Bangladesh Tops South Asia in Out-of-Pocket Health Spending, World Bank Report Says

Bangladesh records the highest out-of-pocket (OOP) health expenditure in South Asia, with individuals bearing 79% of total healthcare costs, according to a recent World Bank analysis based on 2023 data.

The report highlights that for every 100 taka spent on healthcare in Bangladesh, 79 taka comes directly from patients’ own pockets, placing the country at the top of the region in terms of financial burden on individuals seeking medical care.

By contrast, Thailand spends only 10% out-of-pocket, while Maldives records 18%, both meeting the World Health Organization (WHO) recommended threshold of 20% or less.

According to WHO guidelines, personal healthcare spending should ideally not exceed 20% of total health expenditure to ensure financial protection for citizens.

In South Asia, only Thailand and Maldives meet this benchmark. Other countries show significantly higher burdens: Bhutan at 42%, Sri Lanka at 46%, India at 49%, Nepal at 51%, and Pakistan at 56%.

The report places Bangladesh at the highest level in the region, indicating that its OOP spending is nearly four times higher than the WHO-recommended standard.

Health experts attribute the high costs to several structural challenges, including expensive medicines, high diagnostic testing fees, and limited capacity in public hospitals. As a result, many patients are forced to rely on private healthcare providers.

Experts further note that excessive and sometimes unnecessary diagnostic testing in private facilities contributes significantly to rising personal healthcare expenses, increasing financial pressure on households.

The findings underscore growing concerns about healthcare affordability and highlight the need for stronger public health infrastructure and financial protection mechanisms in Bangladesh.