Clinical Epidemiology & Public Health
Public health | Online ISSN 3068-4587
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Volume 3 Number 1 2025
REVIEWS (Open Access)
Healthcare-Seeking Behavior for Chronic Illness Among Urban Slum Dwellers in Bangladesh: A Secondary Analysis and Proposed Policy Framework
Kamruzzaman Mithu
Clinical Epidemiology & Public Health 3 (1) 1-8 https://doi.org/10.25163/health.3110879
Submitted: 07 April 2025 Revised: 28 May 2025 Accepted: 08 June 2025 Published: 10 June 2025
Abstract
Rapid, often unplanned urbanization has reshaped Bangladesh's cities, and slum settlements have absorbed much of that growth — frequently without the infrastructure or health services to match it. This paper offers a secondary, narrative analysis of chronic illness care-seeking among adult slum dwellers, built on the cross-sectional survey data originally reported in Dhaka and Tongi. Rather than collecting new data, we revisit that dataset's descriptive findings — sex distribution, marital status, and Poverty Probability Index (PPI) scores across the two sites — and situate them within a broader literature on primary health care governance, chronic disease self-management, and vulnerable-population access. Descriptive comparisons suggest modest but meaningful site-level differences: Tongi's sample showed a higher proportion of male respondents and a higher mean PPI score than Dhaka's, patterns that plausibly reflect the two sites' distinct labor markets — day labor and informal trade in Dhaka versus export-processing garment work in Tongi. Building on these patterns and the wider literature reviewed, we propose a policy and information-systems framework intended to strengthen chronic illness follow-up in slum settings, including structured medication records, pharmacy-level accountability, and community-based reminder systems. We conclude that closing chronic care gaps in Bangladesh's slums will likely require both better governance of primary care delivery and more consistent, longitudinal data infrastructure than currently exists. This analysis does not present new primary data; its contribution lies in synthesis and in the proposed framework for future intervention and research.
Keywords: Urban slums; chronic illness; healthcare-seeking behavior; Bangladesh; primary health care
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