Browsing by Author "Adams, Alayne M."

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Bangladesh : an intervention study of factors underlying increasing equity in child survival
(2001) Bhuiya, Abbas; Chowdhury, Mushtaque; Ahmed, Faruque; Adams, Alayne M.
Barriers to participation in BRAC RDP
(BRAC Research and Evaluation Division (RED), 1995-11) Evans, Timothy G.; Mohammed, Rafi; Adams, Alayne M.; Chowdhury, Mushtaque
As part of the BRAC RDP Impact Assessment Study (lAS), a participatory wealth ranking exercise stratified households into four socio-economic groups: groups 1 and 2 being wellendowed with land, assets and generally without survival worries; group 3 households having marginal land holdings, minimal assets and resources devoted exclusively to survival; and finally a "4th group" in which household viability is threatened by poverty, ill-health and other adversities. Although both 3rd and 4th group households are eligible to participate in BRAC RDP, concern about the accessibility of the Programme to the destitute "4th group" along with a general ignorance about the characteristics of this group, provided the rationale for this study. Its purposes are: 1. to establish the prevalence of household poverty in rural Bangladesh and the rate of BRAC RDP participation; 2. to elicit the circumstances which inhibit the "4th group" from participating in BRAC RDP; and 3. to identify changes in the structure of RDP, or the need for new initiatives, to improve their well-being. In August through to October 1994, a field survey was undertaken in five well-established, good functioning RDP Area Offices (AOs). Ten percent of the Village Organizations (VOs) in each of these AOs were selected for the sample (78 VOs in 55 villages). Key informants enumerated all households in the sample villages, and, employing Rapid Rural Appraisal (RRA), ranked them into 3 wealth groups: 1. wealthy households; 2. poor households: and 3. very poor households ( 11,805). In each village, 30 households were selected for interview--! 0 RDP members. I 0 eligible non-members, 5 former members, and 5 ineligible or non-target group (NTG) households. Structured questionnaires containing sections on household composition, health, past crises. socio- economic status and BRAC membership were administered to 1637 households.
Changing health-seeking behaviour in Matlab, Bangladesh: do development interventions matter
(2003) Ahmed, Syed Masud; Adams, Alayne M.; Chowdhury, Mushtaque; Bhuiya, Abbas
Erratum to: The influence of travel time on emergency obstetric care seeking behavior in the urban poor of Bangladesh: A GIS study [BMC Pregnancy Childbirth, 16, (2016) (240)]
(© 2016 BioMed Central Ltd., 9/27/2016) Panciera, Rocco; Khan, Akib; Rizvi, Syed Jafar Raza; Ahmed, Tanvir; Islam, Rubana; Adams, Alayne M.
Erratum to: The influence of travel time on emergency obstetric care seeking behavior in the urban poor of Bangladesh: A GIS study [BMC Pregnancy Childbirth, 16, (2016) (240)]
(© 2016 BioMed Central Ltd., 9/27/2016) Panciera, Rocco; Khan, Akib; Rizvi, Syed Jafar Raza; Ahmed, Tanvir; Islam, Rubana; Adams, Alayne M.
Exploring healthcare landscape in urban Bangladesh: findings from health facility mapping of Dinajpur municipality in Bangladesh
(icddr,b, 2021-05-17) Hasan, Shaikh Mehdi; Tuly, Iffat Nowrin; Ahmed, Shakil; Khan, Shaan Muberra; Das, Susmita; Yusuf, Sifat Shahana; Mehjabin, Nusrat; Rakib, Nibras Ar; Islam, Rahenul; Adams, Alayne M.
This study was funded by Options Consultancy Services Limited, UK, through Urban Health System Strengthening Project (UHSSP). icddr,b acknowledges with gratitude the commitment of Options Consultancy Services Limited, the UK to its research efforts. icddr,b is also grateful to the Governments of Bangladesh, Canada, Sweden, and the UK for providing core/unrestricted support. Special thanks to the Directorate General of Health Services (DGHS), Civil Surgeon and the Mayor of Dinajpur Municipality, and Directorate General of Family Planning (DGFP) for giving permission and supporting the implementation of this study. We also acknowledge all the administrative authorities of health programmes, NGOs, and private health associations for their consent to the survey and for providing information on their delivery points and services. The project could not have been successfully completed without the ceaseless effort of our hard-working teams, a sincere thanks to them.
