Form law to make primary healthcare constitutional obligation: experts

Health experts and campaigners yesterday urged the immediate formulation of a law making primary healthcare (PHC) a constitutional obligation aimed at achieving Universal Health Coverage (UHC).

They also called for refocusing and strengthening PHC as the foundation of the country’s health system and for better coordination between rural and urban healthcare services, which currently operate in a fragmented manner.

The calls came at a policy dialogue titled “Review of Draft Primary Healthcare (PHC) Legislation” at the CIRDAP Auditorium in Dhaka.

The event was jointly organised by the Power and Participation Research Centre (PPRC) and the Universal Health Coverage Forum, with support from Unicef.

Primary healthcare is the first point of contact for people with the health system and focuses on providing essential health services close to where people live and work. In May last year, the Health Sector Reform Commission recommended that the government make PHC a constitutional obligation and provide it free of cost to ensure universal access. The commission also suggested enacting a specific law to that end. Subsequently, members of the UHC Forum, with technical support from BRAC and PPRC, prepared a draft of the Primary Healthcare Ordinance-2025 and handed it over to the relevant advisers.

Hossain Zillur Rahman, executive chairman of PPRC and convener of the UHC Forum, said achieving UHC would require a special focus on primary healthcare. 

He noted that while health is currently a government responsibility, it is not a constitutional obligation, making a dedicated PHC law essential. 

He also stressed the need to continue dialogue on health sector reform, along with further advocacy and refinement, to ensure successful implementation.

Prof MA Faiz, former director general of the Directorate General of Health Services, said it is the government’s duty to ensure affordable, accessible and quality primary healthcare. He recommended promulgating an ordinance to enable quick reforms in the sector.

Prof Syed Md Akram Hussain, a member of the Health Sector Reform Commission, said the commission’s recommendation to make PHC a constitutional obligation had not yet been implemented. He suggested that UHC Forum members engage political parties to build consensus on the proposed law.

Akramul Islam, senior director (Health and Humanitarian Crisis Management) of BRAC, said a dedicated organisation and structure are needed to oversee PHC, a recommendation included in the draft ordinance. Aminul Hasan, member secretary of the UHC Forum, said strengthening PHC is essential to achieving UHC by 2030.

                              Prof Rumana Huque, executive director of ARK Foundation, emphasised the need for a clear operational model for PHC in both rural and urban areas. Prof Liaquat Ali, Prof Syed Abdul Hamid of Dhaka University, Prof Abul Kalam Azad, and former health secretary Ashadul Islam also spoke at the programme.