1. Health Care Network of Bangladesh
under the Ministry of Health & Family Welfare
Hierarchies in Ministry of Health & Family Welfare
The Ministry of Health & Family Welfare (MOHFW) is one of largest ministries under the
Government of Bangladesh. It is responsible for national level policy, planning and decision
making at macro level, which are then implemented by different executing and regulatory
authorities. The ministry is headed by the Honorable Minister for Health & Family Welfare,
who is assisted by the Honorable State Minister for Health & Family Welfare. The principal
executing staff of the ministry is the Secretary who works with a set of bureaucrats under
him, viz. Additional Secretary, Joint Secretaries/Joint Chiefs, Deputy Secretaries/Deputy
Chiefs, Senior Assistant Secretaries/Senior Assistant Chiefs, etc.
Minister
State Minister
Secretary
Additional
Secretary
Joint Secretary
(Administration)
Joint Secretary
(Hospital)
(Public Health & WHO)
Joint Secretary
Joint Secretary
(Finance)
Joint Secretary
(Coordination)
Joint Chief
(Planning)
Joint Chief (Health
Economics Unit)
Deputy Secretary
Deputy Secretary
Deputy Secretary
Deputy Secretary
Deputy Secretary
Deputy Chief
Deputy Chief
Senior Assistant
Secretary
Senior Assistant
Secretary
Senior Assistant
Secretary
Senior Assistant
Secretary
Senior Assistant
Secretary
Senior Assistant
Chief
Senior Assistant
Chief
Figure-1.1. Hierarchy of Ministry of Health & Family Welfare
Executing authorities under the Ministry of Health & Family Welfare
Under the MOHFW, there are several executing authorities and regulatory bodies. The
executing authorities are Directorate General of Health Services (DGHS), Directorate
General of Family Planning, Directorate General of Drug Administration (DGDA), Directorate
of Nursing Services (DNS), Health Engineering Department (HED), National Nutrition
Program (NNP), Transport & Equipment Maintenance Organization (TEMO), National
Electro-medical & Engineering Workshop (NEMEW) and Essential Drugs Company Limited
(EDCL).
1 | Health Care Network of Bangladesh

2. MOHFW
Directorate
General of
Health
Services
(DGHS)
Directorate
General of
Family
Planning
(DGFP)
Directorate
General of
Drug
Administration
(DGDA)
Directorate of
Nursing
Services
(DNS)
Construction
Management
&
Maintenance
Unit (CMMU)
National
Nutrition
Program
(NNP)
Transport &
Equipment
Maintenance
Organization
(TEMO)
National
Electromedical
Maintenance
Workshop
(NEMEW)
Essential
Drugs
Company
Limited
(EDCL)
Figure-1.2. Executing authorities under the Ministry of Health & Family Welfare
Regulatory bodies under the Ministry of Health & Family Welfare
The Regulatory bodies are Bangladesh Medical & Dental Council (BMDC), Bangladesh
Nursing Council (BNC), State Medical Faculty (SMF), Homeo, Unani & Ayurvedic Board &
Bangladesh Pharmacy Council.
MOHFW
Bangladesh Medical &
Dental Council (BMDC)
Bangladesh Nursing
Council (BNC)
State Medical Faculty
(SMF)
Homeo, Unani &
Ayurvedic Board
Bangladesh Pharmacy
Council (BPC)
Figure-1.3. Regulatory bodies under MOHFW
Directorate General of health Services (DGHS)
The Directorate General of Health Services (DGHS) is the largest executing authority under
the Ministry of Health & Family Welfare. Having over one hundred thousand officers and
staffs, it operates the health care delivery system for the ministry all over the country
extending as low as up to village level. DGHS also provides technical guidance to the
ministry. The activities of the DGHS are implemented both through the regular revenue set
ups as well as under the development programs. The MOHFW undertakes sector-wide
multi-year approach to draw the development programs. The sector-wide multi-year
development program is popularly known as Health, Nutrition and Population Program
(HNPSP), which has been begun in 2003 and will be completed in June 2011. The ministry is
now planning the new sector program to be started from July 2011.
2 | Health Care Network of Bangladesh

