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Bangladesh's unique RMG factory health facilities

Unlike many other countries, Bangladesh's Labour Rules (2016) require factories to provide their own on-site health services, rather than relying on external government institutions. This ensures that workers have immediate access to healthcare. 

• Up to 300 workers → Basic first aid.
• 300 to 500 workers → At least one doctor and a nurse/paramedic.
• 7,500+ workers → A small hospital with at least three doctors, including one female doctor, and additional resources for every extra 1,000 workers.

This structured approach helps ensure that medical care is available where it is most needed.

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How the ILO Supports Enterprise Clinics

To help factories comply with these requirements, the ILO partnered with the Ministry of Labour and industry associations (BGMEA, BKMEA, BEF) to develop easy-to-use resources.

The ILO’s contribution includes:

• A practical handbook on setting up and running enterprise clinics. 
• Comprehensive guidelines for employers to understand legal requirements. 
• Training programmes for labour inspectors, employers, and workers.
• A video tutorial with a checklist for clinic setup.

These materials were developed in close collaboration with government, employers, and workers to ensure that they are practical, relevant, and sustainable.

Clinics positively received

The Bangladesh Garment Manufacturers and Exporters Association (BGMEA) and the Bangladesh Knitwear Manufacturers & Exporters Association (BKMEA) were actively involved in developing and piloting these guidelines. 

•  Training: Training of Trainers (ToT) was conducted to ensure that industry leaders could pass on their knowledge. 
•  Pilot: A pilot phase involving 30 factories found that employers highly valued the materials, especially the pictorial guides and handbooks. 
•  Employer satisfaction: Employers appreciated how the materials clarified legal obligations and made good practices easier to implement. 

 The response has been overwhelmingly positive, with more factories now looking to adopt the guidelines.

Could this model work in other countries?

Bangladesh’s model is tailored to its own labour laws, requiring factories to take direct responsibility for healthcare. However, this enterprise-led approach could serve as an inspiration for other countries looking to improve worker healthcare. 

 Many nations rely on social security institutions to provide health services but Bangladesh’s system ensures that medical care is always available on-site, reducing the burden on external providers.

The reality: health facilities in different types of factories

The quality of factory healthcare varies significantly:

• Export-oriented factories → Tend to have better facilities, as they undergo brand inspections and compliance checks.
• Lower-tier factories → Often have inadequate or non-existent health facilities, as they face less scrutiny from buyers and regulators.

Ensuring consistent healthcare standards across all factories remains a challenge.

Future outlook: what’s next for this initiative?

With the foundation already in place, the initiative aims to: 

•  Expand awareness among factory owners and workers. 
• Ensure wider adoption of the ILO’s guidelines. 
• Improve health outcomes across the RMG sector. 

By working closely with industry associations and continuing training efforts, the programme is set to scale up, benefiting thousands of workers across Bangladesh. Moreover, this innovative model could serve as a blueprint for other industries and countries, reinforcing the idea that worker health is fundamental to sustainable business growth.

About the report authors

The International Labour Organization (ILO) is devoted to promoting social justice and internationally recognised human and labour rights, pursuing its founding mission that social justice is essential to universal and lasting peace.

The only tripartite U.N. agency, since 1919 the ILO brings together governments, employers and workers of 187 Member States, to set labour standards, develop policies and devise programmes promoting decent work for all women and men.

About Asia Garment Hub

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