Healthcare in the Margins: A Qualitative Study of Healthcare Access and Utilization in Bangladesh's Informal Urban Settlements

This study investigates healthcare access and health-seeking behavior in informal urban settlements of Bangladesh, focusing on the roles played by key stakeholders, public, private, NGO, and informal sectors, toward positive health outcomes. Utilizing data gathered from group discussions (N = 5) and case studies (N = 22) in five informal urban settlements, we uncover many important barriers to healthcare access, with those linked to economic and infrastructural shortcomings emerging as particularly critical. There is available healthcare, but public hospitals face overcrowding and long waiting lists, mistreating poorer patients, and the price of private health facilities is unaffordable for many residents. Culturally relevant alternatives, so-called informal healthcare providers, local pharmacies (unlicensed) in particular, and traditional birth attendants (TBAs) are important, although they often offer services that include risks such as over-prescribing and insufficient training. Factors including financial stress, low health literacy, and a fragmented health care system drive health inequities. This study underscore s the importance of enhancing health literacy and education to enable marginalized groups to make effective health choices. The study provides fresh insights into the healthcare needs and health inequities in these informal urban settlements. These findings reinforce the relevance of SDG 3 goals by emphasizing the need for inclusive, equitable, and community-oriented healthcare approaches to ensure healthy lives and promote well-being for all.