Date of publication:

01/08/2026

Bangladesh

Do domestic laws and policies provide access to secondary and tertiary healthcare services for forcibly displaced and stateless persons?

ANALYSIS

Assessment by population

Refugees
Asylum-seekers
Analysis

The laws or policies of Bangladesh do not explicitly address the right to access secondary public health care services for refugees or asylum-seekers in general. However, the current law and policies of Bangladesh provide for access to secondary public health care services to all people residing within the territory of Bangladesh. Refugees and asylum seekers can get access to secondary public healthcare services in Bangladesh paying the same amount as Bangladeshi Nationals. In the case of Rohingya refugees residing in the camps, they also require authorization from respective CiCs and health partners to take them to the secondary hospitals and the health partners pay the costs of the treatments which are in line with government approved SOP. Affording the cost of the services is a barrier for the refugees and asylum seekers, particularly the urban refugees, as they do not have any right to work or job in Bangladesh. 

The Constitution of People’s Republic of Bangladesh states in Article 15(a) that it is one of the fundamental obligations of the state to ensure the necessities of life that includes treatment to its citizens. Though this article focuses on the citizens, Article 18(1) of the Bangladesh Constitution states that “[t]he State shall regard the raising of the level of nutrition and the improvement of public health as among its primary duties...”.1 The constitution has guaranteed the right to life and liberty of all person2 and through broad interpretation of this right to life, the judiciary has included the right to access health care as a fundamental right.3 The government has enacted an act in 2018 titled ‘Communicable Diseases (Prevention, Control and Eradication) Act, 2018’ to address public health emergencies and to reduce health risks.4 The Act applies to all individuals in general and hence applies to Rohingya refugees and other asylum-seekers. The Local Government (Union Parishad) Act, 2009 also states the duty of local governments to play a crucial role in the monitoring and delivery of public healthcare services at the Union Level (Union Parishads are the lowest administrative unit).5 To grant access to healthcare services to all people, the parliament has recently enacted an Act titled ‘Drugs and Cosmetics Act, 2023’ that ensures availability of drugs to all and hence applies to refugees and asylum seekers also.6 The National Health Policy 2011 does not directly address the secondary healthcare service, but it has stated its vision to increase and expand the easy availability of equality based, client-oriented quality health care services.7

There are many facilities for providing secondary and tertiary healthcare services to the people residing in Bangladesh. Private hospitals, mostly in metropolitan areas, as well as public healthcare facilities in sub-districts, districts, medical colleges, and specialized urban hospitals offer secondary and inpatient care.8 The government has established 429 Upazila (Sub-district) health complexes at primary care level, 110 Maternal & Child Welfare Centers (MCWCs), 62 district hospital at secondary level, 31 medical & dental college hospitals, 3 maternal and child specialized hospitals and 22 postgraduate level specialty facilities at tertiary level.9 The non-Rohingya refugees and asylum-seekers can get their secondary healthcare services in these facilities as the law does not put a barrier in such access to healthcare services by paying the same amount for services as Bangladeshi Nationals. Affording the cost of the services is a barrier for the refugees and asylum seekers, particularly the urban refugees, as they do not have any right to work or job in Bangladesh. 

 A unified and coherent health system has been built for the Rohingya refugees/FDMNs by the Government of Bangladesh and other health partners working in the refugee camps in Cox’s Bazar. The Rohingya refugees residing in the refugee camps in Cox’s Bazar, Bangladesh, face a sort of barrier in accessing these healthcare facilities due to several factors such as restrictions on movements outside camps, inadequate financial support, lengthy process and many other factors. There is a Standard Operating Procedure (SOP) in place which is to facilitate the referral of Rohingya-refugee and asylum seeker patients from the camp health facilities to pre-identified secondary and tertiary health care institutions for advanced medical care. Withing the camp, there are 5 field hospitals providing secondary healthcare services to the Rohingya refugees, but to get service from these hospitals, referral from the primary health care facilities (Health Post, Primary Health Centre) is necessary. The SOP was developed by the Word Heath Organization (WHO), International Organization for Migration (IOM) and UNHCR. It requires several formalities such as the approved common referral form issued by the medical officer &/or designated staff from the referring health facility (Health Post, PHC), patients and attendants Identification Card (ID), to complete the facility-based medical referral register/database and approval of the Camp in Charge. In case of emergency situation, these procedural formalities create a hurdle for the implementing health partners and health interest of the refugee population. Moreover, the SOP does not address the mental health of the Rohingya refugee population at all. 

