basic Science and Para-clinical Medical Teachers 1- 4 weeks 2 14
Different Management and Public Health Specialties
Short-term (4 weeks or less) Training on Training and Teaching Technology, Hospital Management,
1-4 weeks 2 32
Personnel Management, Waste Management, Exposure Visit of Teachers for Curriculum Development
Specialized Overseas Training
Short-term (4 weeks or less) Hands-on Clinical Training for Health Service Providers in Local
1- 4 weeks 8 19
Institutions (Resource persons from abroad)
Sub-total of Overseas Training

30 100
Grand total 1158 29149

Percent distribution of new male and female medical and dental doctors produced from various medical and dental colleges during the 5-year
period from 2011 to 2015
2011 2012 2013 2014 2015

Name of medical or dental college
M F M F M F M F M F
Dhaka Medical College 47.19 52.81 59.90 40.09 54.87 45.13 59.64 40.36 44.83 55.17
Sir Salimullah Medical College 57.06 42.94 61.07 38.92 53.18 46.82 60.71 39.29 40.24 59.76
Rajshahi Medical College 56.1 43.9 63.9 36.09 54.81 45.19 52.32 47.68 47.13 52.87
Rangpur Medical College 52.17 47.83 55.6 44.39 40.46 59.54 4531 54.69 47.57 52.43
Mymensingh Medical College 51.61 48.39 61.35 38.64 53.77 46.23 52.72 47.28 49.41 50.59
Chittagong Medical College 54.42 45.58 60.00 40.00 45.98 54.02 45.81 54.19 38.29 61.71
MAG Osmani Medical College, Sylhet 54.19 45.81 57.14 42.85 57.14 42.86 49.24 50.76 48.45 51.71
Sher-e-Bangla Medical College, Barisal 48.17 51.83 63.15 36.84 61.19 38.81 55.62 44.38 56.91 43.09
Faridpur Medical College 53.33 46.67 49.57 50.42 43.52 56.48 50.25 49.75 58.33 41.67
SZR Medical College, Bogra 43.01 56.99 52.3 47.69 45.45 54.55 52.92 47.08 49.62 50.38
Dinajpur Medical College 48 52 52.94 47.06 56.60 43.37 52.73 47.27 46.51 53.49
Khulna Medical College 52.5 47.5 69.82 30.17 51.26 48.74 46.43 53.57 58.73 41.27
Comilla Medical College 42.86 57.14 36.05 63.94 51.30 48.70 46.45 53.55 41.18 58.82
Shaheed Suhrawardy Medical College, Dhaka 53.05 46.95 62.41 37.59
Pabna Medical College,Pabna 34.62 65.38 58.82 41.18
Noakhali Medical College 34.62 65.38 36.84 63.16
Coxs Bazar Medical College 33.33 66.67 32.35 67.65
Dhaka Dental College 46.51 53.49 41.67 53.84 33.33 66.67 42.11 57.89 36.25 63.75
Chittagong Dental College 28.81 71.19 44.18 55.82 44.74 55.22 32.50 67.50 35.56 64.44
Rajshahi Dental College 30.77 69.23 57.47 42.56 39.13 60.87 34.09 65.91 42.55 57.45
Jessore Medical College 30.77 69.23
Overall 50.18 49.82 55.68 44.32 52.89 47.11 50.61 49.39 47.86 52.14
ANNEX

ANNEX TO CHAPTER 18 Goverment of the People's Republic of Bangladesh
OP/DPP-wise Statement of Allocation, Fund Release
Ministry
andofExpenditure FY 2015-2016
Health & FamilyofWelfare (MOHFW)
OP/DPP-wise Statement of Allocation, Fund Release and Expenditure of FY 2015-2016