Factors enabling comprehensive maternal health services in the benefits package of emerging financing schemes: A crosssectional analysis from 1990 to 2014
(PLOS ONE, 9/25/2018) Vargas, Veronica; Ahmed, Sayem; Adams, Alayne M.
Introduction Maternal delivery is the costliest event during pregnancy, especially if a complicated delivery occurs that requires emergency hospital services. A health financing scheme or program that covers comprehensive maternal services, including specialized hospital services in the benefits health package, enhances maternal survival and improves financial risk protection. Objectives The objective of this study is to identify factors that enable the inclusion of comprehensive maternal services in the benefits package of emerging health financing schemes in low and middle-income countries across selected world regions. Comprehensive care is presumed if, in addition to normal delivery, primary health care, and secondary or tertiary hospital care are included. Methods Multilevel regression analysis is performed on 220 health financing schemes and programs initiated during the period 1990–2014, in 40 countries in Sub-Saharan Africa, Asia, and Latin America. Findings About two-thirds of emerging health financing schemes explicitly include maternal care in the benefits package, and less-than-half cover comprehensive maternal services. Provision of any type of maternal services and comprehensive services is significantly associated with the presence of donors/philanthropies as funders, and beneficiaries possessing an ID card that links them to entitled services. Other enabling factors are prepayment and risk pooling. However, private and community insurances are negatively associated with covering comprehensive maternal services, because they are subject to market failures, such as adverse and risk selection. Conclusions Emerging health financing schemes in low and upper-middle-income countries lag in coverage of maternal care. Advancing financial protection of these services in the health package needs policy attention, including government oversight and mandatory regulations. The enabling factors identified can enrich the ongoing discourse on Universal Health Coverage.
Gender, socioeconomic development and health-seeking behaviour in Bangladesh
(Social Science & Medicine, 2000) Ahmed, Syed Masud; Adams, Alayne M.; Chowdhury, A.M..R.; Bhuiya, Abbas
Gender, socioeconomic development and health-seeking behaviour in Bangladesh
(2000-08) Ahmed, Syed Masud; Adams, Alayne M.; Chowdhury, Mushtaque; Bhuiya, Abbas
Health care seeking in poor urban settlements in Sylhet City Corporation, 2013 : a quantitative survey
(Health Systems and Population Studies Division, icddr,b, 2016-06) Islam, Rubana; Rizvi, Syed Jafar Raza; Hillgrove, Tessa; Ahmed, Rushdia; Adams, Alayne M.
Impact of fortified biscuits on micronutrient deficiencies among primary school children in Bangladesh
(© 2017 Plos One, 4/5/2017) Adams, Alayne M.; Ahmed, Rushdia; Latif, A. H. M. Mahbub; Rasheed, Sabrina; Das, Sumon K.; Hasib, Enamul; Farzana, Fahmida Dil; Ferdous, Farzana; Ahmed, Shahnawaz; Faruque, ASG
Background Micronutrient deficiencies can compromise the development potential of school-aged children, and their later health and productivity as adults. School feeding and school-based fortification approaches have been utilized globally to redress nutritional deficiencies in this age group. Objective We explored the acceptability and micronutrient impact of a Bangladesh Government supported school-based micronutrient fortification program for children attending rural primary schools in 10 disadvantaged sub-districts. Methods We applied a mixed methods approach. The quantitative component assessed the impact of micronutrient fortification on 351 children aged 6–11 years using a cohort pre-post research design with a control group. The qualitative component explored the acceptability of the intervention using focus group discussions, body mapping and semi-structured interviews with teachers, school-going children and school authorities. Results Daily consumption of fortified biscuits by primary school children had a significant positive impact on mean levels of iron, folic acid, vitamin B12, retinol and vitamin D controlling for sex, baseline deficiency status, CRP, and H. pylori. Levels of anemia and vitamin D deficiency were also significantly reduced. Qualitative findings indicated the widespread acceptability of the daily biscuit. Teachers perceived students to be more attentive in class, less tired, and some attributed better school performance to biscuit consumption. Children reported similar improvements in concentration and energy levels. Conclusions This study is among the first in Bangladesh to comprehensively assess a school-based fortification program in terms of its acceptability and impact on micronutrient status of children aged 6–11 years of age. While results strongly support this modality of school feeding, research on the cognitive impacts of micronutrient fortified biscuits will help clarify the case for scaled-up investments in school- based feeding program in Bangladesh and other low and middle income countries.
