Care Project (UPHCP) was initiated by the MOLGRD&C with support from ADB, UNFPA and the Nordic Development Fund. In addition to these four major cities, primary health care services have also been provided in the other urban and municipality areas through the NGO Services Delivery Programme (NSDP) funded by USAID and the Support for Basic Services in Urban Areas Project (SBSUAP) funded by UNICEF. The UPHCP also provides reproductive health services through upgraded municipal maternity centres for the provision of comprehensive EmOC services, family planning, and RTI/STD detection and treatment. Under the SBSUAP, primary health care services are given by the Local Government Division of MOLGRD&C as a component of comprehensive package for community development through Urban Development Centres (UDCs).
238.The Government and NGOs undertake national campaigns to increase public awareness on health promotion, disease prevention, polio eradication, vitamin A and iodine supplementation, prevention of injuries, and the care of pregnant women.
Shortfalls and challenges
239.Despite the above programmes, less than 40% of the population has access to modern primary health care services, beyond immunisation and family planning. Overall, Bangladesh spends only 1.2 percent of GDP on health against a WHO target of 5 percent. Health expenditure per capita is barely inadequate to meet expanding health demands in the country (only 12 US$ including US$ 7 private out of pocket against WHO suggested optimum expenditure of $34 per capita per year for the least developed countries). Persons per physician in 2005 were 3,317 against 4043 in 2001. Alongside the Government, about 400 NGOs run 170 hospitals in different parts of the country and these hospitals have about 4,500 beds. Private healthcare facilities are also available in the country and being increasing involved through initiatives like private-public partnership.
Availability of medical facilities
240.Health expenditure, according to a study conducted by BIDS in 2001, is disproportionately high among the poorest household, who spend approximately 38 percent of household income on the treatment of illness compared to the richest household who spend only 3.4 percent, suggesting that poor households face significant economic pressure to fiancé treatment, and open to real risk of indebtedness.