This referral procedure implemented by the government of Bangladesh creates a barrier to full realization of right to secondary healthcare services. The conditions put on accessing secondary healthcare services do not ensure absolute access to health facilities, drugs, services or timely medical attention in the event of sickness. The World Health Organization (WHO) reports on individuals facing a myriad of health challenges, ranging from infections to chronic diseases, with no discernible route to urgent medical attention.10

Despite all of these policies and measures relating to access secondary healthcare, the refugees are not getting proper health services, from acute hospital care to specialized outpatient services. Due to the long distances and few roads within the camp, it is difficult for Rohingya refugees to travel to health services.11 Seldom are there critical coordination barriers at a camp level in approval processes to permit refugees out of the camps for elective referrals.12 Also, the services provided by the Government health facilities are not of adequate quality, and the Rohingya refugees are also restricted to access specialized hospitals. A significant contributing reason to the delay in attaining universal referral capability for health partners is insufficient funding for referral services.13 In 2020, 8128 patients from the camps were referred by UNHCR and IOM-supported partners (UNHCR 63%, IOM 37%). Out of these recommendations, 35% went to Upazila Health Complexes, Field Hospitals, and PHCs in Ukhiya and Teknaf, 55% went to Sadar District Hospital, Cox's Bazar and 9.2% went to Chittagong, a city near Cox's Bazar.14 5346 patients were referred by UNHCR in 2021, with 67% going to Cox's Bazar Sadar Hospital and 12% going to Chittagong Medical College Hospital.15 This number of referrals, which is about 1%, is quite low compared to the huge number of refugees currently residing in Cox’s Bazar.  

  • 1

    Article 18(1), The Constitution of People’s Republic of Bangladesh

  • 2

    Article 32, The Constitution of the People‌‌‍’s Republic of Bangladesh

  • 3

    Writ Petition No. 1783/1994 (Doctor’s strike case); Dr. M. Farooque v. Bangladesh, 48 D.L.R. 438 (HCD 1996) (Bangladesh).

  • 4

    Section 5, Communicable Diseases (Prevention, Control and Eradication) Act, 2018

  • 5

    Section 6 and 7, Local Government (Union Parishad) Act, 2009

  • 6

    Section 6, 14, Drugs and Cosmetics Act, 2023

  • 7

    National Health Policy 2011, Ministry of Health and Family Welfare, The Government of People’s Republic of Bangladesh

  • 8

    Bangladesh Health System Review. Health Systems In Transition, 5 (3), 2015: WHO Regional Office for the Western Pacific. p. xxi; available at: https://apps.who.int/iris/handle/10665/208214  

  • 9

    Bangladesh Digital Health Strategy 2023-2027, Ministry of Health and Family Welfare Government of the People’s Republic of Bangladesh, p. 8 available at: https://dghs.portal.gov.bd/sites/default/files/files/dghs.portal.gov.bd/page/4124d18a_ab99_40e2_8fef_ff4052948739/2024-04-23-07-09-48541d4dd55108137e50961ebcba0477.pdf

  • 10

    WHO’s Transformative initiative enhances healthcare for refugees in Rohingya Camps, World Health Organization, (4 March 2024) available at: https://www.who.int/bangladesh/news/feature-stories/item/who-transformative-initiative-enhances-healthcare-for-refugees-in-rohingya-camps 

  • 11

    Tarannum, S., Elshazly, M., Harlass, S., & Ventevogel, P. (2019). Integrating mental health into primary health care in Rohingya refugee settings in Bangladesh: Experiences of UNHCR [Article]. Intervention, 17(2), 130–139. doi: 10.4103/intv.Intv_34_19. 

