BUHN 12th Knowledge Sharing Virtual Seminar on Universal Health Coverage (UHC) and Urban Health

The Bangladesh Urban Health Network (BUHN) successfully hosted its 12th Knowledge Sharing Virtual Seminar on “Universal Health Coverage (UHC) and Urban Health” on Sunday, 14 December 2025, from 3:00 PM to 4:30 PM (Bangladesh Time, GMT +6). The seminar brought together senior policymakers, development partners, researchers, practitioners, and civil society representatives to examine persistent challenges and emerging opportunities for advancing universal health coverage in Bangladesh’s rapidly urbanizing context. Moderated by Ummay Farihin Sultana, Project Manager, BUHN, the session fostered an in-depth dialogue on improving equity, efficiency, and integration within urban health systems.

The seminar focused on the growing disparities in access to quality health services in urban areas, particularly among vulnerable populations such as slum dwellers, informal workers, and low-income households. Rapid urbanization has placed increasing pressure on existing health infrastructure, resulting in service delivery gaps, fragmented governance, and high out-of-pocket expenditures. Participants explored how these challenges undermine progress toward UHC and emphasized the need for coordinated, people-centered, and sustainable urban health solutions. Experts from government ministries, development partners, academic institutions, and civil society organizations shared evidence, experiences, and policy perspectives to inform future action.

The objectives of the seminar were fourfold: to examine barriers to equitable, affordable, and quality health services in urban settings; to present recent data, case studies, and innovations related to urban primary healthcare, health financing, and service delivery; to identify approaches for improving collaboration across government, the private sector, and civil society; and to develop actionable policy guidance aligned with national and global UHC goals. These objectives guided the structure of the discussions and framed the exchange of ideas throughout the session.

The seminar began with a welcome address by Dr. Margub Aref Jahangir, Health Specialist (Urban), Health Section, UNICEF Bangladesh. He emphasized the importance of ensuring equitable access to quality health services in urban areas, particularly for marginalized communities. Dr. Jahangir highlighted the value of integrated, people-centered approaches within urban primary healthcare systems and encouraged participants to share practical insights and strategies to address service gaps and accelerate progress toward UHC.

The first presentation was delivered by Mr. Rui Liu, Senior Health Specialist, Asian Development Bank (ADB), who discussed “The Case of ADB Support to Provide Urban Primary Healthcare Services in Bangladesh.” He highlighted ADB’s engagement since 1998 through five project phases to improve urban health and expand access to primary healthcare for the urban poor, utilizing a Public-Private Partnership (PPP) model to finance infrastructure, workforce, equipment, and services for over 43 million people over 27 years, with key achievements including the construction of 195 PHC centers near slums, strengthening city corporation capacity to manage services, and conducting operationally relevant research. He also outlined the next steps, emphasizing the mobilization of domestic resources to sustain urban PHC, with planned expenditures for workforce, facilities, medicines, and equipment.

Following this, Dr. Syed Abdul Hamid, Professor, Institute of Health Economics, University of Dhaka, presented a critical analysis of progress toward UHC in Bangladesh. He framed the discussion around three fundamental questions: whether people are empowered to access essential healthcare, whether health workers are adequately motivated to deliver quality services, and whether political leadership prioritizes investment in health. He noted that current shortcomings across all three dimensions significantly hinder UHC progress. Dr. Hamid also identified key gaps within public health facilities, including limited understanding of service value among patients, lack of clarity among administrators regarding service delivery costs and outcomes, and insufficient recognition of public health service value at the policy level. He stressed that addressing empowerment, valuation, and system-wide awareness is essential for advancing UHC.

The panel discussion further deepened the dialogue on urban health governance and financing. Mr. Shah Imam Ali Reza, Joint Secretary (Planning), Health Services Division, Ministry of Health and Family Welfare (MoHFW), underscored that UHC is a core target under SDG 3.8, requiring improvements in service quality, reductions in out-of-pocket expenditures, and efficient use of public resources. While acknowledging the strength of Bangladesh’s rural health system, he noted that urban primary healthcare has received comparatively less structured attention. He emphasized the need to strengthen urban PHC to reduce pressure on secondary and tertiary hospitals and highlighted an ADB-supported digital health initiative designed to improve referral mechanisms and link urban primary care with higher-level facilities.

Dr. Mohammad Shawkat Hossain Khan, Director (Administration/Research), Health Economics Unit, MoHFW, highlighted the complexity of urban healthcare delivery in Bangladesh, particularly in megacities like Dhaka. He noted that urban services are delivered through a fragmented mix of public, private, NGO, local government, and specialized institutions, resulting in weak coordination and accountability. While secondary and tertiary care are relatively well covered, he pointed out that urban primary healthcare remains underdeveloped and heavily dependent on development partners such as ADB and NGOs. He emphasized that without stronger coordination and clearer institutional roles, achieving UHC in urban areas will remain difficult.

Adding to the discussion, Dr. Sharmin Mizan, PhD, Public Health Specialist, IUPHPSP, LGD, MoLGRD&C, emphasized that urban health encompasses primary, secondary, and tertiary care, all of which must be strengthened simultaneously to ensure population coverage, effective service delivery, and financial protection. She highlighted ongoing UHC-oriented initiatives, including rural health insurance pilots and urban pilot programs. Dr. Mizan noted that progress under the Urban Primary Health Care Services Delivery Project, combined with grid card identification systems and partnerships with Dhaka North and South City Corporations, demonstrates promising steps toward equitable urban health coverage.

From a global and equity-focused perspective, Professor Jahangir A. M. Khan, University of Gothenburg, Sweden, discussed the disproportionate burden of non-communicable diseases (NCDs) in urban areas. He highlighted how unhealthy living and working conditions — such as pollution, overcrowding, lack of green spaces, and limited opportunities for physical activity — exacerbate NCD risks, particularly in urban slums. He further noted that the prevalence of informal employment among the urban poor makes households highly vulnerable to economic shocks, reducing their ability to access healthcare despite the physical proximity of health facilities.

The Chief Guest, Dr. Md. Enamul Haque, Director General (Additional Secretary), Health Economics Unit, HSD, MoHFW shared key remarks during the session, highlighting ADB-supported urban PHC projects as a major milestone in addressing unmet urban health needs and emphasized that efficiency, equity, and quality must guide health financing decisions across the full cycle of revenue generation and spending. He stressed that without improving how resources are allocated, valued, and utilized, the health system cannot deliver equitable and high-quality services, calling for sustained policy attention and evidence-based reforms.

In his closing remarks, Dr. Md. Shamim Hayder Talukder, CEO of Eminence Associates for Social Development and Member Secretary of BUHN, thanked the chief guest, presenters, panelists, and participants for their valuable contributions. He emphasized that achieving UHC in urban areas requires coordinated, multisectoral efforts to strengthen urban primary healthcare, integrate services, and address persistent access barriers. He noted that the seminar provided important guidance for collective action toward building a more inclusive, resilient, and equitable urban health system in Bangladesh.

Based on the discussions, participants agreed on several key recommendations, including expanding integrated care models across all levels of service delivery; prioritizing vulnerable urban populations through targeted outreach and financial protection; strengthening coordination among public, private, NGO, and local government actors; scaling up digital health systems for referrals and data-driven planning; investing in workforce development and infrastructure through sustainable financing; and integrating health promotion and NCD prevention into urban planning. Together, these actions were identified as essential steps toward advancing Universal Health Coverage in Bangladesh’s urban settings.