The views and opinions expressed in this document are those of the author(s) and do not necessarily reflect the official policy or position of any organisation, employer, client, or affiliated institution.
Health sector corruption in the Bangladesh context
Bangladesh has improved in key global health indicators, such as lowering maternal and child mortality rates and boosting life expectancy. However, corruption in the public health system continues to be a significant and often reported issue. A recent article highlights three major corruption issues: procurement irregularities, widespread absenteeism, and inflated drug prices. Another report identifies bureaucratic corruption, bribery, petty irregularities, and political influence in recruitment processes. These types of corruption significantly weaken the health system—an impact that became evident during the COVID-19 pandemic when services could not contain health emergencies.
Corruption in Bangladesh’s health sector is deeply embedded and complex, influenced by systemic and political issues. This has been exacerbated by the longstanding rivalry between major political parties, which has undermined institutional oversight, allowing corruption to become widespread. For example, bribery has become common in Bangladesh's recruitment, promotion, and transfer procedures. Patients often pay bribes for beds, ambulances, and essential health services. Public doctors are often absent during work hours and refer patients to private clinics where they have financial interests.
These widespread corruption issues lead to high out-of-pocket costs (73%), weaken public healthcare, and increase reliance on treatment abroad. Health facilities in Bangladesh face frequent drug shortages and diminishing trust in medical services. Overall, these problems arise from poor governance, financial mismanagement, and an uncoordinated mix of public and private healthcare providers. Compounding these issues are weak oversight and ineffective monitoring. Without systematic reforms, these problems will undoubtedly worsen.
Progressive efforts by the government in tackling corruption in Bangladesh
Despite the widespread corruption in Bangladesh, the government is launching anti-corruption initiatives. Evidence of these initiatives' potential to reduce corruption is that Bangladesh is no longer listed among the top ten most corrupt countries in the world. The ripple effects of this progress on the health sector are yet to be fully visible, despite promises. Two major anti-corruption reforms have been introduced so far in Bangladesh’s health sector – the Electronic Government Procurement (e-GP) system and the Integrated Budget and Accounting System (iBAS).
Bangladesh introduced e-GP in 2011 through the Central Procurement Technical Unit (CPTU). The system digitises procurement— including in health—to reduce corruption and enhance efficiency. By automating bid submissions, providing better access to tender information, and maintaining a secure audit trail, e-GP has limited opportunities for collusion and manipulation. In the health sector, it has simplified the procurement of medicines, equipment, and infrastructure, allowing for quicker decisions and improved pricing. However, while e-GP minimises front-end corruption, it does not fully address post-award risks—such as the supply of substandard medical equipment—which continue to impact service quality.
Furthermore, iBAS has enhanced the efficiency of health sector procurement in Bangladesh. It speeds up processes by automating payments, integrating with e-GP for seamless transactions, and enabling real-time budget monitoring. These improvements decrease delays, minimise errors, and help prevent corruption. As a result, there is faster access to medicines, equipment, and infrastructure, which supports better healthcare services.
Besides these overarching structural and system-enhancement efforts, specific initiatives aimed at improving governance and accountability were implemented. These encompassed hospital management committees, citizen charters, and third-party monitoring. Legal actions concentrated on stricter licensing and registration, although protections for whistleblowers are still limited. Important digital tools, including the District Health Information Software and Human Resource Information System, were adopted to enhance data utilisation and minimise political interference.
Despite these efforts, corruption in the health sector remains a significant issue. Implementing evidence-based actions and structural reforms is now crucial to attain the desired health outcomes.
Non-government efforts in tackling corruption in the health sector
NGOs in Bangladesh have played a vital role in exposing and tackling corruption in the health sector. Their efforts include research, advocacy, citizen engagement, and legal support.
Transparency International Bangladesh (TIB) has led groundbreaking research. Their 2016 report revealed issues like fake doctors, unauthorised fees, and medicine theft. In a 2023 interview, Executive Director Dr. Iftekharuzzaman clearly stated that “health services are deeply troubled by corruption and lack of accountability.” As such, TIB and BRAC introduced citizen report cards, scorecards, and public hearings. These tools empower communities to report irregularities via hotlines and demand improved governance.
NGOs offer training on ethics and transparency. Gonoshasthaya Kendra incorporates anti-corruption modules into its community health programmes. Additionally, NGOs work with the Anti-Corruption Commission (ACC) and watchdogs to bolster legal frameworks. Ain o Salish Kendra (ASK) provides legal aid to victims of bribery and has filed cases against unauthorised hospital fees.
Although facing recent funding obstacles, NGOs still make a significant impact. Their ongoing cooperation with government agencies and development partners continues to advance efforts toward a more transparent and patient-centred healthcare system.
Conclusion
Corruption in Bangladesh’s health sector is not just a governance failure—it’s a barrier to equitable care, public trust, and national progress. While digital reforms like e-GP and iBAS have curbed some procurement abuses, and NGOs have amplified public scrutiny, there are still systematic gaps—particularly in post-award accountability and service delivery. Closing these gaps requires more than technical fixes; it demands bold political commitment, stronger legal protections, and deep-rooted, systemic institutional reforms. A transparent and accountable health system is essential not just for service delivery or as a policy goal, but as a safeguard and lifeline for the nation.
Monaemul Islam Sizear
Public Health Systems Researcher
Program Manager, VisionSpring
Executive Director, Public Health Foundation, Bangladesh
Email: sizear.monaemul@gmail.com
Contact: +8801717143949