Muddling through: limitations and challenges of the health policy process in Bangladesh

This article is an attempt to analyse health-related policies in Bangladesh in the light of the policy cycle. It explores how health policies have been developed and implemented in the specific Bangladeshi context. Formulating a comprehensive health policy has been difficult despite several trials and experiments. Generally, a highly centralized top-down approach has been followed with the policy process conditioned by partisanism, bureaucratization and non-participation. The influence of internal and external forces in agenda setting has been apparent and prioritizing of policy options has happened without adequate research and analyses. The failure to effectively implement policies has been due to absence of sincere political will, resistance of different professional and pressure groups, mal-coordination among implementing agencies and inadequacy of policy evaluation and impact assessment. These factors create obstacles toward adopting an integrated holistic national health policy with proper strategies for implementation.