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Background : Chotpoti is a popular street food among all groups of people from low to high income in most cities of Bangladesh. Objective : This study was conducted to describe the vending sites, the stalls and equipments used for food preparation, current level of food safety knowledge of vendors and the way to prepare foods to understand the risks of food contamination and opportunities for prevention. Materials and Methods : This cross-sectional study was conducted between July and October, 2012. We selected 18 popular chotpoti vending sites including market places, bus stops, road sides and amusement parks located under Dhaka city corporation areas by judgment sampling. From each study site we randomly selected six vendors for interview. A structured pretested questionnaire was used for data collection. Data were collected on (i) socio-economic and demographic characteristics of the respondents; (ii) health and personal hygiene knowledge of vendors; (iii) vendors’ food handling practices and (iv) source of ingredients and process of chotpoti making. Location of the chotpoti vendors, utensils used, handling of food, place of preparation of chotpoti, environment surroundings of the stall, general processing of chotpoti and hygienic practices were observed and recorded through an observation checklist. Results : We interviewed a total of 110 vendors. All vendors were male, the majority was between 21 and 30 years of age. Majority (58.2%) of the vendors acquired the knowledge of chotpoti preparation through observation. Nearly all vendors (99%) handled food with bare hands, 95% did not use aprons and hair covering and 94% handled money while serving chotpoti. Most vendors had leftovers; out of those 30% reported discarding them and the rest stored them for following day’s sale with inappropriate storage. Nearly one-third (32.7%) of the vendors washed their utensils with dirty water which is recycled. Majority reported that they changed the bucket water only once per 12 hours. Presence of flies was observed on food and surroundings of 33% of the stalls. Of the vendors interviewed, most of them did not have garbage receptacles and 23% disposed wastes nearby their stalls and 76% disposed in nearby dustbin. Conclusion : This study demonstrates that chotpoti vendors do not have formal education and formal training on food preparation. Moreover, lack of hand hygiene knowledge, infrequent cleaning of utensils with soap, inappropriate management of leftover foods, and lack of proper waste management create numerous possibilities for food contamination. Consumption of street vended chotpoti may pose a risk of food borne diseases and steps should be taken to educate and train the vendors on personal hygiene and food handling practices. J Enam Med Col 2017; 7(2): 69-76

Bangladesh has achieved remarkable success in improving most of the health indicators over the last couple of decades despite pervasive economic poverty. However, for a sustainable growth health sector should be among the top lists at Government’s policy table. Unfortunately, the recent trend in budget allocation portrayed just the opposite and is concerning as expressed by health experts. Over the last seven fiscal years, budgetary allocation for health dropped from 6.2% to 4.3% of total government expenditure. Due to insufficient public spending, out of pocket payment (OPP) is much higher which is about two-third (64.7%) of total health care spending in Bangladesh. Inadequate and inefficient public healthcare and profiteering tendency of the private healthcare sector are two major factors behind such high private spending. Suffering from a massive shortage of health workforce and with such low public funding it would be very difficult for Bangladesh to fight against upcoming challenges like increasing burden of non communicable diseases (NCDs) and emerging threats due to climate change.Bangladesh Journal of Medical Science Vol.15(4) 2016 p.505-510

Bangladesh has attained notable progress in most of the health indicators, but still, health system of the country is suffering badly from poor funding. Issues like burden of out-of-pocket expenditure, low per capita share in health, inadequate service facilities, and financial barriers in reducing malnutrition are being overlooked due to inadequacy and inappropriate utilization of allocated funds. We aimed to review the current status of health care spending in Bangladesh in response to national health policy (NHP) and determine the future challenges towards achieving universal health coverage (UHC). National health policy suggested a substantial increase in budgetary allocation for health care, although government health care expenditures in proportion to total public spending plummeted down from 6.2% to 4.04% in the past 8 years. Overall, 67% of the health care cost is being paid by people, whereas global standard is below 32%. Only one hospital bed is allocated per 1667 people, and 34% of total posts in health sector are vacant due to scarcity of funds. The country is experiencing demographic dividend with a concurrent rise of aged people, but there seems no financial protection schemes for the aged and working age populations. Such situation results in multiple obstacles in achieving financial risk protection as well as UHC. Policy makers must think effectively to develop and adapt systems in order to achieve UHC and ensure health for all.