Bangladesh is suffering from a severe human resources for health crisis—in terms of a shortage of qualified providers, an inappropriate skills-mix and inequity in distribution—which requires immediate attention from policy makers.
A study revealed that the density (per 10,000 population) of physicians and nurses in Bangladesh increased over the last decade (from 1.9 physicians and 1.1 nurses in 1998 to 5.4 physicians and 2.1 nurses in 2007), though it remains much lower than the estimated average for low-income countries in 1998. The density of dentists has increased, but remains very low (from 0.01 in 1998 to 0.3 in 2007).
The density of formally qualified health care professionals (doctors, nurses and dentists) is lower than other south Asian countries (7.7 in Bangladesh, compared to 21.9 in Sri Lanka, 14.6 in India and 12.5 in Pakistan) and falls far short of the estimate projected by World Health Organization (23) which would be needed for achieving targets for the Millennium Development Goals. During this time, the density of traditional birth attendants declined (from 55 in 1981 to 33 in 2007), presumably due to the stoppage of traditional birth attendant training by the Bangladeshi government in 1998.
The current nurse-doctor ratio of 0.4 (i.e., 2.5 times more doctors than nurses) is far short of the international standard of around three nurses per doctor. An estimate of shortage based on the doctor-population ratio currently prevalent in low-income countries revealed a shortage of over 60,000 doctors, 280,000 nurses and 483,000 health technologists in Bangladesh.
“The large-scale shortage of qualified healthcare providers, coupled with an inappropriate skill-mix (more doctors than nurses and technologists) needs urgent attention to cater to the healthcare needs of the population,” the study said.
1. Ahmed SM, Hossain MA, Rajachowdhury AM, Bhuiya AU. The health workforce crisis in Bangladesh: shortage, inappropriate skill-mix and inequitable distribution. Human Resources for Health 2011; 9: 3. (open access)