Data Modeling
Mathematical and Computational Data Modeling
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Volume 1 Number 1 2020
REVIEWS (Open Access)
Bridging the Gap: Primary Health Care and Chronic Illness Management Among Slum Dwellers in Bangladesh — A Review and Care Management Framework
Kamruzzaman Mithu 1*
Data Modeling 1 (1) 1-11 https://doi.org/10.25163/data.1110860
Submitted: 27 July 2020 Revised: 15 September 2020 Accepted: 23 September 2020 Published: 25 September 2020
Abstract
Chronic illness among slum-dwelling populations tends to be discussed in fairly general terms, which is part of the problem — the specifics matter, and they've often gone missing from the conversation. This review looks at how primary health care systems in Bangladesh engage, or more often fail to fully engage, with chronic and contagious illness among adults living in urban slum settlements, drawing together ten studies alongside the cross-sectional survey evidence as its empirical anchor. Methodologically, the review synthesizes findings narratively rather than systematically, combining structured literature searches with a detailed re-examination of the underlying two-site survey (Dhaka and Tongi), which sampled working-age adults through community health worker clusters and household-level data collection. Results point to a meaningful chronic illness burden — roughly one in five adults across both sites — unevenly translated into care-seeking behavior; conditions like hypertension and diabetes prompted formal engagement more consistently than chronic musculoskeletal pain, and care was sought across a genuinely mixed landscape of government facilities, private clinics, pharmacies, and informal or NGO providers, shaped less by preference than by proximity, cost, and time. Building on these patterns, alongside international evidence on community engagement, peer-led self-management, and health system coordination, the paper proposes a patient care management framework centered on centralized data infrastructure, provider communication, and stronger integration of informal care sources rather than their displacement. The conclusion, tentatively but not without confidence, is that meaningful reform depends less on adding new formal infrastructure and more on coordinating what already exists.
Keywords: primary health care; chronic illness; slum dwellers; Bangladesh; care management framework
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