3. Director
General of
Health
Services
Additional
Director
General
(Administratio
n)
Additional
Director
General
(Planning)
Director,
Planning,
Research &
Development
Director,
Administration
Director, Central
Medical Stores
& Depot
Director,
Finance
Director,
Homeo, Unani
& Ayurvedic
Medicine
Director,
Management
Information
System
Director, Medical
Education &
Health Manpower
Development
Director,
Myco-bacterial
Disease
Control
Deputy
Directors
Deputy
Directors
Deputy
Directors
Deputy
Directors
Deputy
Directors
Deputy
Directors
Deputy
Directors
Deputy
Directors
Assistant
Directors
Assistant
Directors
Assistant
Directors
Assistant
Directors
Assistant
Directors
Assistant
Directors
Assistant
Directors
Assistant
Directors
Figure-1.4. Administrative set up of DGHS
Health, Nutrition & Population Program (HNPSP 2003-2011)
The development programs of the Ministry of Health & Family Welfare have been
implemented under a sector-wide program called Health, Nutrition & Population Sector
Program (HNPSP). The ongoing HNPSP has been launched in July 2003 and is expected to be
completed in June 2011, when a new sector-wide program will take the course. Currently
the MOHFW is preparing the next sector-wide program. Under HNPSP (2003-2011), there
are 38 Operational Plans (OPs), of which the DGHS implements 19 OPs. The remaining 19
OPs are implemented by MOHFW itself (5 OPs), Directorate General of Family Planning (9
OPs), Directorate General of Drug Administration (1 OP), Construction Management &
Maintenance Unit (CMMU) (1 OP), Directorate of Nursing Services (1 OP), National Nutrition
Program (1 OP) and National Institute of Population, Research & Training (NIPORT) (1 OP).
The chief executive officer responsible for implementation of each OP is called Line Director.
Line Directors are brought on deputation or given additional responsibility beyond his or her
regular tasks. Under each Line Director, there are few to several Program Managers and
Deputy Program Managers depending upon the number of programs under specific OPs.
Like the Line Directors, the Program Managers and Deputy Program Managers are also
brought on deputation or given additional responsibility. The list of the Operational Plans
under DGHS is given below:
3 | Health Care Network of Bangladesh

4. List of Operational Plans (OPs) under DGHS
1.
2.
3.
4.
5.
6.
7.
Alternative Medical Care (AMC)
Communicable Disease Control (CDC)
Essential Service Delivery (ESD)
Health Education and Promotion (HEP)
Human Resource Management (HRM)
Improved Financial Management (IFM)
Improved Hospital Services Management
(IHSM)
8. In-Service Training (IST)
9. Management Information System (MIS)
10. Micronutrient Supplementation (MS)
11. Mycobacterial Disease (Tuberculosis & Leprosy)
Control
12. National AIDS/STD Program (NASP) and Safe Blood
Transfusion Program (SBTP)
13. National Eye Care (NEC)
14. Non-communicable Diseases and Other Public Health
Interventions (NCD&PHI)
15. Pre-service Education (PSE)
16. Procurement, Logistics & Supplies Management
(CMSD)
17. Quality Assurance (QA)
18. Research & Development (Health)
19. Sector-wise Program Management (SWPM)
Management structure and type of health facilities beyond DGHS
The distribution of health infrastructures under the DGHS can be divided into different tiers,
viz. national, divisional, district, upazila (sub-district), union, ward and village levels. At the
national level, there are institutes, both for public health functions as well as for
postgraduate medical teaching/training and specialized treatment for patients.
In each division, there is one divisional director for health and under him/her are deputy
directors and assistant directors. In each divisional head quarter, there is one infectious
disease hospital and one or more medical college(s). Each medical college has an attached
medical college hospital. Some divisional head quarters also possess general hospital and
institutes of health technologies.
The district health manager is called civil surgeon (CS). In each district, there is a district
hospital. Some district hospitals have Superintendent to look after the hospital
management. In others, civil surgeons look after the district hospitals. Some of the district
head quarters have medical colleges and attached medical college hospitals. There are also
medical assistant training schools and nursing training institutes in some districts.
In the upazila, upazila health & family planning officer (UHFPO) is the Health Manager. He
manages all public health programs in the upazila and also looks after the upazila hospital
(31- to 50-bed).
In the union level, one or other of the three kinds of health facilities may exist, viz. rural
health center, union sub-center or union health & family welfare center (UHFWC). In a
union health facility, there is a post of medical doctor. All union facilities possess medical
assistants to provide health service to the people.
In the ward level, community clinics (CC), one for every 6,000 population are being
established. So far 9,525 independent community clinics have been established as of May
2010. The existing union and upazila facilities (4,500) also provide community clinic services.
Therefore, about 14,000 community clinics are already in operation. The Government
estimates that 18,000 community clinics will be required to cover all the rural population.
There remaining community clinics will be constructed and added in next 2 to 3 years. In the
ward or village levels, there are domiciliary workers, one for every 5 to 6 thousand
population. There are 26,436 sanctioned posts of domiciliary workers under DGHS, of which
20,841 are for health assistants (HA), 4,196 for assistant health inspectors (AHI) and 1,399
4 | Health Care Network of Bangladesh

