Primary Healthcare Reform Urged to Pave Way for Universal Health Coverage

Reforming the country’s primary healthcare system is essential to pave the way for universal health coverage, while sustained dialogue on health sector reform must continue. These recommendations emerged from sector stakeholders at a policy dialogue jointly organized by private research organization Power and Participation Research Centre (PPRC) and the UHC Forum, with support from UNICEF.

Speakers at the meeting emphasized that while laws and regulations are important, real change will come through effective implementation, institutional accountability, and strong political commitment.

Addressing a high-level policy dialogue on the draft Primary Healthcare (PHC) law at the CIRDAP auditorium in the capital on Wednesday, January 21, PPRC Executive Chairman Dr. Hossain Zillur Rahman said discussions on health sector reform must be sustained. Although notable progress has been made, he stressed that stronger initiatives are required for the successful implementation of PHC reforms. He noted that despite important advances in primary healthcare reform, continued advocacy and revisions are necessary to ensure effective execution.

BRAC Senior Director Akram Hossain said, “Health must be elevated to a core political commitment. All political parties need to take the health sector seriously. There is no alternative to decentralization if healthcare services are to be ensured for 200 million people, and primary healthcare must be delivered at the grassroots level. Both the expansion of services and improvement in quality must move forward together.”

He also observed that the current healthcare system is not sustainable in the long run. In addition, he highlighted the need to increase public participation and ensure parity in service quality between public and private healthcare providers.

Dhaka University Professor Romana Haque said, “It is crucial to clearly define the scope and structure of primary healthcare. Although the number of beds at upazila-level hospitals has increased, there is still no clear guideline on how many physicians should be deployed at the union level or who should be included in the primary healthcare team.” She added that without a well-defined primary healthcare model, fragmented initiatives would not deliver the desired outcomes. The lack of clarity over which services qualify as primary healthcare and which do not is also slowing down the reform process, she noted.

Former President of the Obstetrical and Gynaecological Society of Bangladesh (OGSB), Rowshan Ara Begum, said, “Currently, around 9,000 to 10,000 trained midwives remain unemployed in the country. Properly utilizing them could significantly improve maternal health services. To advance the health sector, maternal healthcare must be integrated as an inseparable component of primary healthcare.”

According to a press release issued by PPRC, stronger initiatives are needed for the successful implementation of primary healthcare reforms. Participants at the meeting described the draft PHC law as a significant milestone in the country’s health reform journey, as it seeks to re-center primary healthcare as the foundation of the healthcare system. They noted that while the draft demonstrates meaningful progress, continued advocacy and refinement will be essential to ensure its effective implementation.

DBTech/EK/MU/OR