Upto Nov-2016 All Amount is In Lac Taka
Allocation Released Expenditure Exp%

SL# Name of Project/OP
RPA-GOB RPA-GOB RPA-GOB Allocation
GOB DPA PA-Total Total GOB DPA PA-Total Total GOB DPA PA-Total Total
RPA-Other RPA-Other RPA-Other Release
OP
DGHS
1 Maternal, Neonatal, Child and 27,650.00 24,541.94 23,431.97 83.31
5,343.00 24,795.00 52,445.00 57,788.00 5,335.25 19,656.95 44,198.89 49,534.14 5,056.27 19,656.95 43,088.92 48,145.19
Adolescent Health (RADP-1) 0.00 0.00 0.00 97.20
2 Essential Services Delivery 8,000.00 2,988.75 2,349.68 39.22
3,500.00 0.00 8,000.00 11,500.00 2,380.64 0.00 2,988.75 5,369.39 2,160.32 0.00 2,349.68 4,510.00
(RADP-1) 0.00 0.00 0.00 83.99
3 Community Based Health Care 0.00 9,931.50 11,820.13 163.52
25,918.00 0.00 0.00 25,918.00 32,514.00 393.79 13,193.79 45,707.79 30,167.19 393.79 12,213.92 42,381.11
(RADP-1) 0.00 2,868.50 0.00 92.72
4 TB and Leprosy Control (ADP) 3,500.00 3,500.00 393.50 69.76
450.00 9,300.00 12,800.00 13,250.00 300.00 8,615.40 12,115.40 12,415.40 205.99 8,643.26 9,036.76 9,242.75
0.00 0.00 0.00 74.45
5 National AIDS/STD Program 3,800.00 3,085.00 2,512.51 64.54
150.00 0.00 3,800.00 3,950.00 75.00 0.00 3,085.00 3,160.00 36.83 0.00 2,512.51 2,549.34
(ADP) 0.00 0.00 0.00 80.68
6 Communicable Diseases Control 4,550.00 4,600.00 3,294.64 90.53
3,300.00 6,100.00 10,700.00 14,000.00 3,300.00 6,100.00 10,700.00 14,000.00 3,280.00 6,099.63 9,394.27 12,674.27
(ADP) 50.00 0.00 0.00 90.53
7 Non-Communicable Diseases 2,700.00 2,250.00 1,081.75 65.04
1,423.00 50.00 2,750.00 4,173.00 2,000.00 37.00 2,287.00 4,287.00 1,595.74 36.73 1,118.48 2,714.22
(RADP-2) 0.00 0.00 0.00 63.31
8 National Eye Care (RADP-1) 272.00 213.00 191.05 77.12
160.00 0.00 272.00 432.00 160.00 0.00 213.00 373.00 142.13 0.00 191.05 333.18
0.00 0.00 0.00 89.32
9 Hospital Services Management & 37,785.00 37,785.00 35,154.89 89.74
13,000.00 500.00 38,700.00 51,700.00 13,000.00 500.00 38,700.00 51,700.00 10,858.78 381.34 35,536.90 46,395.68
Safe Blood Transfusion 415.00 415.00 0.67 89.74
(RADP-1)
10 Alternate Medical Care 400.00 400.00 92.56 89.50
3,100.00 0.00 400.00 3,500.00 3,100.00 0.00 400.00 3,500.00 3,040.00 0.00 92.56 3,132.56
(RADP-1) 0.00 0.00 0.00 89.50
11 In-Service Training (ADP) 2,400.00 2,400.00 1,779.76 77.86
700.00 0.00 2,400.00 3,100.00 682.50 0.00 2,400.00 3,082.50 633.92 0.00 1,779.76 2,413.68
0.00 0.00 0.00 78.30
12 Pre-Service Education (RADP-1) 12,000.00 12,000.00 11,975.61 98.38
5,500.00 0.00 12,000.00 17,500.00 5,500.00 0.00 12,000.00 17,500.00 5,240.09 0.00 11,975.61 17,215.70
0.00 0.00 0.00 98.38
13 Planning, Monitoring and 175.00 175.00 175.00 98.04
200.00 25.00 200.00 400.00 200.00 25.00 200.00 400.00 192.18 25.00 200.00 392.18
Research (Health) (ADP) 0.00 0.00 0.00 98.04
14 Health Information System & 2,000.00 2,000.00 1,909.77 99.27
4,500.00 100.00 2,100.00 6,600.00 4,500.00 142.00 2,142.00 6,642.00 4,499.98 142.00 2,051.77 6,551.75
e-Health (RADP-1) 0.00 0.00 0.00 98.64
15 Health Education and Promotion 869.00 1,447.40 720.13 110.43
852.50 300.00 1,169.00 2,021.50 1,250.00 300.00 1,747.40 2,997.40 1,212.15 300.00 1,020.13 2,232.28
(RADP-1) 0.00 0.00 0.00 74.47