5. for health inspectors (HI). The Directorate General of Family Planning (DGFP) also has
domiciliary family planning staffs to work in the village levels. Currently, the domiciliary
staffs both from DGHS and DGFP share the responsibility of running the independent
community clinics. However, the ministry will soon recruit 13,500 full time community
health care providers (CHCP) to run the community clinics.
DGHS
Divisional
Level
National Level
District Level
Upazila Level
Union Level
Ward Level
Director of
Institute
Principal of
Medical
College
Divisional
Director, Health
Civil Surgeon
Superintendent
Upazila Health &
Family Planning
Officer
Medical Officer
Health
Inspector
Deputy Director
Vice Principal
Deputy Director
Medical Officer
Consultant /
Medical Officer
Jr consultant /
Medical Officer
Medical
Assistant
Assistant
Health
Inspector
Assistant
Director
Assistant
Director
Health
Assistant
Figure-1.5. Managerial hierarchies from national to the lowest level under DGHS
National
Table-1.1. Type of health facilities under DGHS in different administrative tiers
Divisional
District
Upazila
Union
• Public Health
Institute
• Postgraduate
Medical Institute &
Hospital with
nursing institute
• Specialized
Health Center
• Medical College
& Hospital with
nursing institute
• General hospital
with nursing
institute
• Infectious
Disease Hospital
• Institute of Health
Technology
• District Hospital with
nursing institute
• General Hospital with
nursing Institute (in
some)
• Medical College &
Hospital with nursing
institute (in some)
• Chest Clinic (in some)
• Leprosy Hospital (in
some)
• Medical Assistants’
Training School
5 | Health Care Network of Bangladesh
• Upazila
Health
Complex
• TB Clinic (in
some)
• Rural Health
Center (in
some)
• Union subcenter in
some)
• Union Health
& Family
Welfare
Center (in
some)
Ward
• Community
Clinic (in some)

6. Managerial structure and health facilities under Directorate General of Family Planning
(DGFP)
The primary intention of Health Bulletin 2010 is to capture the health information pertaining
to Directorate General of Health Services. However, to give the readers an impression of the
family planning services under the public sector, a brief mention about the latter is
pertinent. The DGFP also has more or less similar type of managerial structure from the
national down to ward levels, viz. director general, directors, deputy directors and assistant
directors at the head office, divisional director, deputy director and assistant director at the
division, district family planning officer (DFPO) at the district and upazila family planning
officer (UFPO) in the upazila. DGFP has limited number of medical doctors, viz. one medical
officer for maternal and child health (MO, MCH) in each upazila, one sub-assistant medical
officer (SACMO – a medical assistant by background) in union health facility. For performing
family planning procedures, DGFP also has FWV (family welfare visitor) in the upazila and
union facility. The domiciliary staffs of DGFP to work in the ward level are called family
planning inspector (FPI), assistant family planning inspector (AFPI) and family welfare
assistant (FWA). The DGFP run union facility which is equivalent to that of union health &
family welfare center of DGHS is called family welfare center (FWC). There are 3,719 HFWCs
at the union level. Besides, DGFP operates 97 MCWCs (maternal and child welfare centers:
24 in union level, 12 in upazila level and 61 in district level), 471 MCH-FP clinics (407 in
upazila level and 64 in district level) and 8 model clinics (2 at national level and 6 at regional
levels). DGFP organizes 30,000 makeshift satellite clinics each month. It also supports
operation of 179 NGO clinics (27 in union level, 86 in upazila level, 44 in district level and 22
in national level).
________________________________
Source of information: DGHS and DGFP (2010)
6 | Health Care Network of Bangladesh