Impact of fortified biscuits on micronutrient deficiencies among primary school children in Bangladesh
(© 2017 Plos One, 4/5/2017) Adams, Alayne M.; Ahmed, Rushdia; Latif, A. H. M. Mahbub; Rasheed, Sabrina; Das, Sumon K.; Hasib, Enamul; Farzana, Fahmida Dil; Ferdous, Farzana; Ahmed, Shahnawaz; Faruque, ASG
Background Micronutrient deficiencies can compromise the development potential of school-aged children, and their later health and productivity as adults. School feeding and school-based fortification approaches have been utilized globally to redress nutritional deficiencies in this age group. Objective We explored the acceptability and micronutrient impact of a Bangladesh Government supported school-based micronutrient fortification program for children attending rural primary schools in 10 disadvantaged sub-districts. Methods We applied a mixed methods approach. The quantitative component assessed the impact of micronutrient fortification on 351 children aged 6–11 years using a cohort pre-post research design with a control group. The qualitative component explored the acceptability of the intervention using focus group discussions, body mapping and semi-structured interviews with teachers, school-going children and school authorities. Results Daily consumption of fortified biscuits by primary school children had a significant positive impact on mean levels of iron, folic acid, vitamin B12, retinol and vitamin D controlling for sex, baseline deficiency status, CRP, and H. pylori. Levels of anemia and vitamin D deficiency were also significantly reduced. Qualitative findings indicated the widespread acceptability of the daily biscuit. Teachers perceived students to be more attentive in class, less tired, and some attributed better school performance to biscuit consumption. Children reported similar improvements in concentration and energy levels. Conclusions This study is among the first in Bangladesh to comprehensively assess a school-based fortification program in terms of its acceptability and impact on micronutrient status of children aged 6–11 years of age. While results strongly support this modality of school feeding, research on the cognitive impacts of micronutrient fortified biscuits will help clarify the case for scaled-up investments in school- based feeding program in Bangladesh and other low and middle income countries.
Impact of traffic variability on geographic accessibility to 24/7 emergency healthcare for the urban poor: A GIS study in Dhaka, Bangladesh
(PLOS ONE, 9/16/2019) Ahmed, Shakil; Adams, Alayne M.; Islam, Rubana; Hasan, Shaikh Mehdi; Panciera, Rocco
Ensuring access to healthcare in emergency health situations is a persistent concern for health system planners. Emergency services, including critical care units for severe burns and coronary events, are amongst those for which travel time is the most crucial, potentially making a difference between life and death. Although it is generally assumed that access to healthcare is not an issue in densely populated urban areas due to short distances, we prove otherwise by applying improved methods of assessing accessibility to emergency services by the urban poor that take traffic variability into account. Combining unique data on emergency health service locations, traffic flow variability and informal settlements boundaries, we generated time-cost based service areas to assess the extent to which emergency health services are reachable by urban slum dwellers when realistic traffic conditions and their variability in time are considered. Variability in traffic congestion is found to have significant impact on the measurement of timely access to, and availability of, healthcare services for slum populations. While under moderate traffic conditions all slums in Dhaka City are within 60-minutes travel time from an emergency service, in congested traffic conditions only 63% of the city's slum population is within 60-minutes reach of most emergency services, and only 32% are within 60-minutes reach of a Burn Unit. Moreover, under congested traffic conditions only 12% of slums in Dhaka City Corporation comply with Bangladesh's policy guidelines that call for access to 1 health service per 50,000 population for most emergency service types, and not a single slum achieved this target for Burn Units. Emergency Obstetric Care (EmOC) and First Aid & Casualty services provide the best coverage, with nearly 100% of the slum population having timely access within 60-minutes in any traffic condition. Ignoring variability in traffic conditions results in a 3-fold overestimation of geographic coverage and masks intra-urban inequities in accessibility to emergency care, by overestimating geographic accessibility in peripheral areas and underestimating the same for central city areas. The evidence provided can help policy makers and urban planners improve health service delivery for the urban poor. We recommend that taking traffic conditions be taken into account in future GIS-based analysis and planning for healthcare service accessibility in urban areas.
Increaseing survival and decreasing inequity in rural Bangladesh
(BRAC, 2001) Adams, Alayne M.; Ahmed, Faruque; Bhuiya, Abbas; Chowdhury, A.M..R.
