The government is planning a Tk11,993 crore project to improve primary healthcare infrastructure at the union and ward levels across the country, involving the construction, reconstruction, repair and renovation of 16,265 health facilities.
Under the proposed project, 948 new facilities will be constructed, 6,364 facilities will be reconstructed, and 8,953 facilities will undergo repair and renovation.
The work is targeted for completion by November 2029.
The proposed project, titled “Construction, Reconstruction, Upgrading, Renovation, Repair and Rehabilitation of Health Infrastructure at All Union and Ward Levels of Bangladesh,” has been sent to the Planning Commission for approval.
The entire cost is proposed to be financed from the government budget.
According to the Development Project Proposal (DPP), the main objective is to establish safe, climate-resilient, sustainable and functional primary healthcare infrastructure at the union and ward levels.
The project is expected to strengthen infrastructure for maternal and child healthcare, women’s health, mental health, services for elderly and people with disabilities, basic laboratory services, pharmacies and referral facilities.
Under the plan, 5,936 vulnerable and dilapidated Primary Healthcare (PHC) hubs will be reconstructed, while 8,348 repairable hubs will be repaired and renovated. Another 350 new PHC hubs will be built in priority wards with inadequate healthcare facilities.
The project also includes reconstruction of 428 vulnerable PHC centres, repair and renovation of 605 centres, and construction of 598 new centres in unions without health infrastructure.
Altogether, work will be carried out on 14,634 hubs and 1,631 centres.
The project goes beyond construction of buildings, with each facility expected to receive furniture and medical equipment according to requirements, along with water supply, electricity or solar power, sanitation, medical waste management, fire safety and disability-friendly access.
Facilities will also include waiting areas for mothers and children, safe toilets, ramps, signage and adequate lighting, taking into consideration the needs of women, children, elderly people and those with special needs.
Under the proposed model, union-based health units will be established in rural areas, while ward- or population-based units will be developed in urban areas.
PHC hubs will serve as centres for health promotion and primary services close to communities, while centres will provide relatively broader treatment, basic diagnostic services, pharmacy facilities and referral coordination. Patients requiring specialised treatment will be referred to upazila and district hospitals.
State Minister for Health and Family Welfare MA Muhit told The Business Standard that the government wants to overhaul the country’s primary healthcare system.
“We want to overhaul the primary healthcare system. In this year’s budget, the health sector received the highest allocation in the 54-55 years since independence,” he said.
“After taking responsibility, we saw hospitals collapsing in some places, equipment lying unusable in others and a lack of technicians. We will work to address these gaps,” he added.
The state minister said the government has also decided to establish a basic pathology laboratory at every upazila health complex so that people can receive many common and necessary tests free of charge.
He also said the government plans to establish a national ambulance pool, noting that ambulance services at district and upazila levels have deteriorated over the years.
“We will establish a national ambulance pool so that people can get an ambulance quickly from anywhere in the country and reach a hospital,” he said.
According to the DPP, implementation of the project could reduce travel and waiting times for poor and remote communities, loss of working hours, and some out-of-pocket expenses for medicines and diagnostic tests.
However, it noted that the benefits may not be fully realised unless adequate manpower, medicines, laboratory supplies and other necessary services are ensured.
The project will also take into account risks such as floods, waterlogging, cyclones, river erosion, heavy rainfall and earthquakes during construction. Separate designs have been proposed for haor areas.
Of the 598 new centres, land acquisition costs for 559 sites have been estimated at Tk67 crore. Construction will begin only after verification of land ownership, possession, boundaries, access roads and relevant documents.
The project also provides for continuity of healthcare services during construction. Services may be shifted to safe parts of existing facilities, nearby government buildings or temporary structures.
An estimated Tk9.05 crore has been allocated for renting temporary buildings to keep services running during construction.
The Health Services Division is the sponsoring ministry, while the Directorate General of Health Services (DGHS) will implement the project and the Health Engineering Department will be responsible for construction.
The DPP says manpower, medicines, utilities, cleaning, security and maintenance costs will need to be covered from the revenue budget after completion to keep the facilities operational. It also takes into account operation and maintenance requirements over a 30-year period.
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