Health ministry’s PICU project marred by massive corruption

A project worth Tk63.86 billion was undertaken to strengthen preparedness for future health risks alongside tackling pandemics, expand intensive care capacity, and enhance critical care services for children. However, six years later, despite the project's completion, not a single one of the planned 16 Paediatric Intensive Care Units (PICUs) has become operational. Likewise, an initiative to establish Intensive Care Units (ICUs) in 50 district headquarters hospitals has failed to provide functional services.

An evaluation report by the Implementation Monitoring and Evaluation Division (IMED) of the Ministry of Planning has revealed that severe lack of coordination, frequent changes of project directors, flaws in needs assessment, and weak management effectively caused the multi-billion-taka initiative to collapse. Health experts say this represents not only an administrative failure but also a striking example of serious neglect of public health and a lack of accountability.

The project, titled Emergency Response and Pandemic Preparedness (ERPP), was largely financed by the World Bank. However, due to the lack of significant progress within the stipulated timeframe, the lender suspended disbursement of part of its committed funding.

Public health expert Dr Mushtaq Hossain said, “A pattern of extreme irresponsibility was evident in this project. Had the 16 PICUs and ICUs in 50 district hospitals been made operational as planned, the current treatment crisis facing children suffering from measles, pneumonia and other complex illnesses could have been substantially mitigated.”

He added, “The new government could potentially restore this financing through negotiations with the World Bank. The funds could then be utilised for targeted projects aimed at improving healthcare services and disease prevention.”

Under the project, 16 separate PICUs were to be established beyond the existing facilities at 14 medical college hospitals, the Bangladesh Shishu Hospital and Institute, and the Institute of Child and Mother Health. These units were intended to provide advanced treatment for critically ill children and were expected to play a vital role in saving the lives of patients suffering from measles, pneumonia, severe infections, congenital diseases and other serious conditions.

However, according to the IMED report, not a single PICU was made operational by the time the project ended. As a result, despite spending billions of taka, children have been deprived of the expected services.

The failure was not limited to PICUs. Plans to establish ICUs in 50 district headquarters hospitals also remained unimplemented. In some locations, construction work was left unfinished; in others, equipment was not installed; while elsewhere services could not be launched because the required personnel had not been recruited.

Work stagnated largely because of poor coordination between the project office and the Public Works Department. IMED identified this lack of coordination as one of the principal causes of the project's failure. Responsibility for procuring medical equipment rested with the project office, while construction of buildings and infrastructure required for installation fell under the Public Works Department. The absence of effective coordination between the two bodies significantly hindered progress.

In many cases, equipment procurement was planned despite the necessary infrastructure not being ready. In other cases, infrastructure development had not even commenced. Consequently, the entire implementation process became bogged down in delays and inactivity.

IMED also observed that frequent changes in project directors had a negative impact on implementation. The lack of leadership continuity and shortcomings in identifying actual needs created a substantial gap between planning and execution. Many project activities were designed without adequately considering practical requirements, leading to numerous complications during implementation.

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Sources said the World Bank's decision to suspend funding was influenced not only by slow progress but also by weaknesses in project management, poor interdepartmental coordination and various irregularities. Although there were later plans to complete the unfinished work under the Fifth Health, Nutrition and Population Sector Programme, these too failed because no effective alternative arrangements were put in place.

Bangladesh is witnessing a rise in the number of children affected by measles and other infectious diseases. Experts say PICU facilities for critically ill children remain extremely limited across the country. The number of beds in public hospitals falls far short of demand, meaning many patients cannot be admitted when needed.

Due to the shortage of intensive care facilities, many parents are forced to take their children from one hospital to another in search of treatment. Delays in receiving care often worsen children's conditions and, in some cases, result in death.

Source: Bangladesh Pratidin