Innovation for universal health coverage in Bangladesh: a call to action
(© 2013 The Lancet, 2013) Adams, Alayne M.; Ahmed, Tanvir; El Arifeen, Shams E.; Evans, Timothy Grant; Huda, Tanvir M.; Reichenbach, Laura J.; Ahmed, Faruque S K; Ahmed, Shamim; Ahmed, Syéd Masud; Azad, Kishwar; Bhuiya, Abbas Uddin; Mahmood, Shehrin Shaila; Cash, Richard A.; Chen, Lincoln; Chowdhury, Mahbub Elahi Khan; Chowdhury, Ahmed Mushtaque Raza; Christou, Aliki; Halder, Shantana R.; Husain, Mushtuq Mushtaq; Islam, Mohammad Sirajul; Islam, Khaled Shamsul; Huq, Shireen; Hussain, Zakir; Mahmud, Simeen; Mallick, Fuad Hassan; May, Maria A.; Osman, Ferdous Arfina; Peters, David H.; Perry, Henry B.; Rabbani, Atonu; Rahman, Mijanur Aminur; Rahman, Mahmudur Ziaur; Rasheed, Sabrina; Rashid, Sabina F.; Al-Sabir, Ahmed; Standing, Hilary; Mahmud, Simeen
A post-Millennium Development Goals agenda for health in Bangladesh should be defined to encourage a second generation of health-system innovations under the clarion call of universal health coverage. This agenda should draw on the experience of the first generation of innovations that underlie the country's impressive health achievements and creatively address future health challenges. Central to the reform process will be the development of a multipronged strategic approach that: responds to existing demands in a way that assures affordable, equitable, high-quality health care from a pluralistic health system; anticipates health-care needs in a period of rapid health and social transition; and addresses underlying structural issues that otherwise might hamper progress. A pragmatic reform agenda for achieving universal health coverage in Bangladesh should include development of a long-term national human resources policy and action plan, establishment of a national insurance system, building of an interoperable electronic health information system, investment to strengthen the capacity of the Ministry of Health and Family Welfare, and creation of a supraministerial council on health. Greater political, financial, and technical investment to implement this reform agenda offers the prospect of a stronger, more resilient, sustainable, and equitable health system.
Innovation for universal health coverage in Bangladesh: a call to action
(© 2013 The Lancet, 2013) Adams, Alayne M.; Ahmed, Tanvir; El Arifeen, Shams E.; Evans, Timothy Grant; Huda, Tanvir M.; Reichenbach, Laura J.; Ahmed, Faruque S K; Ahmed, Shamim; Ahmed, Syéd Masud; Azad, Kishwar; Bhuiya, Abbas Uddin; Mahmood, Shehrin Shaila; Cash, Richard A.; Chen, Lincoln; Chowdhury, Mahbub Elahi Khan; Chowdhury, Ahmed Mushtaque Raza; Christou, Aliki; Halder, Shantana R.; Husain, Mushtuq Mushtaq; Islam, Mohammad Sirajul; Islam, Khaled Shamsul; Huq, Shireen; Hussain, Zakir; Mahmud, Simeen; Mallick, Fuad Hassan; May, Maria A.; Osman, Ferdous Arfina; Peters, David H.; Perry, Henry B.; Rabbani, Atonu; Rahman, Mijanur Aminur; Rahman, Mahmudur Ziaur; Rasheed, Sabrina; Rashid, Sabina F.; Al-Sabir, Ahmed; Standing, Hilary; Mahmud, Simeen
A post-Millennium Development Goals agenda for health in Bangladesh should be defined to encourage a second generation of health-system innovations under the clarion call of universal health coverage. This agenda should draw on the experience of the first generation of innovations that underlie the country's impressive health achievements and creatively address future health challenges. Central to the reform process will be the development of a multipronged strategic approach that: responds to existing demands in a way that assures affordable, equitable, high-quality health care from a pluralistic health system; anticipates health-care needs in a period of rapid health and social transition; and addresses underlying structural issues that otherwise might hamper progress. A pragmatic reform agenda for achieving universal health coverage in Bangladesh should include development of a long-term national human resources policy and action plan, establishment of a national insurance system, building of an interoperable electronic health information system, investment to strengthen the capacity of the Ministry of Health and Family Welfare, and creation of a supraministerial council on health. Greater political, financial, and technical investment to implement this reform agenda offers the prospect of a stronger, more resilient, sustainable, and equitable health system.
