The document outlines the management structure of public sector health services in Bangladesh. It describes that the Ministry of Health and Family Welfare is responsible for health across the country, with some exceptions. It also discusses the various directorates and departments that implement health services, including the Directorate General of Health Services and Directorate General of Family Planning. The document notes challenges including division of roles between the ministry and directorates, centralized management, and shortages in human resources.

1. Public Sector Health Services
Management in Bangladesh
27 May 2016

2. Public Sector Responsibilities
1. Service delivery
2. Regulation
3. Standard setting
4. Quality Control
5. Stewardship

3. Public Sector Health Services
• Ministry of Health and Family Welfare (MOHFW) is
responsible for health of entire country with two exceptions.
• Urban Primary Health Care is the responsibility of respective
Local Government Institutes (City Corporations and
Municipalities) which are under Ministry of Local
Government, Rural Development and Cooperatives
(MOLGRD&C)
• Health, Family Planning and other line departments office
(Health Engineering Department, Family Welfare Visitor
Training Institute, Regional Training Center) are transferred to
the respective Hill District Councils (HDCs) which are Ministry
of Chittagong Hill Tracts Affairs.
• All most every ministries and departments have some sort
provisions of health service delivery – CMH, BGB Hospitals,
Police Hospitals, Railway Hospitals etc.

4. MOHFW
• Minister
• State Minister
• Secretary
• Additional Secretary
• Joint Secretaries/Chief/Director General
 Administration (Human Resource Management)
 Hospital (& Nursing)
 Public Health and World Health Organization
 Finance
 Physical Facilities and Medical Education
 Planning
 Health Economics Unit
• Deputy Secretaries
• Senior/Assistant Secretaries

5. Implementers of MOHFW
• Directorate General of Health Services (DGHS)
• Directorate General of Family Planning (DGFP)
• Directorate General of Drug Administration (DGDA)
• Directorate of Nursing Services (DNS)
• Health Engineering Department (HEU)
• National Institute of Population Research and
Training (NIPORT)
• Transport and Equipment Maintenance Organization
(TEMO)
• National Elector-medical and Engineering Workshop
(NEMEW)
• Essential Drug Company Limited (EDCL)

6. DGHS
• DG
• Additional DGs – Administration; Planning and
Research
• Directors – Deputy Directors – Assistant Directors
 Administration
 Central Medical Store and Depot (CMSD)
 Finance
 Homeo, Unani and Ayurvedic Medicine
 Management Information System (MIS)
 Medical Education and Health Manpower
Development

7. DGHS contd.
 Hospitals and Clinics
 Primary Health Care
 Disease Control
 Microbacterial Disease Control
 Planning Research and Development
 Dental
 Institute of Public Health
 Institute of Public Health Nutrition
 National Institute of Preventive and Social Medicine
(NIPSOM)
 Centre for Medical Education
• Bureau of Health Education headed by Chief

8. DGHS contd.
• Ward : Health Assistant, Assistant Health
Inspector, Health Inspector
• Union : Medical Officer (of USC) and others
• Upazila : Upazila Health and Family Planning
Officer (UHFPO)
• District : Civil Surgeon; Superintendent of
Hospital
• Division : Divisional Director (Health), Director
of Hospital, Principal of Medical College
• National : Director of Institute

9. DGFP
• DG
• Directors – Deputy Director – Assistant Director
 Administration
 Finance
 Audit
 Planning
 Management Information System
 Logistics and Supply
 Information, Education, Motivation
 Maternal Child Health - services
 Field service delivery
 Clinical Contraceptive Service Delivery
 Maternal Child Health Training Institute
 Mohammodpur Fertility Services and Training Center

10. DGFP contd.
• Ward : Family Welfare Assistant
• Union : Family Planning Inspector
Sub-Assistant Community MO
Family Welfare Visitor
• Upazila : Upazila Family Planning Officer
Medical Officer (MCH-FP)
• District : Deputy Director – Family Planning
• Division : Director

11. Regulatory Bodies with MOHFW
1. Bangladesh Medical and Dental Council
(BMDC)
2. Bangladesh Nursing Council (BNC)
3. State Medical Faculty (SMF)
4. Pharmacy Council of Bangladesh (PCB)
5. Bangladesh Homeopathic Board
6. Bangladesh Board of Unani and Ayurvedic
Systems of Medicine

12. Regulatory Functions of MOHFW
1. Permitting Medical, Nursing and allied education
in private sector by MOHFW
2. Registration of hospitals and clinics in private
sector by DGHS through Director, Hospital and
Private Clinics
3. Registration of blood banks in private sector by
DGHS through Director, Hospital and Private
Clinics
4. Registration of Alternate Medical Care (AMC)
Graduates by Director, AMC, DGHS

13. Other Institutions with MOHFW
• Bangladesh College of Physicians and
Surgeons (BCPS)
• Bangladesh Medical Research Council (BMRC)
• Institute of Child and Mother Health (ICMH)
• Bongobandhu Sheikh Mujib Medical
University (BSSMU)

14. Challenges in Health System
Management
• Division of Roles between Ministry and
Implementing Directorates
Ministry too busy in implementation, so less
attention for policy formulation, stewardship,
regulation etc.
• Too much centralized management
• Business as usual, no reform appetite
• To much politicization of government machinery
• Lack of capacity

15. Challenges in Health System
Management
• Service Delivery
 Field based service versus Facility based service – FP,
EPI, Nutrition
 Universal coverage of basic health versus super
specialist facilities (mostly at capital)
 Human Resources
 Shortage
 Mal-distribution
 Skill-mix
 Negative work environment
 Weak knowledge base

16. Neglected areas of Public Sector
responsibilities
• Standard settings – almost absent
• Quality Control – almost absent
• Stewardship – almost absent
• Regulation - weak