As December 12 approaches, Universal Health Coverage (UHC) Day reminds us that a strong health system must serve everyone, including those with life-limiting illnesses, making Palliative Care a most essential, yet consistently overlooked, component in Bangladesh for ensuring dignity, comfort, and Quality of Life.
UHC’s commitment extends beyond treating curable diseases to guaranteeing pain relief and compassionate support at every life stage. This is particularly relevant in Bangladesh because of three critical issues: firstly, a Critical Gap exists where over 600,000 people annually require palliative care but only about 1 percent receive it—a shocking disparity highlighted in studies such as “The Burden of Palliative Care Needs and Access Disparity in Bangladesh: A National Assessment” (Hossain et al., 2025; BPSCF).
Secondly, the Financial Burden is overwhelming, underscored by the UHC Day 2025 theme, as more than 70% of total health expenditure is Out-of-Pocket (OOP). This figure, documented in reports like the “Bangladesh National Health Account (2017-2021): Health Expenditure and Financing” (Bangladesh National Health Account, 2021), severely threatens to push families into poverty due to the long-term costs of palliative care.
And thirdly, it is a Humanitarian Mandate that UHC must fulfill its goal of providing quality care without financial hardship, ensuring no patient, even in the absence of a cure, is denied the right to be cared for.
Palliative Care in Bangladesh: A Silent Gap in the System
Despite the rising burden of cancer, chronic kidney disease, heart failure, dementia, and other non-communicable diseases, access to palliative care remains extremely limited in Bangladesh. Only a small fraction of patients receive formal palliative support, and most families struggle alone, often without clinical guidance or adequate pain management.
This significant gap is deepened by several barriers, including high out-of-pocket expenses for medications and hospital visits, low public investment in long-term and home-based care, limited availability of trained professionals, weak community-level services, and a general stigma and lack of awareness about palliative care among families.
Why This Service is an Essential Part of UHC?
When we discuss Universal Health Coverage (UHC), the core objective is to ensure healthcare for all, leaving no one behind. Yet, the most neglected group in our country are those who require palliative care for life-limiting or incurable illnesses.
National and international research on health equity clearly indicates the urgency: in Bangladesh, over 600,000 people annually require this compassionate care. Unfortunately, the data reveals a profound gap—only about 1 percent of those in need actually receive the service. This means a massive number of citizens are forced to endure extreme physical and mental suffering during their final days, and UHC is the only viable alternative to alleviate this widespread distress.
However, a significant challenge remains: a critical gap exists in Bangladesh’s current UHC monitoring framework regarding the inclusion of palliative care. To address this humanitarian crisis and build a truly compassionate health system, policy-level declaration and effective implementation of palliative care as an indispensable component of UHC is an urgent national priority.
How UHC Can Transform Palliative Care Access in Bangladesh
Universal Health Coverage (UHC) can revolutionize the accessibility and quality of palliative care in Bangladesh, starting with financial protection for families facing long-term illness by reducing high out-of-pocket expenses, subsidizing pain medicines, and covering home-based services to protect families from catastrophic health expenditure.
A core principle of UHC involves the integration of palliative care into primary health care, embedding it within community clinics and district hospitals to detect needs earlier, reduce hospitalizations, and bring compassionate care closer to communities.
Furthermore, a UHC-driven system would be crucial for ensuring access to essential medicines like opioids, guaranteeing uninterrupted supply, affordability, and proper provider training. An UHC-aligned national plan would also strengthen the health workforce capacity by expanding training for specialist physicians, nurses, and home-care providers.
Finally, UHC plays a vital role in addressing equity by helping to extend palliative care to vulnerable groups often overlooked in traditional planning, such as those in rural areas, the elderly, and the disabled, and terminally ill children.
Why Bangladesh Should Prioritize Palliative Care Within UHC?
Bangladesh should prioritize palliative care within its Universal Health Coverage (UHC) framework for three crucial reasons. Firstly, the nation faces a rising burden of chronic diseases like cancer, kidney failure, and heart disease, meaning a growing number of citizens require care focused on comfort and quality of life, not just cure.
Secondly, ensuring relief from severe pain and suffering is a fundamental human rights obligation, aligning palliative care with the right to health and dignity for all individuals, regardless of their income or illness.
Finally, palliative care is highly cost-effective; by integrating it into primary and home-based care, it can significantly reduce unnecessary hospitalizations, costly emergency room visits, and aggressive end-of-life treatments that offer little benefit, thereby making healthcare spending more efficient for the entire system.
The pursuit of Universal Health Coverage (UHC) in Bangladesh loses its fundamental meaning if citizens with serious illnesses are left neglected.
By strategically embedding comprehensive palliative care services within the UHC framework, Bangladesh can achieve a truly compassionate healthcare system that ensures no one suffers in silence, no family is pushed into poverty due to long-term illness costs, and no patient is denied dignity at the most vulnerable stage of life. This integration is essential for delivering equitable, humane, and complete care to all citizens.
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Author Bio: Sumit Banik is a public health activist and trainer from Bangladesh, dedicated to increasing access to palliative care. He was involved with the “Compassionate Narayanganj” initiative. His work mainly focuses on providing this care at the community level through trained volunteers and health workers. He strongly advocates for raising public awareness about the importance of palliative care and pushing for policy reforms through his various articles and writings. You can reach the author via E-mail: sumitbd.writer@gmail.com
To read the articles previously published on ehospice, please click the link: https://wakelet.com/wake/qPTAnQUqD4W90F7OJOORJ
“The Burden of Palliative Care Needs and Access Disparity in Bangladesh: A National Assessment” (Hossain et al., 2025; BPSCF). I cant find this article, can you help?