Food safety in public hospitals is a basic right, not luxury

Food safety in public hospitals is not merely an operational issue but a legal right for patients. It goes without saying that hospital-prepared food should be tailored to a patient's medical condition. Furthermore, the hygiene, safety, and nutritional value of the food must be ensured. Reports from hospital food vendors, unfortunately, point to unhygienic food preparation and vending environments, with a lack of adequate food safety measures. There is also insufficient data on hygienic food practices, availability of food safety facilities, and perspectives of hospital food vendors. This creates a knowledge gap that can be quite impactful.

In a country where more than 654 public hospitals serve millions of people—particularly low-income patients—access to safe, nutritious, and medically appropriate food is a crucial issue. Most patients seek care at public hospitals due to their affordability, especially for those without insurance or the means to access private care. These hospitals are often the only available option in underserved or rural areas. Despite this, patients' rights to proper treatment are being violated through unhygienic and poor-quality food.

Earlier, the food budget per patient was Tk 125, which increased to Tk 175 after the COVID pandemic. For patients in the intensive care unit (ICU) and high dependency unit (HDU) at the National Institute of Burn and Plastic Surgery, the allocation is Tk 300 per patient. Despite these increases, complaints about food quality persist. Common issues include coarse, foul-smelling rice; watery lentils; and flavourless curries. There is no system to customise meals based on caloric needs, age, weight, or medical condition. Dietitians are often only nominally involved, with little influence on meal planning or monitoring. Oversight of food quality and nutritional care remains weak. This state of affairs can have severe consequences for patients.

The Bangladesh Food Safety Authority (BFSA), established under the Food Safety Act, 2013, is responsible for regulating food safety, including in public hospitals. The BFSA oversees various aspects of the food supply chain, including import, production, storage, and distribution. However, enforcement in public healthcare settings has been weak and inconsistent. This gap between policy and practice further endangers patient health.

Over the years, there has been a surge in the number of public hospitals and health facilities. However, a substantial portion of the population still faces significant barriers to healthcare access. Over 60 percent of people lack access to basic healthcare, and fewer than 40 percent receive essential medical care. These figures highlight broader structural problems including underuse of government hospitals, cost-effectiveness concerns, and sustainability challenges. They also reflect the urgent need to improve the quality of care—starting with something as fundamental as safe food.

To identify gaps in hospital nutrition care, we should consider issues such as a lack of proper staff training, inconsistent implementation of guidelines, poor teamwork, failure to focus on individual patient needs, limited screening for malnutrition, and challenges related to technology. Additionally, we must evaluate food quality, follow up on patient outcomes, assess resource limitations, and measure how well nutrition is integrated into overall care. Evidence-based research is essential to addressing these gaps effectively.

But first, we must acknowledge that food safety is a basic patient right—not a luxury—and that poor hygiene, low food quality, and weak enforcement of food safety laws in public hospitals are endangering patients. Simply increasing food budgets is not enough without proper management, monitoring, and trained personnel.

To resolve this problem, the government should strictly enforce the Food Safety Act of 2013, hire trained dietitians, ensure regular hygiene training for food handlers, and customise meals according to patient needs. Collecting data from hospitals and vendors is also crucial to closing existing knowledge gaps. Safe food in hospitals can lead to better recovery outcomes, reinforce patient dignity, and strengthen the healthcare system overall.

Sabrina Pervin Shanta is an LLM student at North South University.

Views expressed in this article are the author's own. 

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