DMCH Struggles to Meet Demand for Affordable Healthcare

Dhaka Medical College Hospital (DMCH)

As healthcare costs continue to rise in Bangladesh, access to affordable care has become a growing challenge for the general public. Many people rely on government hospitals for basic medical services, but facilities like Dhaka Medical College Hospital (DMCH), along with others such as Suhrawardy Hospital and the Dhaka Children’s Hospital, are often overwhelmed with demand.

While these hospitals offer lower-cost care compared to private alternatives, they frequently fail to meet patients' needs, pushing many to seek private treatment despite the financial burden.
Resource Constraints in Public Healthcare

Brigadier General Asaduzzaman Khan, Director of DMCH, openly acknowledges the strain on public healthcare facilities, citing the high patient volumes and severe resource limitations that hinder the quality of care. “The demand far exceeds our capacity,” he explained, emphasizing that overcrowding, long wait times, and shortages of medical supplies are routine challenges.

With limited resources and a constant influx of patients, DMCH and similar public hospitals are under intense pressure. This often results in cramped wards, extended delays in treatment, and varying levels of staff engagement, leaving patients frustrated and dissatisfied.

For many patients, the experience at public hospitals can be disheartening. Milon Haque, a small business owner who was recently admitted to DMCH, shared how overwhelming patient numbers led to delays in his care. “I had multiple health complications, but I couldn’t get timely attention from the doctors,” he said, describing not only the extended wait times but also the subpar conditions and occasional unprofessional behavior from staff.

The lack of timely, adequate care pushed Milon to seek treatment at a private clinic, further straining his finances. For him, the choice between financial strain and essential healthcare was clear, even if it meant spending beyond his means.

Milon's experience is not unique. Parents of young children, especially, face tough decisions when seeking care at institutions like Dhaka Children’s Hospital. A couple recently rushed their two-year-old daughter, Mahi, to the hospital, only to leave in search of a private facility when no bed was available. “I don’t know how long we can bear the expense, but my child’s health comes first,” Mahi’s father explained. For many, the financial sacrifice becomes unavoidable in the face of inadequate public care.
The Appeal of Private Healthcare

While private hospitals in Bangladesh offer a stark contrast, they come at a high price. Despite the steep costs, many patients report a better overall experience. Higher-quality facilities, faster service, and more personal attention are just some of the reasons private care is so appealing.

Enamul Karim, 58, recently received treatment at a private hospital after struggling with the long waits and overcrowded conditions at public hospitals. “The doctors at government hospitals are skilled, but the sheer number of patients means I rarely get the personal attention I need,” he explained. “Private hospitals may be expensive, but the care is far more consistent and immediate.”

This sentiment is echoed across socio-economic classes. For many, the choice to pay for private care is driven by the need for timely and reliable treatment that public hospitals, stretched thin by demand, often cannot provide.
Rising Out-of-Pocket Health Expenditures

A recent report from the Directorate General of Health Services reveals a troubling trend: out-of-pocket health expenditures in Bangladesh now account for approximately 69% of total healthcare costs. Pharmaceuticals, diagnostics, and medical services are the primary contributors to this financial burden. The rising cost of living and economic downturn have only worsened the situation, leaving many Bangladeshis unable to afford necessary healthcare.

This escalating expense forces individuals to make difficult choices between their health and their financial security. For some, delaying medical care due to financial constraints only worsens their condition, leading to higher long-term costs and complications. Moreover, non-medical costs—such as transportation, lost wages, and the need for caregiver support—add another layer of financial strain, which is often overlooked in discussions of healthcare costs.

Public health experts warn that the rising burden of out-of-pocket expenses can exacerbate existing inequalities in access to care, pushing even more people to rely on unqualified providers or delay seeking medical attention altogether.
Structural Inequities in Bangladesh’s Healthcare System

Bangladesh has a vast healthcare network, with over 3,976 public facilities and nearly 1,000 private hospitals and clinics. However, despite this infrastructure, the majority of Bangladeshis still turn to private or unqualified providers for care. A study by the Centre for International Epidemiological Training (CIET) found that only 13% of the population uses government health services, while 27% rely on private or NGO hospitals. Alarmingly, 60% of people opt for unqualified providers due to accessibility and cost concerns.

A study led by Syed Saad Andaleeb of Pennsylvania State University suggests that the funding mechanisms behind public and private hospitals are a key factor in the disparity between service quality. Public hospitals, which operate under tight government budgets, often lack the resources to deliver adequate care, while private hospitals are incentivized by client fees to provide higher-quality services. This economic imbalance pushes more people toward private healthcare options, despite the financial strain.
A Growing Call for Healthcare Reform

The stories emerging from DMCH and other public hospitals highlight the urgent need for comprehensive healthcare reform. To meet the growing demand for quality care, significant improvements are necessary in resource allocation, patient management, and staff training. There is also a growing consensus among policymakers and healthcare professionals that reforms are needed to reduce the financial burden on patients and bridge the gap between public and private healthcare services.

The "Health Care Financing Strategy 2012-2032" envisions a system where the cost of healthcare no longer dictates access to essential services. By improving the efficiency and quality of public healthcare facilities, Bangladesh can ensure that affordable healthcare is accessible to all, not just those who can afford to pay out-of-pocket or seek private care.

As the country moves forward on its path to development, the experiences of individuals like Milon and Mahi’s family underscore the urgency of addressing the systemic challenges facing the healthcare system. Public hospitals like DMCH are the backbone of Bangladesh’s healthcare infrastructure, but unless significant reforms are made, they will continue to struggle to meet the needs of the population.