As is the case elsewhere in Asia, urbanization is growing at a rapid
pace in Bangladesh. With the increased urbanization, the basic
amenities of life are not expanding for the urbanites. Rather, the
increased populations have been exerting continuous pressure on the
existing limited facilities. The poor, who constitute a large portion
(45 per cent) of the urban population, are the principal victims of this
predicament and are significantly disadvantaged in access to basic
services, particularly public health services. Urban governance has yet
to be efficient enough to deal with this urgent issue. The country still
lacks adequate policy direction for urban public health and the
management of existing services is also quite inefficient. This paper
attempts to identify the weaknesses of urban governance that result in
the poor having inadequate access to public and primary health services
by reviewing the existing policies and institutional arrangements for the
provision of services and by examining the extent to which they are put
into practice in terms of ensuring access to these services for the urban
poor. Thus the study seeks to identify the inadequacies of the policies
and practices contributing to the lack of primary and public health
services for the urban poor. It draws on the findings of an empirical
study conducted in four slums of the capital city of Bangladesh.