Our 2024-25 Policy Brief assesses Bangladesh’s Community Clinic Program focusing on its alignment with international standards and the challenges it faces in regional implementation.

Community Clinics in Bangladesh

Bangladesh’s PHC framework emphasizes three pillars: care at the community level, addressing socio-economic and environmental determinants of health, and empowering health decision-making. Despite its decentralized structure, featuring over 10,000 community clinics, many face challenges like inconsistent staffing, resource shortages, and limited emergency care, particularly in rural areas.

Regional Efficacy: The Case for Barishal

With 9.1 million residents, Barishal faces unique challenges due to climate vulnerability, including coastal erosion and frequent natural disasters. These environmental issues strain the healthcare system, leading to higher maternal and infant mortality rates. Clinics in the region suffer from staffing gaps, limited maternal healthcare, and challenges in data management and resource allocation.

Global Best Practices

Models from Brazil, Rwanda, and India demonstrate how integrating digital tools, community outreach, and mobile health services can improve access to care.

Recommendations

We offer four multi-faceted recommendations to improve the regional efficacy of community clinics.

1. Eradicate Corruption: Implement real-time data reporting, audits, and merit-based hiring. Form a national health commission, restructure oversight boards, and enforce conflict-of-interest rules.

2. Improve Training Programs: Conduct skill gap assessments (e.g., emergency care), provide hands-on instruction (including paramedics), and introduce region-specific mentorship with sufficient budgets for ongoing evaluation.

3. Modernize Community Clinic Program: Partner with NGOs to fill capacity gaps, strengthen referral systems, co-design services with communities, adopt digital inventory tracking, expand the Essential Service Package, and leverage private-sector support.

4. Promote Independent Research: Investigate clinical quality, health-seeking behaviors, and equity. Compare medicine distribution models, publish findings, and involve diverse stakeholders for data-driven improvements.

Through cross-sectoral action, Bangladesh can improve the efficacy of 10,000+ community clinics.