16 Procurement, Logistics & 1,000.00 750.00 63.69 92.41
11,597.00 0.00 1,000.00 12,597.00 11,597.00 0.00 750.00 12,347.00 11,577.15 0.00 63.69 11,640.84
Supplies Management (RADP-1) 0.00 0.00 0.00 94.28
17 National Nutrition Services 7,500.00 5,100.00 3,296.64 49.94
900.00 500.00 8,000.00 8,900.00 822.00 499.82 5,599.82 6,421.82 648.32 499.82 3,796.46 4,444.78
(ADP) 0.00 0.00 0.00 69.21
1025 Test () 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00
114,601.00 113,167.59 100,243.28 91.42
Total of DGHS OP 80,593.50 41,670.00 156,736.00 237,329.50 86,716.39 36,269.96 152,721.05 239,437.44 80,547.03 36,179.00 136,422.00 216,969.00
465.00 3,283.50 0.67 90.62
DGFP
18 Maternal, Child, Reproductive & 9,000.00 7,250.00 6,776.69 82.42
3,200.00 1,200.00 10,300.00 13,500.00 3,200.00 1,165.00 8,512.50 11,712.50 3,090.79 1,165.00 8,036.05 11,126.84
Adolescent Health (FP) 100.00 97.50 94.36 95.00
(RADP-2)
19 Clinical Contraception Services 6,570.00 2,107.00 1,915.26 68.91
9,000.00 880.00 7,450.00 16,450.00 9,000.00 595.59 2,702.59 11,702.59 8,824.72 595.59 2,510.85 11,335.57
Delivery (RADP-1) 0.00 0.00 0.00 96.86
20 Family Planning Field Services 8,000.00 4,560.00 0.00 32.24
3,800.00 200.00 8,200.00 12,000.00 3,800.00 192.21 4,752.21 8,552.21 3,676.66 192.21 192.21 3,868.87
Delivery Program (RADP-1) 0.00 0.00 0.00 45.24
21 Planning, Monitoring and 230.00 150.00 148.47 73.95
110.00 0.00 230.00 340.00 110.01 0.00 150.00 260.01 102.97 0.00 148.47 251.44
Evaluation of Family Planning 0.00 0.00 0.00 96.70
(RADP-1)
22 Management Information Systems 850.00 310.00 250.93 33.29
230.00 0.00 850.00 1,080.00 186.00 0.00 310.00 496.00 108.59 0.00 250.93 359.52
(FP) (RADP-1) 0.00 0.00 0.00 72.48
23 Information, Education and 1,640.00 1,109.00 1,403.45 86.32
1,100.00 100.00 1,740.00 2,840.00 1,100.00 100.00 1,510.00 2,610.00 948.04 100.00 1,503.45 2,451.49
Communication (FP) (RADP-1) 0.00 301.00 0.00 93.93
24 Procurement, Storage and 100.00 50.00 27.20 73.65
2,170.00 0.00 100.00 2,270.00 1,900.00 0.00 50.00 1,950.00 1,644.62 0.00 27.20 1,671.82
Supplies Management (RADP-1) 0.00 0.00 0.00 85.73
26,390.00 15,536.00 10,522.00 64.08
Total of DGFP OP 19,610.00 2,380.00 28,870.00 48,480.00 19,296.01 2,052.80 17,987.30 37,283.31 18,396.39 2,053.00 12,669.00 31,066.00
100.00 398.50 94.36 83.32
MOHFW
28 Physical Facilities Development 0.00 5,500.00 0.00 17.05
93,310.00 0.00 0.00 93,310.00 18,900.00 0.00 5,500.00 24,400.00 13,597.00 0.00 2,309.00 15,906.00
(ADP) 0.00 0.00 2,309.00 65.19
29 Human Resources Management 175.00 400.00 102.18 66.90
150.00 5.00 180.00 330.00 150.00 0.00 400.00 550.00 118.60 0.00 102.18 220.78
(RADP-1) 0.00 0.00 0.00 40.14
30 Sector-Wide Program 250.00 125.00 13.80 17.51
40.00 200.00 450.00 490.00 30.00 72.00 197.00 227.00 10.32 61.70 75.50 85.82
Management and Monitoring 0.00 0.00 0.00 37.81
(ADP)
31 Improved Financial Management 420.00 380.00 372.70 84.03
120.00 0.00 420.00 540.00 92.00 0.00 380.00 472.00 81.04 0.00 372.70 453.74
(RADP-1) 0.00 0.00 0.00 96.13
32 Health Economics and Financing 0.00 829.43 332.94 0.00
0.00 0.00 0.00 0.00 325.00 103.78 953.78 1,278.78 116.55 91.35 424.29 540.84
(ADP) 0.00 20.57 0.00 42.29
ANNEX

