What is it about?
Many people living in rapidly growing cities struggle to access affordable, good-quality primary healthcare. This study examines the real-world implementation of the Aalo Clinic model, an urban primary healthcare initiative designed to improve access to essential services for underserved populations. We explored how the model worked in practice, what helped it succeed, and what made implementation difficult.
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Why is it important?
Urban populations are growing rapidly, especially in low- and middle-income countries, yet most primary healthcare systems are not designed to meet the needs of dense, underserved city populations. Evidence on how urban primary healthcare models actually function in real program settings remains limited. This study provides rare programmatic evidence from an implemented urban primary healthcare model, moving beyond theory to examine operational realities. It identifies both enabling attributes, such as digital monitoring, rational prescribing, and quality improvement efforts, and systemic barriers, including supply chain limitations, workforce constraints, and unstable financing. The findings show that while pilot models can improve access to care, the long-term impact hinges on sustained public financing and integration into national health systems. These insights are directly relevant for policymakers and planners seeking scalable solutions for urban health system strengthening.
Perspectives
Working on this study was particularly meaningful because it allowed us to examine not just whether a healthcare model works, but how it works, what can be improved, and how services can be refined to make them better. Too often, innovative pilot programmes show promise but struggle to survive within real health systems. Understanding that gap between success and sustainability felt particularly important. This research highlights and reiterates that improving urban primary healthcare is not only about designing good service models, but it is also about financing, governance, and system integration. I hope this work helps move the conversation about health reform and strengthening urban primary healthcare in Bangladesh and beyond.
Khadija Islam Tisha
International Centre for Diarrhoeal Disease Research
Read the Original
This page is a summary of: Opportunities and challenges of implementing an urban primary healthcare delivery model: Programmatic lessons from Aalo Clinic, Bangladesh, PLOS One, February 2026, PLOS,
DOI: 10.1371/journal.pone.0341924.
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