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Bangladesh needs a comprehensive healthcare system | The star of the day
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Bangladesh needs a comprehensive healthcare system | The star of the day

International Day of Care and Support

The cost of new care solutions introduced by communities and entrepreneurs makes them inaccessible to most families. FILE PHOTO: SK ENAMUL HAQ

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Bangladesh needs a comprehensive healthcare system

The cost of new care solutions introduced by communities and entrepreneurs makes them inaccessible to most families. FILE PHOTO: SK ENAMUL HAQ

Salma*, a young textile worker, moved to Dhaka from Comilla with her partner four years ago and they now have an eight-month-old son. They both found work in the same factory. The factory gave them maternity leave and benefits during the birth of their child, and Salma returned to work after two months of leave. She first placed her son in the factory daycare. Thanks to two breastfeeding breaks during her work, Salma was able to ensure that her child was exclusively breastfed for six months. Even though daycare was free, traveling with a young child was a challenge. She recently opted for in-home child care in her neighborhood, leaving her son in the care of a woman until they got home from work. This service alone costs them Tk 4,000 per month, a significant portion of the family’s expenses given that their combined monthly household income is Tk 35,000.

Shafiq* is a sales manager in a pharmaceutical company and lives in Dhaka with his family, including his elderly mother who needs support in her daily activities. Although his wife, Shefa*, had a degree in accounting from Dhaka University, Shafiq and Shefa decided that Shefa would leave her job at the bank to care for Shafiq’s mother. Shefa hopes to get her job back one day. However, caring for Shafiq’s mother currently remains a priority for the family.

Rahmat* and Rehana* migrated from Mymensingh in search of work and now live in Dhaka with their three daughters aged eight, six and two. Rehana is a domestic worker, while Rahmat pulls a rickshaw. Rehana’s eldest daughter has not yet started school, as she has to care for her two younger siblings while her parents work. Although Rahmat and Rehana would like to send their daughters to school soon, they are currently unable to find an arrangement to care for the youngest, so all three girls stay at home.

Here are some stories from working families in Bangladesh that highlight the challenges of lacking a comprehensive care system.

With the changing nature of work, migration, inflation and climate change, past care arrangements that relied heavily on families are no longer suited to today’s world of work.

As Bangladesh continues to promote women’s economic participation, traditional approaches to care, which rely on women as the primary caregivers within families, remain predominant. This limits women’s opportunities to acquire the education and skills needed to start their own businesses or enter and remain in the workforce and contribute to the national economy. The female labor force participation rate is low, at 21.25 percent.

As new care solutions are introduced by communities and entrepreneurs, their cost makes them inaccessible to most families. The current healthcare system must be reformed to ensure better provision, guaranteed quality, accessibility and affordable prices for all.

The government provides some care services for children, the elderly, and the disabled, but their scope is limited. For example, the Ministry of Women and Children currently operates some 63 publicly funded child care centers across the country. Additionally, the Bangladesh Labor Act, 2006 provides legal provisions for employers to ensure that workplaces have child care facilities, either on-site or off-site.

A comprehensive care system would bring together people, institutions and resources, both public and private, to provide child care, elder care, health care, work injury support and rehabilitation, as well as assistance to people with disabilities and special needs.

The professionalization of care work is essential to provide quality services. Currently, most professions and workers in the care sector are not legally recognized as workers. This maintains informality, produces poor working conditions and provides limited opportunities for skills development and career advancement.

There is a need to standardize care work and organize care workers to ensure their voices are heard and considered when designing decent and dignified working conditions in the care professions.

Moving forward, government, the private sector and workers must together establish a roadmap for change so that the current care burden on women can be reduced through the development of a care system capable of meet the needs of a growing economy and social protection for women. all this in Bangladesh.

*These are not their real names


Tuomo Poutiainen is Country Director of the International Labor Organization in Bangladesh.


The opinions expressed in this article are those of the author.


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