845.00 7,234.43 821.62 18.18
Total of MOHFW OP 93,620.00 205.00 1,050.00 94,670.00 19,497.00 175.78 7,430.78 26,927.78 13,923.51 153.00 3,284.00 17,207.00

0.00 20.57 2,309.00 63.90
NIPORT
25 Training, Research and 1,990.00 961.33 818.29 38.71
380.00 10.00 2,000.00 2,380.00 176.50 0.00 961.33 1,137.83 103.08 0.00 818.29 921.37
Development (NIPORT) 0.00 0.00 0.00 80.98
(RADP-1)
1,990.00 961.33 818.29 38.71
Total of NIPORT OP 380.00 10.00 2,000.00 2,380.00 176.50 0 961.33 1,137.83 103.08 0.00 818.00 921.00
0.00 0.00 0.00 80.98
DNS
26 Nursing Education and Services 2,400.00 2,100.00 1,165.42 125.38
124.50 700.00 3,100.00 3,224.50 1,000.00 2,000.00 4,100.00 5,100.00 877.48 2,000.00 3,165.42 4,042.90
(RADP-1) 0.00 0.00 0.00 79.27
2,400.00 2,100.00 1,165.42 125.38
Total of DNS OP 124.50 700.00 3,100.00 3,224.50 1,000.00 2,000.00 4,100.00 5,100.00 877.48 2,000.00 3,165.00 4,043.00
0.00 0.00 0.00 79.27
DGDA
27 Strengthening of Drug 550.00 351.00 128.09 18.64
264.00 0.00 550.00 814.00 150.00 0.00 351.00 501.00 23.60 0.00 128.09 151.69
Administration and Management 0.00 0.00 0.00 30.28
(RADP-1)
550.00 351.00 128.09 18.64
Total of DGDA OP 264.00 0.00 550.00 814.00 150.00 0 351.00 501.00 23.60 0.00 128.00 152.00
0.00 0.00 0.00 30.28
146,776 139,350 113,698.70 69.88
Sub Total of OP 194,592.00 44,965.00 192,306.00 386,898.00 126,835.90 40,498.54 183,551.46 310,387.36 113,871.09 40,384.37 156,487.10 270,358.19
565 3,703 2,404 87.10
Projects
1123 Sheikh Hasina National Institue of 0.00 0.00 0.00 51.42
200.00 0.00 0.00 200.00 200.00 0.00 0.00 200.00 102.84 0.00 0.00 102.84
Burn and Plastic Surgery, Dhaka 0.00 0.00 0.00 51.42
(RADP-1)
1124 Establishment of Tangail Medical 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
College & Extension of 250 0.00 0.00 0.00 0.00
bedded General Hospital into 500
Beded Medical College Hospital
Tangail ()
0.00 0.00 0.00 51.42
Total of DGHS Projects 200.00 0.00 0 200.00 200.00 0 0 200.00 102.84 0.00 0.00 103.00
0.00 0.00 0.00 51.42
1 Est. of 250 beded National 0.00 0.00 0.00 33.79
20.00 0.00 0.00 20.00 15.00 0.00 0.00 15.00 6.76 0.00 0.00 6.76
Ophthalmology Inst. and Hospital 0.00 0.00 0.00 45.06
(1st Phase: 250 beds) (RADP-1)
2 Upgradation of National Institute 0.00 0.00 0.00 64.80
250.00 500.00 500.00 750.00 250.00 253.54 253.54 503.54 232.45 253.54 253.54 485.99
of Cancer Research and Hospital 0.00 0.00 0.00 96.51
from 50 bed to 300 beds
(RADP-1)
3 Establishment of National Institute 0.00 0.00 0.00 73.21
4,885.00 0.00 0.00 4,885.00 4,885.00 0.00 0.00 4,885.00 3,576.53 0.00 0.00 3,576.53
of Laboratory Medicine and 0.00 0.00 0.00 73.21
Refferal Centre (RADP-1)
4 Extension of Dhaka 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Shisu(Children) Hospital Project 0.00 0.00 0.00 0.00
