The Healthcare System in Bangladesh: Funding, Care for Foreigners and Health Risks

World Bank indicators describe a system little funded by the community: about 2% of GDP devoted to current health spending, of which nearly 80% paid directly by households at the time of care. Life expectancy at birth is about 75 years. These orders of magnitude explain why international insurers and France Diplomatie insist on the financial preparation of a stay: hospital treatment is generally paid in advance or on discharge, before any reimbursement.

As Bangladesh is linked to France by no social security agreement, no coordination applies: no European card, no cross-border cover form. How the public network works (Ministry of Health and Family Welfare, university hospitals and district establishments) should be confirmed on the health authorities’ websites; the reimbursements possible for a French national are presented in the page healthcare reimbursement in Bangladesh.

France Diplomatie writes that “medical infrastructure in Bangladesh is insufficient”. Some establishments in Dhaka offer acceptable care and are suggested to travellers by a short list on the France Diplomatie Health page, which also includes an international research centre specialised in digestive disorders. Outside Dhaka, medical resources are very limited, even non-existent. Serious cases most often require medical evacuation to Bangkok or Singapore.

For a resident, the choice of provider is therefore made beforehand, with their insurer: checking direct payment, hospitalisation ceilings, medical evacuation and response time. Private hospitals are not cited here; the list of establishments retained by the embassy can be consulted on the France Diplomatie website.

The official sources consulted describe no health insurance scheme open to foreign residents. A French national is therefore treated at their own expense, with the reimbursement they derive from their situation: French scheme retained for a seconded employee (unilateral secondment provided for by French law), the Caisse des Français de l’Étranger (the voluntary social protection body for French expatriates), international insurance or travel assistance. France Diplomatie considers an assistance contract or insurance covering all medical costs, including surgery and hospitalisation, and medical repatriation essential, because the embassy cannot pay these costs.

See the guide CFE, the page expat health insurance and repatriation and assistance.

The general emergency number is 999 (police, fire brigade, rescue services); 1090 gives information and advice during natural disasters. The French embassy can be reached on +880 2 55 66 86 00, in the Baridhara diplomatic enclave in Dhaka; the consular section is on Madani Avenue, in the same enclave. During the monsoon (June to the end of September), roads are often cut and the journey to a care facility is planned according to weather bulletins.

Trains are crowded, roads and domestic flights are often disrupted, and many boats have no suitable safety equipment: these transport constraints weigh on the time taken to reach care and justify an assistance contract including medical transport.

Dengue is present: the risk peaks during the monsoon from June to October but persists all year across the territory. There is no curative treatment and anti-inflammatories are to be avoided. Malaria concerns almost exclusively the thirteen districts bordering Myanmar and India, especially the Chittagong Hill Tracts and the west of the country; Dhaka is generally spared but sometimes affected. The Nipah virus appears seasonally from December to May, with neither treatment nor vaccine: avoid bats and animals that may carry it, as well as contaminated fruit and raw date palm juice.

Typhoid fever is transmitted by contaminated water and food. It is recommended to consume only capped or sealed drinks, or filtered, boiled or chemically disinfected water, to avoid raw or undercooked food and medicines sold in the street (France Diplomatie).

From November to March, air pollution is severe in large cities, mainly in Dhaka: France Diplomatie recommends a quality mask outdoors, an air purifier at home, doors and windows closed during peaks and limited outdoor activity. People with asthma or vulnerabilities consult their doctor before the dry season.

The French vaccination schedule must be up to date. Depending on the conditions and length of stay, vaccines against hepatitis A and B, typhoid, meningitis ACWY (dry season or epidemic), rabies, chikungunya, dengue, Japanese encephalitis and, for children under 15 on frequent or long stays, tuberculosis are to be discussed with a doctor or an international vaccination centre.

France Diplomatie advises against buying medicines from street vendors; a chronic treatment is prepared before departure, with a prescription and sufficient quantities. The usual precautions also apply to contact with animals, exposure to heat and sun, road safety and swimming. A medical consultation is needed after any risky exposure or persistent fever, particularly in dengue season.

For families, the organisation of paediatric care and maternity is prepared with the insurer before settling, as international contracts generally apply a waiting period to maternity and sometimes require that conception take place after joining.