There are currently around 122,000 personnel working at various levels in the country’s public healthcare sector. Many senior administrative posts in the sector have more officials than the approved number. In particular, positions such as Director, Principal, Deputy Director, and Deputy Civil Surgeon have been appointed in excess of the approved number of posts. On the other hand, there is a shortage of nearly 50,000 personnel in direct service-providing roles such as doctors, nurses, health assistants, medical staff, and lab technicians. According to relevant sources, this significant shortage is disrupting medical services.
Experts say the number of doctors, nurses, and technicians in Bangladesh is not sufficient in proportion to the population. Even the internationally recommended number of doctors and nurses is lacking.
According to the World Health Organization (WHO), there should be three nurses and five technicians for every doctor in a healthcare system. There should be 23 doctors for every 10,000 people. Based on that, there should be at least two doctors per 1,000 people.
According to the Health Bulletin published by the Directorate General of Health Services (DGHS), the number of registered doctors in the country (as of December 2023) stands at 141,999. Considering Bangladesh’s population of 171 million, there are only 0.83 doctors per 1,000 people. The doctor-to-population ratio in Bangladesh is far behind that of other countries in the Southeast Asia region.
Due to the shortage of doctors and healthcare workers, patients are facing difficulties in receiving services at various government hospitals and healthcare institutions. On the other hand, even though the service providers are often sincere, they are unable to offer proper care under the pressure of too many patients. As a result, those who can afford it are gradually turning away from public hospitals and healthcare centers. More people are seeking treatment abroad. Those who do not have that option are suffering on a daily basis. Experts believe that the government must take urgent steps to address this shortage in the health sector’s workforce. They also think reforms in this sector are essential.
An analysis of the latest bulletin published by the Directorate General of Health Services (November 2024) shows that there is a shortage of frontline service providers in the health sector. Meanwhile, several top-level administrative positions have been overstaffed. There are 134 approved posts for Director, Principal, Vice Principal, and equivalent ranks. However, 189 people have been appointed to these posts—55 more than the approved number.
There are 156 approved posts for Deputy Director and equivalent ranks at the DGHS. However, 314 officials are currently working in those positions, which means 158 extra appointments. For Assistant Director, Civil Surgeon, and similar ranks, a total of 280 posts have been approved, yet there are 487 officials assigned—207 more than approved. In the case of Deputy Civil Surgeon, Upazila Health Officer, and Family Planning Officer, there are 1,170 approved posts. But 3,199 people are working in these roles—an excess of 2,029 appointments.
According to relevant sources, this overstaffing at the top level has not only increased costs for the health department, but many of these officials are retaining their posts while continuing to enjoy government benefits. However, according to DGHS sources, there are multiple reasons for appointing double or even triple the number of officials in these administrative posts. Many officials are on leave for higher studies abroad or are attached to other institutions in the country while pursuing higher degrees, so they are being kept as OSDs (officers on special duty). In addition, many officials have been appointed to positions that technically do not exist. That is why the health bulletin reflects the presence of excess officials. The Directorate, however, has confirmed that the situation has recently been adjusted.
According to the bulletin’s statistics, more than 34 percent of government-approved positions across various levels in the health sector remain vacant. Most of these unfilled posts are frontline, service-delivery roles. There are 38,042 approved positions from grades 1 to 9. Among them, a total of 7,925 positions are vacant. An analysis of the data shows that while there is excess staffing in positions such as Director, Principal, Vice Principal, and similar ranks, there are 4,367 vacant posts for Senior Consultants, Junior Consultants, and Assistant Surgeons.
The Directorate General of Health Services (DGHS) states that the high number of vacancies in Consultant and Assistant Surgeon posts is creating challenges in both central and field-level medical services and coordination. Work is already underway to expedite recruitment for these vacant posts.
Acknowledging the manpower crisis in the country’s health sector, Dr. Moinul Ahsan, Director (Hospital) of the Directorate General of Health Services, told Bonik Barta, “The main problem we always face in providing services is the shortage of manpower. Our Directorate is working in a coordinated manner to resolve this issue. But another problem is the uneven distribution of appointed personnel. Instead of focusing most recruitments in Dhaka, it’s important to appoint people at the grassroots level so that all segments of the population can access services. We are also working to ensure that those who are already in service can provide the highest level of care to patients.”
The largest number of vacancies in the health sector is in lower-level approved positions, particularly those in grades 11 to 16. There are 17 types of posts within this range, including Sub-Assistant Community Medical Officer, field workers, Health Inspectors, Assistant Health Inspectors, and various categories under Medical Technologist roles such as pharmacy, dental, lab, radiology, radiotherapy, and physiotherapy. The government has approved a total of 92,294 positions for these roles, of which 32,526 remain vacant. In addition, out of 26,049 posts under grades 17 to 20, a total of 12,585 are vacant.
Bonik Barta made several attempts to contact Professor Dr. Md Abu Zafar, Director General of the Directorate General of Health Services (DGHS), to learn more about the severe manpower shortage in the country’s health sector, but was unable to reach him.
Due to the large number of unfilled doctor posts at the field level, medical services across the country are being disrupted. Officials from various district and upazila hospitals reported that the shortage of Medical Technologists in district and upazila hospitals and health complexes is making it difficult to ensure full-fledged healthcare services.
There is a severe shortage of doctors in the health sector compared to the country’s large population. Experts working in the sector believe that a comprehensive and well-structured plan is essential to ensure quality healthcare services.
Regarding the issue, public health expert Dr. Lenin Choudhury told Bonik Barta, “The country lacks the comprehensive planning necessary to provide healthcare services. There aren’t enough doctors or skilled teams; there’s also a shortage of nurses and technicians in proportion to doctors. As a result, a major manpower crisis is unfolding in the delivery of healthcare services. Proper planning and reforms are needed to run the health sector in a well-organized manner. But we don’t see that happening.”