Despite being a resource poor country, Bangladesh has achieved impressive health gains which make it an example for other developing countries. Over the last decades key health indicators like life expectancy and coverage of immunisation have improved significantly while infant mortality, maternal mortality and fertility rates have dropped considerably. But most of these achievements are mainly quantitative while qualitative improvement is negligible. Poor access to services, low quality of care, high rate of maternal mortality and poor status of child health still remain as challenges of the health sector. This article reviews the health programmes undertaken since independence and the system itself to see which aspects of the policy have contributed to these achievements and challenges. The findings show that the healthcare plans and policy have actually helped to expand services causing quantitative advances while managerial weaknesses and governance problems are the main factors inhibiting qualitative improvement. Finally, the article puts forward some suggestions to address these challenges.