Innovation for universal health coverage in Bangladesh: a call to action
(© 2013 The Lancet, 2013) Adams, Alayne M.; Ahmed, Tanvir; El Arifeen, Shams E.; Evans, Timothy Grant; Huda, Tanvir M.; Reichenbach, Laura J.; Ahmed, Faruque S K; Ahmed, Shamim; Ahmed, Syéd Masud; Azad, Kishwar; Bhuiya, Abbas Uddin; Mahmood, Shehrin Shaila; Cash, Richard A.; Chen, Lincoln; Chowdhury, Mahbub Elahi Khan; Chowdhury, Ahmed Mushtaque Raza; Christou, Aliki; Halder, Shantana R.; Husain, Mushtuq Mushtaq; Islam, Mohammad Sirajul; Islam, Khaled Shamsul; Huq, Shireen; Hussain, Zakir; Mahmud, Simeen; Mallick, Fuad Hassan; May, Maria A.; Osman, Ferdous Arfina; Peters, David H.; Perry, Henry B.; Rabbani, Atonu; Rahman, Mijanur Aminur; Rahman, Mahmudur Ziaur; Rasheed, Sabrina; Rashid, Sabina F.; Al-Sabir, Ahmed; Standing, Hilary; Mahmud, Simeen
A post-Millennium Development Goals agenda for health in Bangladesh should be defined to encourage a second generation of health-system innovations under the clarion call of universal health coverage. This agenda should draw on the experience of the first generation of innovations that underlie the country's impressive health achievements and creatively address future health challenges. Central to the reform process will be the development of a multipronged strategic approach that: responds to existing demands in a way that assures affordable, equitable, high-quality health care from a pluralistic health system; anticipates health-care needs in a period of rapid health and social transition; and addresses underlying structural issues that otherwise might hamper progress. A pragmatic reform agenda for achieving universal health coverage in Bangladesh should include development of a long-term national human resources policy and action plan, establishment of a national insurance system, building of an interoperable electronic health information system, investment to strengthen the capacity of the Ministry of Health and Family Welfare, and creation of a supraministerial council on health. Greater political, financial, and technical investment to implement this reform agenda offers the prospect of a stronger, more resilient, sustainable, and equitable health system.
Innovation for universal health coverage in Bangladesh: a call to action
(© 2013 The Lancet, 2013) Adams, Alayne M.; Ahmed, Tanvir; El Arifeen, Shams E.; Evans, Timothy Grant; Huda, Tanvir M.; Reichenbach, Laura J.; Ahmed, Faruque S K; Ahmed, Shamim; Ahmed, Syéd Masud; Azad, Kishwar; Bhuiya, Abbas Uddin; Mahmood, Shehrin Shaila; Cash, Richard A.; Chen, Lincoln; Chowdhury, Mahbub Elahi Khan; Chowdhury, Ahmed Mushtaque Raza; Christou, Aliki; Halder, Shantana R.; Husain, Mushtuq Mushtaq; Islam, Mohammad Sirajul; Islam, Khaled Shamsul; Huq, Shireen; Hussain, Zakir; Mahmud, Simeen; Mallick, Fuad Hassan; May, Maria A.; Osman, Ferdous Arfina; Peters, David H.; Perry, Henry B.; Rabbani, Atonu; Rahman, Mijanur Aminur; Rahman, Mahmudur Ziaur; Rasheed, Sabrina; Rashid, Sabina F.; Al-Sabir, Ahmed; Standing, Hilary; Mahmud, Simeen
A post-Millennium Development Goals agenda for health in Bangladesh should be defined to encourage a second generation of health-system innovations under the clarion call of universal health coverage. This agenda should draw on the experience of the first generation of innovations that underlie the country's impressive health achievements and creatively address future health challenges. Central to the reform process will be the development of a multipronged strategic approach that: responds to existing demands in a way that assures affordable, equitable, high-quality health care from a pluralistic health system; anticipates health-care needs in a period of rapid health and social transition; and addresses underlying structural issues that otherwise might hamper progress. A pragmatic reform agenda for achieving universal health coverage in Bangladesh should include development of a long-term national human resources policy and action plan, establishment of a national insurance system, building of an interoperable electronic health information system, investment to strengthen the capacity of the Ministry of Health and Family Welfare, and creation of a supraministerial council on health. Greater political, financial, and technical investment to implement this reform agenda offers the prospect of a stronger, more resilient, sustainable, and equitable health system.