()
5 Establishment of Essential Drugs 0.00 0.00 0.00 51.05
11,615.00 0.00 0.00 11,615.00 7,317.32 0.00 0.00 7,317.32 5,929.72 0.00 0.00 5,929.72
Company Limited, 3rd Plant, 0.00 0.00 0.00 81.04
Gopalganj (RADP-2)
6 Expansion and Quality 0.00 0.00 0.00 54.66
2,405.00 0.00 0.00 2,405.00 2,405.00 0.00 0.00 2,405.00 1,314.64 0.00 0.00 1,314.64
Improvement of Nursing 0.00 0.00 0.00 54.66
Education (ADP)
7 Revitalization of Community 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Health care initiatives in 0.00 0.00 0.00 0.00
Bangladesh ()
8 Conversion of BSMMU to a center 0.00 0.00 0.00 90.23
6,862.00 0.00 0.00 6,862.00 6,862.00 0.00 0.00 6,862.00 6,191.65 0.00 0.00 6,191.65
of excellence project (ADP) 0.00 0.00 0.00 90.23
9 Establishment of Sheikh 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Fajilatunnesa Mujib Eye Hospital 0.00 0.00 0.00 0.00
and Training Institute, Gopalganj.
()
10 Establishment of National Centre 0.00 0.00 0.00 98.37
210.00 0.00 0.00 210.00 210.00 0.00 0.00 210.00 206.58 0.00 0.00 206.58
for Cervical and Breast Cancer 0.00 0.00 0.00 98.37
Screening and Training at BSMMU
(RADP-1)
11 Establishment Sheikh Sayera 0.00 0.00 0.00 99.93
4,800.00 0.00 0.00 4,800.00 4,800.00 0.00 0.00 4,800.00 4,796.71 0.00 0.00 4,796.71
Khatun Medical College and 0.00 0.00 0.00 99.93
Hospital and Nursing Institute,
Gopalganj. (RADP-1)
12 Establisment of Shatkhira Medical 0.00 0.00 0.00 93.10
3,446.00 0.00 0.00 3,446.00 3,446.00 0.00 0.00 3,446.00 3,208.32 0.00 0.00 3,208.32
College & Hospital (RADP-1) 0.00 0.00 0.00 93.10
13 Establishment of Faridpur Medical 0.00 0.00 0.00 1,726.05
9,200.00 0.00 0.00 9,200.00 2,300.00 0.00 0.00 2,300.00 158,796.96 0.00 0.00 158,796.96
College & Hospital (ADP) 0.00 0.00 0.00 6,904.22
14 National Institute of Digestive 0.00 0.00 0.00 1,907.53
100.00 0.00 0.00 100.00 2,000.00 0.00 0.00 2,000.00 1,907.53 0.00 0.00 1,907.53
Diseases Research & Hospital 0.00 0.00 0.00 95.38
(RADP-1)
15 Establishment of Kushtia Medical 0.00 0.00 0.00 85.76
6,003.00 0.00 0.00 6,003.00 6,003.00 0.00 0.00 6,003.00 5,148.05 0.00 0.00 5,148.05
College and Hospital Project 0.00 0.00 0.00 85.76
(RADP-1)
16 Establishment of Shaheed Sayed 0.00 0.00 0.00 86.19
12,277.00 0.00 0.00 12,277.00 24,562.00 0.00 0.00 24,562.00 10,581.00 0.00 0.00 10,581.00
Nazrul Islam Medical college , 0.00 0.00 0.00 43.08
Kishorgong (RADP-2)
17 Extention of Shaheed Sheikh Abu 0.00 0.00 0.00 0.00
1,990.00 0.00 0.00 1,990.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Naser Specialized Hospital, 0.00 0.00 0.00 0.00
Khulna (ADP)
18 Establishment of Trauma centre 0.00 0.00 0.00 181.96
735.00 0.00 0.00 735.00 506.14 0.00 0.00 506.14 1,337.40 0.00 0.00 1,337.40
at Gopalgong (ADP) 0.00 0.00 0.00 264.24
ANNEX

