Turn recommendations into focused, inclusive action agenda, say stakeholders

Stakeholders on Sunday stressed the urgent need to translate the Health Reform Commission's recommendations into a focused and inclusive action agenda that responds to ground realities and citizens' expectations.

The call came at a consultation titled "Health Reforms: Review of Commission Recommendations and Way Forward" and jointly hosted by the Power and Participation Research Centre (PPRC), UHC Forum, and United Nations Children's Fund (UNICEF) at a hotel in the capital.

The session was chaired and moderated by Dr Hossain Zillur Rahman, executive chairman of PPRC and convener of UHC Forum.

Participants included current and former officials of the Directorate General of Health Services (DGHS) and Directorate General of Family Planning (DGFP), members of the Health Reform Commission, public health experts, representatives from the private sector and academia, and media professionals.

They noted that while the reform commission's report marks an important milestone, there is now a pressing need to move beyond vision to execution.

Speakers from diverse backgrounds pointed to critical challenges in implementation readiness, institutional clarity, and the need for sharper prioritisation to ensure that the momentum of reform is not lost.

A consistent theme was the gap between citizens' expectations, especially in areas like maternal dignity, emergency services, primary healthcare, and the health system's current delivery architecture.

It was observed that despite extensive proposals, the report lacks a clear result framework, baseline data, and defined milestones necessary for time-bound action.

Speakers highlighted the potential of digital innovations, including e-prescriptions and global positioning system (GPS)-enabled ambulance networks, to bridge access gaps.

However, these must be embedded in a wider culture of accountability, integration, and inclusive service delivery.

Participants emphasised the importance of ensuring that recommendations are aligned with realistic financing strategies and that institutional reforms, such as creating a Bangladesh Health Commission and unified service architecture, must be grounded in political and administrative feasibility.

Attention was also drawn to gender-responsive reforms, with calls for specialised facilities, referral strengthening, and ensuring access to menstrual and reproductive health services for women in hard-to-reach areas.

Speaking at the event, Dr Hossain Zillur cautioned against viewing the report as an end in itself.

"In a country like ours, nothing is linear. We must see the post-report phase as part of a democratic process," he said.

Stressing the need for social validation and collective ownership, he urged the Health Reform Commission and the civil society to jointly articulate a priority action agenda for 2025 with a priority to ensure legal steps to make primary healthcare a constitutional right, as recommended by the commission.

He called for the creation of a feedback and validation mechanism that centres on user experience and community input.

Besides, he emphasised the need to resist the temptation of endless new pilots and instead repurpose the existing infrastructure and lessons learned into a more integrated and accountable health system.

Former DGHS director general Dr Abul Kalam Azad said this is an opportunity to enhance efficiency in the healthcare system.

He noted that two key steps are crucial to implementing the commission's recommendations - amending the constitution where necessary and passing an ordinance to give the recommendations legal effect.

The consultation concluded with a renewed consensus that bold yet grounded steps must follow the reform commission's report.

A roadmap for 2025 anchored in inclusivity, feasibility, and urgency was proposed as the next critical step in Bangladesh's health reform journey.

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