Current Students’ Healthcare Ecosystem in Bangladesh and How to Move Forward

Students are the inaugural part of a nation’s future and Bangladesh is no exception. While newer generations are much more informed than ever before, their mental and physical well-being has taken a back seat due to the country’s ill-equipped healthcare system, which often struggles to provide even basic care for the general public.

Inadequate access to healthcare is a much too common scenario worldwide, but in Bangladesh, it is particularly evident. The country has a severely constrained healthcare system with overcrowded hospitals, an inadequate doctor-patient ratio, and a lack of healthcare insurance, funding and resources. As per WHO, Bangladesh has only 7 doctors available for every 10,000 people. Such shortage results in overcrowded hospitals – as patients lacking access to primary and general practitioner physicians – often seek out specialists in tertiary hospitals or emergencies for minor illnesses. When a nation is struggling to provide adequate generalised care to its citizens, it will have very little resources, funding or specialised care for the student population.

On the mental healthcare front, this problem is particularly dire as faculty and staff are often not trained on how to engage with students’ emotions or identify triggers. A student does not necessarily have to have a clinical mental illness to suffer a decline in physical health. Prolonged generalised anxiety can lead to a decline in physical health. There is also limited understanding and a lack of community support due to persistent mental health stigma. Many times, mental health is overlooked due to misconception – and people fail to do their due diligence to look after their health and the health of their loved ones or address the underlying cause of it.

While most private institutions appear to have the funding to provide counselling and mental health resources, state-funded institutions have the bare minimum. In fact, in most countries, privately funded schools reported that mental health support was a higher priority and identified fewer barriers to provision compared to publicly funded schools. This directly plays out the performance of students in schools and ultimately universities.

Furthermore, Bangladesh lacks comprehensive mental health legislation. While Bangladesh finally replaced the Lunacy Act of 1912 from the colonial era, the Act has plenty of shortcomings. Most importantly, the Act primarily addresses those already diagnosed or suffering from clinical illnesses, rather than focusing on preventive measures. This is a global issue, as many countries do not have sufficient mental health resources, including adequate staff support, access to specialists, and counselling services.

Women are particularly vulnerable in this regard, as they are more likely to be predisposed to anxiety and mental health illnesses and likely to suffer from postnatal depression – which often goes unnoticed or is overlooked. Women are more likely to seek care at a later stage, delaying care for both physical and mental health, and are more reactive than proactive in their approach. Similarly, female students face various challenges throughout their academic years, due to the nature of their symptoms, societal stigma, lack of specialised care, and the level of family support available.

In light of the lack of support from the government, academic institutions, both public and private can and must play a critical role. Schools and universities are ideal environments to address both physical and mental health promotion and prevention for the youth. Notably, the onset of mental health challenges often occurs during childhood – and the majority of children's time during the school year is spent in schools. School counsellors are an integral part of both mental and physical health promotion and prevention – in schools in their roles as leaders, advocates, and mentors for students and teachers. They can extend this care by collaborating with parents and community stakeholders. Parents and teachers spend the most time with a student, whether its primary or secondary schools or higher education.

Nonetheless, the Bangladesh government must invest in healthcare funding as well as strengthen care and policies. In the meantime, private universities must take the lead in advocating for and supporting students’ mental and physical well-being. Institutions with enough resources and funding should hold workshops, and colloquiums for students, parents, and academics to discuss stress management, academic settings and healthy habits. These institutions can also invite scholars, activists, and healthcare professionals to join forces and participate in seminars. As physical and mental well-being have a direct impact on students’ academic performance, providing adequate care in these areas will not only enhance the learning environment but also improve students' performance in exams. Furthermore, it will offer the necessary support that students need to secure good grades, obtain internships, and enhance their job prospects, among other benefits.

To engage in advocacy action, for example, a school counsellor should consider partnering with local, or national professional groups aligned with the mission to eradicate systemic injustice and inequality in education. While many scholars and organisations have discussed the implementation of Artificial Intelligence (AI) to streamline healthcare and improve access, it must be used responsibly. Without data privacy legislation or an adequate platform for monitoring AI biases, the use of AI may only exacerbate inequalities and lack of access to healthcare in Bangladesh.

Afifa Waheed is a legal professional, trained Barrister and healthcare law scholar currently based in the United States. She can be reached at [email protected]