‘Advancing Maternal and Newborn Health Care in Bangladesh: Strengthening Quality of Care Through Space, Design, and System Innovation’
DHAKA, Bangladesh, July 8, 2025 – The Policy Dialogue on ‘Advancing Maternal and Newborn Health care in Bangladesh: Strengthening Quality of Care through Space, Design, and System Innovation’ was held today in Dhaka, convening senior government officials, health care professionals, architects and engineers from PWD and HED, NGO representatives, and development partners. The event marked a critical step toward improving maternal and neonatal health outcomes by integrating social, geographical, and administrative realities into the country’s health care service design and delivery centering space and physical environment. It was jointly hosted by Directorate General of Health Services under the Ministry of Health and Family Welfare and international non-profit organization specializing in health and health care quality improvement, the Institute for Healthcare Improvement (IHI).
ADG (Planning and Development) of DGHS, MOHFW, Dr. Sheikh Sayidul Haque chaired the event while Dr. Ashrafi Ahmed, NDC, Director General of DGFP attended as a special guest. Dr. Md. Shibbir Ahmed Osmani, Joint Secretary, Public Health, MOHFW; Brig. General Mir Sarwar Hossain Chowdhury, AFWC, PSC, Chief Engineer of HED, MOHFW; A.K.M. Suhrawardy, Superintending Engineer, PWD; Prof. Dr. Liaquat Ali, Chairman of Pothikrit Foundation and member of Health Reform Commission; Prof. Farhana Dewan, President of OGSB; Prof. Dr. Md. Mahbubul Hoque, President of Bangladesh Neonatal Forum, Brig. General (Retired) Dr. AFM Rafiqul Islam, Country Director of IHI in Bangladesh along with high officials from WHO, World Bank, UNICEF, UNFPA, BRAC, SMC and other development partners were also present.
The dialogue spotlighted the urgent need to rethink how health care spaces are designed and services are delivered particularly at the community and sub-district levels to improve quality of care, patient dignity, and system efficiency.
Experts emphasized that health care models from other countries must be adapted, not replicated. Service redesign must be rooted in Bangladesh’s specific cultural, geographical, and administrative context. Recommendations from the dialogue called for inclusive engagement of gynecologists, service users, and disability advocates in future planning processes to create responsive and patient-centered care environments. Participants called attention to longstanding infrastructure challenges such as overcrowded wards, outdated layouts, and a lack of dedicated maternity and neonatal units. Budgetary limitations, shortage of human resources and logistical barriers that have slowed progress in hospital expansion and reconstruction efforts were also highlighted.
The dialogue highlighted the overstretched capacity of community clinics and the need to prioritize service integration at the grassroots level. Proposals included upgrading community clinics to provide 10-bed maternal wards, ultrasound services, and breastfeeding support. However, key services such as Kangaroo Mother Care (KMC) remain absent at this level, pointing to an urgent need for expansion and capacity building. At the same time, importance of zero separation has been repeatedly brought up to ensure mothers and newborns are not separated after delivery. Kangaroo Mother Care (KMC) and zero separation are techniques for keeping newborns, especially preterm or low birthweight babies close to their mothers through skin-to-skin contact and shared care immediately after birth to promote bonding, breastfeeding, and better health outcomes. To ensure all of these, the space design of a health care service center design needs to be mindful and patient-centric keeping in mind how to better ensure the patients and their companions’ comfort, safety, privacy, dignity and flexibility for religious and cultural practices related to childbirth.
A critical gap Identified was the absence of formal training In hospital architecture In Bangladesh. Participants noted that institutions like BUET currently do not offer specialized courses in health care facility design. Stakeholders stressed the importance of training architects and engineers to create functional, hygienic, and patient-friendly spaces with features such as ramps, designated and accessible washrooms, and integrated maternal-newborn units on the same floor.
Simple interventions such as ensuring privacy with curtains during delivery and maintaining clean, safe labor rooms were recognized as low-cost, high-impact solutions. Speakers reiterated that investing in dignity and respectful care can significantly improve patient trust and service uptake, even without major infrastructure overhauls.
Speakers also raised concerns about the arbitrary nature of current facility-level decision-making. Many protocols are guided by habit rather than clinical standards, reinforcing the need for context-specific, evidence-based operational guidelines.
Key recommendations included:
- Integrate space into maternal health and infrastructure strategies for all public and private facilities in Bangladesh. Set minimum standards, align with national health strategies, and incorporate redesign into MNH frameworks.
- Update space standards to include private birthing spaces, prayer areas, and improved hygiene facilities.
- Routine five-year facility reviews focusing on neonatal capacity, infection control, and patient safety standards.
- Universal pregnancy registration linked to digital platforms for accurate tracking and referrals.
- Introducing patient-friendly service flow models and crowd management systems to reduce confusion and improve service experiences.
- Coordinated service planning at Union and sub-district levels to reduce duplication and improve referral systems. Redesign Union Health and Family Welfare Centers (UHFWCs) and Community Clinics for antenatal care (ANC), delivery, postpartum care, and newborn care.
- Establishing routine maintenance protocols for water, electricity, ventilation, and sanitation.
- Allocating budget for sustainability practices such as energy-efficient lighting and clean water access alongside the flexibility to upgrade and renovate existing spaces to meet minimum standards shifting focus from development budget to revenue budget.
IHI has been working in Bangladesh since 2018 in close collaboration with the Ministry of Health and Family Welfare, Government of Bangladesh and development partners to improve quality of care in maternal and newborn health.
About the Institute for Healthcare Improvement (IHI)
The Institute for Healthcare Improvement (IHI) is a leading, globally recognized not-for-profit health care improvement organization that has been applying evidence-based quality improvement methods to meet current and future health care challenges for more than 30 years. IHI provides millions of people in health care with methods, tools, and resources to make care better, safer, and more equitable; convenes experts to enable knowledge sharing and peer-learning; and advises health systems and hospitals of all sizes in improving their systems and outcomes at scale. IHI’s mission is to innovate and lead transformational improvement in health and health care worldwide.