19 Sustaining Influenza Surveillance 0.00 0.00 0.00 165.31
5.00 129.90 129.90 134.90 0.00 129.90 129.90 129.90 0.00 223.00 223.00 223.00
Networks and Response to

0.00 0.00 0.00 171.67
Seasonal and Pandemic Influenza
In Bangladesh (ADP)
20 Provision for equipment and 0.00 0.00 0.00 100.00
2,000.00 0.00 0.00 2,000.00 2,000.00 0.00 0.00 2,000.00 2,000.00 0.00 0.00 2,000.00
professional training for Ahsania 0.00 0.00 0.00 100.00
Mission Cancer Hospital (ADP)
21 Extention of National Institute of 0.00 0.00 0.00 91.77
4,857.50 0.00 0.00 4,857.50 5,000.00 0.00 0.00 5,000.00 4,457.88 0.00 0.00 4,457.88
Orthopadic Hospital and 0.00 0.00 0.00 89.16
Rehabilitation center (NITOR)
(RADP-1)
22 Establishment of Nursing Institute 0.00 0.00 0.00 606.73
100.00 0.00 0.00 100.00 607.00 0.00 0.00 607.00 606.73 0.00 0.00 606.73
of Pabna (ADP) 0.00 0.00 0.00 99.96
23 Establishment of National Institute 700.00 0.00 0.00 0.00
50.00 0.00 700.00 750.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
of Advanced Practice Nurses in 0.00 0.00 0.00 0.00
Bangladesh (ADP)
24 Establishment of Sheikh Lutfar 0.00 0.00 0.00 0.00
187.58 0.00 0.00 187.58 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Rahman Dental College (ADP) 0.00 0.00 0.00 0.00
1118 Establishment of Institute for 0.00 0.00 0.00 35.72
425.00 0.00 0.00 425.00 582.29 0.00 0.00 582.29 151.80 0.00 0.00 151.80
Pediatric Neuro-disorder and 0.00 0.00 0.00 26.07
Autism in BSMMU (ADP)
1119 One Health Fellowships 0.00 0.00 0.00 65.43
0.00 100.46 100.46 100.46 0.00 100.71 100.71 100.71 0.00 65.73 65.73 65.73
Integrating Education and Action 0.00 0.00 0.00 65.27
for One Health in Bangladesh
(ADP)
1120 Establishment of a Medical 0.00 0.00 5.73 363.36
4,000.00 0.00 0.00 4,000.00 4,000.00 0.00 0.00 4,000.00 14,528.76 0.00 5.73 14,534.48
College and 250 Bedded Hospital, 0.00 0.00 0.00 363.36
Manikganj (ADP)
1121 Establishment of a Medical 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
College and 250 Bedded Hospital, 0.00 0.00 0.00 0.00
Manikganj ()
1122 Shaheed M.Monsur Ali Medical 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
College and 500 Bed Medical 0.00 0.00 0.00 0.00
College at Sirajganj ()
700.00 0.00 5.73 289.68
Total of MOHFW Projects 76,423.08 730.00 1,430.36 77,853.44 77,750.75 484.15 484.15 78,234.90 224,979.48 542.00 548.00 225,527.00
0.00 0.00 0.00 288.27
700 0.00 5.73 289.07
Sub Total of Projects 76,623.08 730.36 1,430.36 78,053.44 77,950.75 484.15 484.15 78,434.90 225,082.32 542.27 548.00 225,630.31
0.00 0.00 0.00 287.67
147,476.00 139,350.35 113,704.42 106.68
Grand Total : 271,215.08 45,695.36 193,736.36 464,951.44 204,786.65 40,982.69 184,035.61 388,822.26 338,953.41 40,926.64 157,035.09 495,988.50
565.00 3,702.57 2,404.03 127.56

