Dhaka: Health system policymakers, external development partners, and researchers from various countries assembled in Dhaka to discuss the challenges and prospects of urban health in Least and Middle-Income Countries (LMICs).
At the urban health policy dialogue, organized by ARK Foundation and BRAC James P. Grant School of Public Health on Thursday (January 30, 2025), participants emphasized the urgent need for evidence-based policy reforms and program interventions to address health inequities in cities.
According to the World Health Organization, a significant portion of the 4.2 billion people living in cities face inadequate housing, poor transport systems, insufficient sanitation, weak waste management, and poor air quality, all of which pose severe health risks. In particular, the urban poor have limited access to quality health care.
The event brought together government officials and researchers from Nepal, Bangladesh, Ghana, Nigeria, and the UK.
On the occasion, the Director of HERD International Nepal Dr. Sushil Baral emphasized that urban populations were facing health vulnerabilities, particularly poor urban populations who had limited access to quality health care were often masked in government data. “Not only in Nepal but also in other low- and middle-income countries, access to quality health care is limited in urban areas. Governments need to adequately use the available evidence to strengthen urban health systems to ensure that quality health care reaches poor urban populations,” he said.
During the event, Mr. Dr. Md. Enamul Haque, Director General of Health Economics Unit at Health Service Division, Ministry of Health and Family Welfare (MoHFW) emphasized that despite having health financing strategies and urban health policies in place, implementation was limited hindering urban primary health care in Bangladesh.
During the discussions, participants underscored the need for better coordination among government entities, clearer delineation of roles in urban health management, and effective implementation of national policies, protocols, and guidelines for urban primary health care in lower-and-middle income countries. Additionally, they called for establishing data linkages between private healthcare providers and the public health system and improving primary healthcare services to ease the burden on tertiary hospitals.
The event was part of the Community-led Responsive and Effective Urban Health Systems (CHORUS), a research program consortium working in Bangladesh, Ghana, Nigeria, and Nepal. The CHORUS study found that poor urban residents often prefer seeking healthcare services from private and informal providers due to the public sector’s lack of readiness, inadequate resources, and inconvenient service hours.
“As urban populations grow and the prevalence of diabetes and hypertension rises, a wide range of private-for-profit, NGO, and informal providers have emerged to meet healthcare demand. Our research indicates a strong need for linkage between public and private providers,” said Prof. Helen Elsey, CHORUS Co-director. The CHORUS research is funded by the Foreign, Commonwealth & Development Office (FCDO).
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