Palliative care is increasingly essential for achieving universal health coverage (UHC) and equitable healthcare, yet it must go beyond broad frameworks to become deeply rooted in local cultures, needs, and resources. Localisation—the adaptation of global strategies to specific community contexts—is key to making palliative care accessible, relevant, and impactful.
In Bangladesh, a country rich in cultural heritage yet challenged by a fragile healthcare system, localising palliative care can empower communities, align services with cultural values, and drive broader health reforms. Despite the World Health Organization’s focus on palliative care, many low- and middle-income countries, including Bangladesh, struggle to provide inclusive, accessible services. With rising rates of chronic and life-limiting illnesses, a localised approach to palliative care is essential not only to meet community needs but also to set a globally relevant example of compassionate end-of-life care. This article explores how localisation can advance palliative care in Bangladesh and outlines key initiatives to make this approach effective.
Current State of Palliative Care in Bangladesh
Palliative care in Bangladesh remains underdeveloped, primarily due to limited resources, a shortage of trained professionals, and a lack of awareness among both the public and healthcare providers. The country faces a growing burden of non-communicable diseases (NCDs) such as cancer, diabetes, and cardiovascular diseases, which frequently necessitate palliative care. However, despite the increasing need, only a small percentage of those requiring palliative care receive it.
Currently, palliative care is primarily available in a few urban hospitals, leaving most of the rural population underserved. Many patients in rural areas, especially those with limited financial resources, do not have access to basic palliative services, forcing families to shoulder the burden without professional support. Furthermore, Bangladesh’s healthcare system lacks an integrated approach, meaning palliative care is often siloed and disconnected from mainstream health services, limiting its reach and impact.
The Importance of Localising Palliative Care
Localising palliative care in Bangladesh is crucial for providing compassionate, culturally sensitive support to those facing life-limiting illnesses. Here, “suffering” often encompasses emotional and spiritual dimensions, shaped by family, religious, and community ties. Addressing these expectations requires incorporating spiritual counseling, traditional healers, and family involvement in care. Localised strategies also reduce barriers like limited healthcare infrastructure, economic challenges, and a shortage of trained professionals.
Mobile clinics and telemedicine can expand access, especially in rural areas. Building community trust through local awareness campaigns can shift cultural hesitations around discussing end-of-life care, promoting it as a compassionate option. Empowering local healthcare workers with culturally relevant training ensures that palliative care resonates with community values. Together, these efforts create an inclusive, sustainable model of palliative care tailored to Bangladesh’s unique needs and cultural landscape.
Strategies for Amplifying Local Voices in Palliative Care
Amplifying local voices is key to effective palliative care, ensuring services are culturally aligned and broadly accepted. Community-based needs assessments involving patients, families, leaders, and healthcare providers can reveal regional preferences in Bangladesh, such as a focus on home-based care and family support. Building on these insights, culturally tailored training for health workers—emphasising empathy, religious customs, and traditional medicine—through partnerships with local institutions can further enhance care.
Community-led awareness campaigns with trusted leaders and influencers help normalise palliative care, reducing stigma. Incorporating traditional healing practices where respected, especially in rural areas, bridges cultural divides and fosters acceptance. Together, these strategies create a compassionate, community-focused model rooted in local values.
Possible Initiatives in Bangladesh for Localised Palliative Care
The need for localised, accessible, and culturally sensitive palliative care in Bangladesh is evident, and several strategic initiatives could greatly enhance its delivery. First, developing community-based palliative care units within local health centres or through partnerships with NGOs would allow services to reach rural and underserved populations, focusing on home-based care, community support networks, and training local health workers. By involving local stakeholders, these units would be sustainable and tailored to specific community needs.
Mobile clinics and telemedicine services also offer valuable solutions, enabling providers to deliver virtual consultations and follow-up care in remote areas, bridging gaps in access due to Bangladesh’s geographic and infrastructure challenges.Integrating palliative care within primary healthcare systems would further strengthen reach and impact, allowing primary care physicians and rural health workers to provide early intervention and continuous care for patients with chronic or terminal illnesses, reducing reliance on specialised hospitals.
Developing national guidelines and policies with input from local healthcare providers, community leaders, and grassroots organizations would ensure that policies are realistic, culturally aligned, and actionable. Establishing advisory councils with representatives from diverse districts, cultures, and religions would create a more inclusive framework.
Finally, engaging local universities and research institutes in researching community-specific palliative care needs, developing culturally relevant training, and assessing localised models can cultivate a generation of well-prepared healthcare professionals equipped to support palliative care expansion across the country. Together, these initiatives could form the foundation of a compassionate, effective, and inclusive palliative care system in Bangladesh.
Recommendations for the Interim Government and Development Partners
To advance palliative care in Bangladesh, the interim government and development partners must pursue a strategic, collaborative approach. Central to this is the creation of a comprehensive National Palliative Care Policy that delineates the roles of healthcare providers, community health workers, and volunteers, setting a solid framework for integration into the national health system. Dedicated funding is also essential to expand care access, especially in rural and underserved areas, and to support the training of healthcare professionals in holistic palliative care methods. Such training, in collaboration with medical institutions and development partners, would enable healthcare workers, social workers, and community volunteers to provide culturally sensitive, compassionate care that addresses both physical and emotional needs.
Promoting community-based models, supported by local NGOs and community leaders, can further drive sustainable, grassroots care delivery. Public awareness campaigns are crucial to educate communities about palliative care’s benefits, reduce stigma, and underscore its role in improving the quality of life and dignity at the end of life. Partnerships with NGOs and international organizations are invaluable, as they bring technical expertise, innovative models, and additional funding that enhance local efforts. Finally, telemedicine services must be implemented to extend palliative care to rural regions, where the necessary infrastructure and training can be supported by development partners, ensuring that those in remote areas also receive essential palliative care services.
Localisation is essential to making palliative care in Bangladesh effective, accessible, and meaningful. By aligning palliative care services with the cultural, spiritual, and practical needs of the population, Bangladesh’s healthcare system can greatly improve. Community-driven initiatives, local leadership, and policies attuned to Bangladesh’s context can create a strong foundation for palliative care, enhancing quality of life for patients and setting a global example.
For the interim government and development partners, positioning palliative care as a core public health service will not only serve vulnerable populations but also establish Bangladesh as a leader in end-of-life care. Through strategic planning, resource investment, and community-focused initiatives, Bangladesh can create a compassionate and inclusive palliative care model that champions health as a human right and inspires broader impact.
Mr. Sumit Banik, a dedicated Public Health Activist and Writer, focuses on health system strengthening and public health programmes, particularly in palliative care. As Project Coordinator at AYAT Education, he works in the Compassionate Narayanganj initiatives in Bangladesh helping to manage WHPCA project in Bangladesh. Starting his public health career at icddr,b in 2009, Sumit has extensive field experience within Bangladesh’s healthcare landscape. Advocating for increased government healthcare funding, stronger rural facilities, and equitable healthcare access, Sumit advocates for a visionary and dynamic policy approach to achieve sustainable and impactful improvements in public health.
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