When Bangladeshis fall ill, they mostly pay for it themselves. According to WHO health-accounts data, out-of-pocket payments made up 78% of all current health spending in 2022 — far above India (45%), Pakistan (47%) or Sri Lanka (45%), and the highest share in South Asia.
79%
of current health expenditure was paid directly by households in 2023, up from 62% in 2000. The share has risen almost every year.
The trend runs against most of the region. Total health spending has stayed at a little over 2% of GDP for two decades, so as the population has grown richer and sicker with chronic diseases, families have filled the gap — mostly through pharmacies and private clinics.
The workforce is thin too. Bangladesh has about 0.7 doctors and 0.7 nurses and midwives per 1,000 people (2023), and roughly one hospital bed per 1,000. Both have improved, but they remain well below what the WHO considers necessary for universal health coverage.
High out-of-pocket costs push households into poverty, delay treatment until conditions are severe, and fall hardest on the rural poor. Raising public health spending and expanding prepaid financing — insurance or tax-funded — would do more to close the access gap than new buildings alone.
Sources: WHO Global Health Expenditure Database; WHO National Health Workforce Accounts; World Bank WDI (SH.XPD.OOPC.CH.ZS, SH.XPD.CHEX.GD.ZS, SH.MED.PHYS.ZS, SH.MED.NUMW.P3, SH.MED.BEDS.ZS).