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This study evaluates the capacity and service readiness of healthcare facilities in Bangladesh for managing non-communicable diseases.

May 14, 2026Open Access

Capacity and service readiness of facilities for non-communicable diseases in Bangladesh: a health system perspective from two selected districts

MKMasudur Rahman KanchonState University of Bangladesh MAMd. Rakib AkonBRAC University ZTZarin TasnimBRAC University

Key Points

This study evaluates the capacity and service readiness of healthcare facilities in Bangladesh for managing non-communicable diseases.
Cross-sectional study design conducted in 328 public and private health facilities.
Assessment utilized the WHO's Service Availability and Readiness Assessment manual across four domains: trained staff & guidelines, basic equipment, diagnostics, and essential medicines.
A composite mean readiness index score was calculated to determine facility readiness, with a score of 70% or higher indicating readiness.
84% (n = 277) of the facilities are public sector facilities, with high readiness observed for hypertension (HTN) and diabetes mellitus (DM) in district hospitals and Upazila Health Complexes.
No facility met the readiness criterion for chronic respiratory diseases (CRDs).
Key deficiencies in Union-level Health Facilities and Community Clinics were noted, particularly in staffing, diagnostics, and essential medicine supply.

Abstract

BACKGROUND: Non-communicable diseases (NCDs) are a growing health crisis in Bangladesh and a leading cause of morbidity and mortality. This study assessed the capacity and service readiness of healthcare facilities for the management of NCDs, including hypertension (HTN), diabetes mellitus (DM), and chronic respiratory diseases (CRDs), in two selected districts of Bangladesh. METHODS: A cross-sectional study was conducted in 328 public and private health facilities utilising the World Health Organisation's Service Availability and Readiness Assessment manual. The study assessed the facilities' readiness to manage NCDs across four domains: trained staff & guidelines, basic equipment, diagnostics, and essential medicines. A composite mean readiness index (RI) score was calculated using these domains. A facility with a composite RI score of 70% or higher was considered ready to manage NCDs. RESULTS: A total of 84% (n = 277) of facilities belong to the public sector. District hospitals (DH) and Upazila Health Complexes (UHCs) demonstrated high readiness for HTN (83% and 78%, respectively) and DM (78% and 71%, respectively), surpassing the 70% cutoff. However, no facilities met this criterion for CRDs. The highest RI scores were found for equipment for HTN and DM, and in staff & guidelines for CRDs. In contrast, the lowest RI scores were: medicines for HTN (8% in Union-level Facilities and 3% in Community Clinics (CCs)) and diagnostics for DM (4% and 2% respectively). CONCLUSION: PHC-level health facilities, particularly Union-level Health Facilities and CCs in Bangladesh, are critically underprepared for NCD management, with key deficiencies in staffing, diagnostics, and medicine supply. This necessitates an effective, equity-driven approach to equip both public and private healthcare facilities and improve overall NCD care in the country.

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