The health and nutrition policies and programs of Bangladesh have prioritized efforts in rural areas for the past 45 years. Therefore, providing the urban poor with equal access to high-quality health and nutrition services has become an urgent development concern.
Bangladesh is rapidly urbanizing, with the urban population increasing by 35% between 2001 and 2011. In 2011, about 23% of Bangladesh's people lived in cities. However, more than half of the country's people are likely to live in cities by 2050.
The government estimated that there were 14,000 slum areas in 2014. Health problems are exacerbated in these communities because of high population densities, huge shares of migrants from rural regions, inadequate public water and sanitation services, and low-quality housing. Most of the average health and nutrition outcomes are poorer for slum residents than for non-slum residents. Average socioeconomic characteristics also are generally poorer for slum residents than for non-slum residents.
For the most part, rural areas have been the focus of health and nutrition policies and programs. Therefore, the urban poor have not had adequate access to health and nutrition services. In addition, there is a lack of information on urban health. As Bangladesh continues its urbanization process, the country risks losing the health benefits it has gained if its cities are not made healthier.
Equal access to quality care, continuity of care, patient-centeredness, and patient rights are not adequately prioritized in the urban health care system. A lack of responsibility permeates the system as well. Noncommunicable disease services are limited.
As a result, we need to reorganize the urban health system so that we can treat chronic diseases, improve access to care for marginalized populations, and accommodate the needs of the working population. Furthermore, we should ensure a cohesive collaboration between ministries, NGOs, and the private sector by dividing roles clearly, coordinating financial resources and accountability, and building capacity.