Palliative care in Bangladesh is still emerging, yet rising chronic illness, aging populations, and poverty make its expansion urgent. Community-based programs are vital for reaching underserved areas, especially urban slums and rural regions with limited healthcare access.
Volunteers play a central role, offering compassionate support to patients and families. The study “A Qualitative Study of Experiences, Motivations and Challenges for Volunteers…” sheds light on their lived experiences, revealing both their impact and the barriers they face. These insights offer a roadmap for strengthening Bangladesh’s palliative care system in ways that are sustainable, culturally sensitive, and responsive to local resource constraints.
Volunteers’ Motivations and Experiences
Volunteers in Bangladesh’s palliative care system are driven by personal and social motivations, often inspired by caring for sick relatives or witnessing suffering in their communities.
Their work is emotionally fulfilling, with deep satisfaction drawn from patient gratitude and connection. Beyond basic healthcare, volunteers offer emotional support, health education, and even assist with cultural rituals after death, reflecting a holistic and compassionate approach.
Their shared community background fosters trust and culturally sensitive care.
Training methods vary: Compassionate Narayanganj project Initiatives offers structured, three-day sessions led by professionals, while Compassionate Korail relies on experiential learning through shadowing. Though both models have value, volunteers voiced a need for more comprehensive and ongoing training, including refreshers and practical skills like symptom recognition and blood pressure monitoring.
Addressing this gap is crucial for strengthening Bangladesh’s community-based palliative care framework.
Challenges Faced by Volunteers
Despite their dedication, volunteers in Bangladesh’s palliative care sector face numerous challenges that threaten the sustainability of their work. A major issue is the lack of essential resources—medicines, food, and transport—especially for families who cannot afford basic needs.
Infrastructure gaps, such as the absence of ambulances or care centers, worsen the situation, particularly during crises like COVID-19. Social barriers also persist, with women volunteers facing family resistance due to cultural norms that discourage community engagement, especially with male patients.
Balancing personal responsibilities like education and jobs adds further strain. Additionally, initial mistrust from communities—fearing NGO-led scams—hindered early outreach. However, once trust was built, acceptance grew, highlighting the need for culturally sensitive recruitment and consistent engagement. Addressing these challenges is vital to strengthen volunteer-driven care and ensure long-term impact.
Palliative Care in Bangladesh: Key Recommendations
Strengthening palliative care in Bangladesh requires a multifaceted approach.
A key recommendation is to recruit and train local community volunteers, fostering trust and cultural sensitivity. Training programs should feature core modules on communication and emotional support, plus region-specific content like disaster preparedness.
A national curriculum with local adaptations would ensure consistency. Volunteers must be integrated into formal healthcare teams through joint visits and mentorship to enhance care quality and their confidence.
Emotional support is crucial for volunteer retention, so establishing peer support groups and counseling services is vital to prevent burnout. To address resource shortages, strategic partnerships with NGOs, microfinance institutions, and businesses are necessary.
Finally, public awareness campaigns, led by volunteers as advocates, are essential to build community trust and acceptance of palliative care as a compassionate service.
Policy Recommendations for Bangladesh
Bangladesh’s health system has long prioritized maternal, child, and infectious disease care, leaving palliative services underdeveloped.
To build a more inclusive model, the government should establish a national palliative care strategy that includes community-based approaches, aligned with WHO’s call for universal access. Integrating palliative care into primary healthcare—especially at union and upazila levels—would expand reach to rural areas.
Medical curricula must include palliative care for doctors, nurses, and health workers, enabling better collaboration with volunteers. Though volunteers may not seek payment, small stipends, travel support, or recognition can sustain their motivation and acknowledge their vital role in patient care.
Addressing Gender-Related Challenges
In Bangladesh, gender-related barriers hinder women’s participation in community-based palliative care. Women volunteers often face family resistance due to safety concerns and cultural norms, especially when caring for male patients or being away from home. This limits women’s involvement and restricts the reach of care, as many female patients prefer female volunteers.
To overcome these issues, community engagement is crucial. Organizations must sensitize families to the value of women’s contributions through awareness campaigns. Additionally, training programs should include gender-sensitive modules on safe and respectful engagement. Implementing supportive policies like mentorship and secure travel arrangements will foster a more inclusive volunteer base.
Integration with the Existing Healthcare System
To ensure palliative care thrives in Bangladesh, it must be integrated into the national healthcare system. Currently dominated by fragmented NGO efforts, a coordinated model would enhance sustainability.
Leveraging community clinics and family welfare centers can help identify patients, with trained volunteers providing household follow-up. Clear referral pathways to local hospitals would improve outcomes. Embedding palliative care into national programs—such as those for NCDs, tuberculosis, and elderly care—would boost efficiency.
Integration would also encourage government ownership, reducing dependence on donor funding and scattered initiatives, while creating a more accessible, scalable, and resilient palliative care framework across the country.
Lessons from Kerala, India
Bangladesh can learn from Kerala, India, where community-based palliative care has earned global recognition for its sustainability and impact.
Rooted in volunteerism and community ownership since the 1990s, Kerala’s model built trust and long-term engagement.
Government support through policy integration and funding, along with structured training for volunteers and healthcare providers, ensured consistent service quality.
A strong network of NGOs, professionals, and community groups further strengthened advocacy and resources. Bangladesh can adapt these elements to enhance its own palliative care efforts, while customizing the approach to fit its distinct cultural, geographic, and economic realities for lasting relevance and effectiveness.
Future Research Directions
Volunteer-driven palliative care in Bangladesh holds great promise, yet gaps remain in understanding its long-term impact. Future research should assess outcomes like pain relief, quality of life, and reduced hospital visits, while exploring economic benefits and gender-specific challenges, especially for female volunteers in rural areas.
Insights into volunteer motivation and retention are also crucial for sustainability. The study “A Qualitative Study of Experiences, Motivations and Challenges…” reveals that volunteers are not just caregivers but agents of change, offering culturally sensitive, compassionate support.
Strengthening training, addressing resource gaps, and integrating volunteers into formal healthcare—while learning from Kerala’s model—can help Bangladesh build a more equitable system. With the right policies, resources, and community engagement, palliative care can bring dignity and hope to the most vulnerable, ensuring no one is left behind.
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A pdf version of the report can be downloaded here.
Author: Sumit Banik is a public health professional and trainer dedicated to improving health equity and community well-being. He designs and leads impactful health initiatives while writing on issues like palliative care, women’s empowerment, healthcare access, and social justice. His work blends advocacy, storytelling, and grassroots action. He played an active role in the Compassionate Narayanganj Initiative under the WHPCA project. You can reach the author via E-mail: sumitbd.writer@gmail.com
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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