  • 12

    ibid

  • 13

    Health Sector Strategic Plan 2023-24, Health Sector, Cox’s Bazar, p. 19

  • 14

    Patient Referrals and Transfers to Secondary & Tertiary Level Healthcare Facilities for the Refugee/Forcibly Displaced Myanmar Nationals in Cox’s Bazar, Bangladesh. 

  • 15

    Health Sector Strategic Plan 2023-24, Health Sector, Cox’s Bazar (August 2022)

    LAW & POLICY

    Related provisions of domestic law or policy

    The Communicable Diseases (Prevention, Control and Elimination) Act, 2018

    Legal provision

    Section 5: Duties and functions of the Directorate

    (1) To fulfill the objectives of this Act, within the purview of the general or special power of the Government the duties and functions of the Directorate shall be, inter alia, as follows, namely:- (a) Prevention, control and eradication of communicable diseases and taking concerted initiatives including the development of action plan with a view to providing protection to the people from its national and international spreading; (b) Taking assistance from government, private, local and international agencies for the implementation of the action plan mentioned in Clause (a); (c) Addressing emergency situations relating to public health and taking necessary initiatives for the enhancement of awareness, reduction of health related risks, prevention, control and eradication of communicable diseases; (d) Giving necessary directives to isolate infected areas from uninfected areas, prevent the outbreak of the said disease in the uninfected areas and prevent its reoccurrence in the infected areas; (e) Taking necessary actions for the prevention of unnecessary use and misuse of the antibiotic drugs used in the treatment of communicable diseases; (f) If any person affected by any communicable disease is given treatment in any residence, other buildings, clinic, hospital and diagnostic center or if such an establishment is considered as the source of such disease, inspecting the said place or establishment and taking necessary measures thereby; (g) Conducting the physical test and laboratory test of the affected person and, if need be, administering antibiotic, vaccine or medicine; (h) Giving directives to such person with whom there is information relating to any communicable disease to send the information relating to the said disease to the Directorate; (i) Killing harmful insects, and with a view to prevention and control of vector borne diseases- (i) Applying insecticide to residences, other houses, mosquito nets, curtains, bed-sheets, and other usable clothes; (ii) Determining the safe dose of insecticides; (iii) Entering any compound for collecting information; (iv) Management of breeding place; (v) If insecticide is applied to control the vectors of any communicable disease, abstaining from washing, whitewashing or plastering it within the next 5 (five) months, and preventing any measures to be taken on its surface; (j) Inspecting and testing of food, beverage, or their raw materials at the time of their manufacturing, preservation, transportation and distribution to detect contamination and spuriousness; (k) Keeping any such person who is suspected to have been infected by any communicable disease in quarantine or in isolation in a specific hospital, temporary hospital, establishment or home; (l) Preventing germ induced contamination and destroying or removing the source of infection; (m) Prohibiting such engineering, agricultural or industrial projects that may cause increase or spread of malaria and other communicable diseases; (n) Prohibiting the sales of such kind of goods that may hamper the effectiveness of long lasting insecticidal net (LLIN) of insecticidal net seal or curtain; (o) May lock down any marketplace, mass gathering, station, airport, seaport, and land ports temporarily in order to prevent the spread of a communicable disease; (p) Prohibiting inbound and outbound movement of aircrafts, ships, buses, trains and other vehicles as well as their movement from one place to another within the country with a view to preventing the spread of communicable diseases; (q) Performing other tasks including carrying out the duties assigned by the Government time to time. (2) The Director General shall remain responsible for carrying out the duties and performing tasks under this Act.