Innovation for universal health coverage in Bangladesh: a call to action
(© 2013 The Lancet, 2013) Adams, Alayne M.; Ahmed, Tanvir; El Arifeen, Shams E.; Evans, Timothy Grant; Huda, Tanvir M.; Reichenbach, Laura J.; Ahmed, Faruque S K; Ahmed, Shamim; Ahmed, Syéd Masud; Azad, Kishwar; Bhuiya, Abbas Uddin; Mahmood, Shehrin Shaila; Cash, Richard A.; Chen, Lincoln; Chowdhury, Mahbub Elahi Khan; Chowdhury, Ahmed Mushtaque Raza; Christou, Aliki; Halder, Shantana R.; Husain, Mushtuq Mushtaq; Islam, Mohammad Sirajul; Islam, Khaled Shamsul; Huq, Shireen; Hussain, Zakir; Mahmud, Simeen; Mallick, Fuad Hassan; May, Maria A.; Osman, Ferdous Arfina; Peters, David H.; Perry, Henry B.; Rabbani, Atonu; Rahman, Mijanur Aminur; Rahman, Mahmudur Ziaur; Rasheed, Sabrina; Rashid, Sabina F.; Al-Sabir, Ahmed; Standing, Hilary; Mahmud, Simeen
A post-Millennium Development Goals agenda for health in Bangladesh should be defined to encourage a second generation of health-system innovations under the clarion call of universal health coverage. This agenda should draw on the experience of the first generation of innovations that underlie the country's impressive health achievements and creatively address future health challenges. Central to the reform process will be the development of a multipronged strategic approach that: responds to existing demands in a way that assures affordable, equitable, high-quality health care from a pluralistic health system; anticipates health-care needs in a period of rapid health and social transition; and addresses underlying structural issues that otherwise might hamper progress. A pragmatic reform agenda for achieving universal health coverage in Bangladesh should include development of a long-term national human resources policy and action plan, establishment of a national insurance system, building of an interoperable electronic health information system, investment to strengthen the capacity of the Ministry of Health and Family Welfare, and creation of a supraministerial council on health. Greater political, financial, and technical investment to implement this reform agenda offers the prospect of a stronger, more resilient, sustainable, and equitable health system.
Innovation for universal health coverage in Bangladesh: a call to action
(© 2013 The Lancet, 2013) Adams, Alayne M.; Ahmed, Tanvir; El Arifeen, Shams E.; Evans, Timothy Grant; Huda, Tanvir M.; Reichenbach, Laura J.; Ahmed, Faruque S K; Ahmed, Shamim; Ahmed, Syéd Masud; Azad, Kishwar; Bhuiya, Abbas Uddin; Mahmood, Shehrin Shaila; Cash, Richard A.; Chen, Lincoln; Chowdhury, Mahbub Elahi Khan; Chowdhury, Ahmed Mushtaque Raza; Christou, Aliki; Halder, Shantana R.; Husain, Mushtuq Mushtaq; Islam, Mohammad Sirajul; Islam, Khaled Shamsul; Huq, Shireen; Hussain, Zakir; Mahmud, Simeen; Mallick, Fuad Hassan; May, Maria A.; Osman, Ferdous Arfina; Peters, David H.; Perry, Henry B.; Rabbani, Atonu; Rahman, Mijanur Aminur; Rahman, Mahmudur Ziaur; Rasheed, Sabrina; Rashid, Sabina F.; Al-Sabir, Ahmed; Standing, Hilary; Mahmud, Simeen
A post-Millennium Development Goals agenda for health in Bangladesh should be defined to encourage a second generation of health-system innovations under the clarion call of universal health coverage. This agenda should draw on the experience of the first generation of innovations that underlie the country's impressive health achievements and creatively address future health challenges. Central to the reform process will be the development of a multipronged strategic approach that: responds to existing demands in a way that assures affordable, equitable, high-quality health care from a pluralistic health system; anticipates health-care needs in a period of rapid health and social transition; and addresses underlying structural issues that otherwise might hamper progress. A pragmatic reform agenda for achieving universal health coverage in Bangladesh should include development of a long-term national human resources policy and action plan, establishment of a national insurance system, building of an interoperable electronic health information system, investment to strengthen the capacity of the Ministry of Health and Family Welfare, and creation of a supraministerial council on health. Greater political, financial, and technical investment to implement this reform agenda offers the prospect of a stronger, more resilient, sustainable, and equitable health system.