Noncommunicable chronic disease in Bangladesh: Overview of existing programs and priorities going forward

Objective: This paper reviews existing NCD programs in Bangladesh and identifies key priorities for the country to help address the NCD burden. Methods: To identify existing chronic disease programs in Bangladesh, country experts were interviewed and literature searches were conducted in PubMed and Ovid Medline (January 1970 to June 2009) for potentially relevant studies focused on tobacco-related illnesses, diabetes or cardiovascular disease. Programs not being implemented at the time of the study were excluded. Programs underway at the time of the study were included. Results: Bangladesh has a total of 11 NCD programs at varying levels of development. Roughly half of the programs involved diabetes; three addressed the reduction of primary risk factors and about half provided infrastructure (e.g., hospitals or clinics) for NCD services or health professional training. The programs were roughly divided between the government and nongovernment organizations (NGOs). Conclusions: The Bangladeshi government and non-government organizations have taken several steps to implement appropriate NCD programs, but there are many areas where efforts could be enhanced or strengthened. Key among them is improved monitoring and evaluation of NCD programs and the development of nationally representative NCD surveillance data which includes prevalence and associated risk factors.