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HB 2016 - 2nd - Edition - 13 - 01 - 17

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Government of the Peoples Republic of Bangladesh

Ministry of Health and Family Welfare

Management Information System

Development is a collaborative process. With this spirit, let us work

Over the last few years, Bangladesh made tremendous progress in

Our goal to establish a Digital Bangladesh has been achieved more

Joy Bangla, Joy Bangabandhu.

I recall with gratitude that our government and non-government

I congratulate the health personnel in all organizations under the

Joy Bangla, Joy Bangabandhu.

Our historic achievements in the Millennium Development

I am confident that information contained in this publication

Md. Sirazul Islam

MESSAGE AND EDITORIAL

2016 has been a year of special significance as the development partners

I extend my heartiest congratulations to the members of the production

It needs to be specially mentioned that the readers may, in some cases,

We are committed to dedicating more efforts to improve the quality of

Professor Dr. Abul Kalam Azad

Bangladesh is continuously developing its health indicators.

We want to ensure Universal Health Coverage within 2029.

Management Information System of the DGHS is continuously

Despite best efforts of all the personnel behind publication

Dr. Nazimun Nessa

Chapter 1 Bangladesh country profile with health indicators 13

Chapter 2 Healthcare Network in Bangladesh 19

Chapter 3 Health-related Sustainable Development Goals 24

Chapter 4 Primary healthcare 49

Chapter 5 Secondary and tertiary healthcare 63

Chapter 6 Utilization of public health facilities 67

Chapter 7 Healthcare for Admitted Patients in Public Hospitals 76

Chapter 8 Mortality in Public Hospitals 85

Chapter 9 Communicable disease control in Bangladesh 101

Chapter 10 Preparedness and response in health emergencies 130

Chapter 11 Non-communicable diseases 134

Chapter 12 Safe blood transfusion 144

Chapter 13 Nutrition situation in Bangladesh 148

Chapter 14 Institute of Epidemiology, Disease Control and Research 159

Chapter 15 Institute of Public Health 164

Chapter 16 Health workforce situation in Bangladesh 170

Chapter 17 Health information system, ehealth, and MBT 183

Chapter 18 Financing healthcare 198

Geographical location 100% and is the highest during the monsoon

Health Bulletin 2016 13

Currently the country is divided into 8

The agrarian sector still dominates the countrys

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Health Bulletin 2016 15

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Seats for medical degrees Immunization (valid vaccination coverage)

Health Bulletin 2016 17

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Hierarchy of personnel in the Ministry of 4. Directorate General of Drug Administration

Health Bulletin 2016 19

Senior/ Senior/ Senior/ Senior/ Senior/ Senior/ Senior/ Senior/

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Along with the operation of Management structure and type of health

Figure 2.2. Administrative setup of the Directorate General of Health Services