In Bangladesh, the conversation around healthcare often revolves around prevention and cure. Yet, for millions living with life-limiting or terminal illnesses, a different kind of care is needed — one that goes beyond treatment and focuses on comfort, dignity, and quality of life.
This is where palliative care stands as an essential but largely unmet need in the country’s health system.
The Growing Burden of Need
According to recent assessments, more than 600,000 people in Bangladesh require palliative care each year, yet only a fraction of them have access to it. The country’s rapidly aging population, coupled with rising rates of non-communicable diseases such as cancer, cardiovascular illness, and diabetes, has created a silent crisis. For many patients in rural or underserved regions, pain and suffering remain untreated simply because appropriate services do not exist.
While urban areas like Dhaka and Chattogram have a few dedicated palliative care centers, most healthcare institutions still lack trained professionals and integrated palliative services. In government hospitals, end-of-life care is often reduced to basic symptom management, leaving patients and families to cope emotionally and financially on their own.
A Fragmented System and Limited Awareness
One of the core challenges in expanding palliative care in Bangladesh lies in limited awareness — not just among the public, but also within the medical community. Many health professionals equate palliative care with the final stages of cancer, rather than understanding it as holistic, multidisciplinary support that can begin at any stage of serious illness.
Families, too, often avoid discussions about death or comfort care due to cultural taboos and misconceptions. This results in late referrals, avoidable suffering, and emotional distress for both patients and caregivers.
Policy Framework and Institutional Gaps
Bangladesh has made notable progress in health policy over the past two decades, but palliative care still lacks sufficient integration. Although the National Strategy for Palliative Care (2018–2030) was introduced with WHO guidance, its implementation remains slow. A shortage of trained physicians, nurses, and community workers continues to hinder progress.
The Ministry of Health and Family Welfare has initiated pilot programs and collaborated with organizations such as the Bangladesh Palliative and Supportive Care Foundation (BPSCF) and Centre for Palliative Care (CPC), Bangladesh Medical University (Ex, BSMMU), to promote training and awareness. Yet, without stronger government commitment and resource allocation, these efforts risk remaining fragmented and localized.
Learning from Community-Based Models
A few community-based initiatives offer promising models. The Compassionate Narayanganj and Compassionate Korail projects, for example, have demonstrated how local volunteers and healthcare workers can deliver home-based palliative care at minimal cost. These models build on the cultural fabric of empathy and community solidarity — showing that effective palliative care does not always require sophisticated infrastructure, but rather human connection and coordinated support.
Similarly, NGOs such as Palliative Care Society of Bangladesh, Bangladesh Palliative and Supportive Care Foundation, ASHIC Foundation, AYAT Education, and Hospice Bangladesh, have integrated palliative services into their outreach programs, reaching families in remote areas where hospital-based care is often inaccessible. These initiatives illustrate that when local government, civil society, and health institutions collaborate, dignified end-of-life care can be both affordable and sustainable.
The Human Cost of Neglect
For patients living with chronic pain or terminal illness, the absence of palliative care means more than physical suffering. It often results in social isolation, financial collapse, and deep psychological distress. Family members, especially women, become the primary caregivers — frequently without training or support. Many leave their jobs or schooling to provide care, intensifying cycles of poverty.
This gendered burden of caregiving underscores the need to view palliative care not only as a medical service but also as a social justice issue. Every person, regardless of income or geography, deserves access to relief from pain and the right to die with dignity.
Training, Research, and Integration
Expanding palliative care in Bangladesh will require multi-level investment in education and professional development. Medical and nursing curricula should include mandatory palliative care training, equipping future professionals with communication, pain management, and psychosocial support skills.
At the same time, research and data collection must be strengthened to better understand disease burden, care needs, and patient experiences across the country. Without solid evidence and continuous monitoring, policymaking will remain reactive rather than proactive.
Integration is another crucial step. Palliative care should be woven into the entire continuum of healthcare — from primary health centers to tertiary hospitals. This means early identification of patients who may benefit from palliative care, timely referral systems, and collaboration between public health departments and community organizations.
A Call to Compassionate Action
The theme of World Hospice and Palliative Care Day 2025 — “Compassion in Action” — resonates deeply with Bangladesh’s current reality. The path forward demands not only clinical innovation but also empathy-driven leadership. Policymakers, healthcare providers, and communities must work together to ensure that no one faces the end of life in pain or neglect.
Bangladesh has already proven its capacity for large-scale health reforms — from immunization success to community-based maternal care. Now, it must channel that same commitment into palliative and supportive care, recognizing it as an essential pillar of universal health coverage.
Palliative care is not a privilege; it is a human right. As Bangladesh advances toward its vision of “Health for All,” it cannot afford to overlook the millions who are beyond the reach of cure but still within the realm of care. By integrating palliative care into national health priorities, investing in workforce training, and empowering communities, the country can build a compassionate health system that honors both life and dignity — even in its final stages.
Author Bio: Sumit Banik is a respected Public Health Activist and Trainer dedicated to advancing palliative care in Bangladesh, particularly in underserved communities.
His core contribution lies in championing the community-based care model. He was a key coordinator for the ‘Compassionate Narayanganj’ project, which successfully integrated palliative services into the primary healthcare system through trained local volunteers. This work proves that affordable, home-based care is feasible, even in low-resource settings.
Through his extensive writing for international platforms like ehospice, Banik serves as a leading advocate for health equity. He emphasizes that palliative care is a human right and a social justice issue, calling for better government policy, capacity building, and the empowerment of community workers to ensure comfort and dignity for all patients.
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Previous articles written by Sumit Banik and published in ehospice include:
https://ehospice.com/international_posts/ten-years-since-the-resolution-how-is-bangladesh-faring/
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