The government of Bangladesh spends substantial amounts of resources on health services but dissatisfaction is often expressed over availability and  quality of these services. The study assesses, using primary information from a survey, whether the public health facilities suffer from inadequacies and identifies factors which act as barriers to effective utilisation of public health facilities. The findings show that, in general, women and the poor are more likely to use these facilities. The study notes that although physical accessibility is no longer a major barrier, economic accessibility remains as a major hurdle. The poorest are the largest users of public health facilities but they also bear a disproportionate share of the burden of ill health and sufferings. There also exist a number of governance issues which contribute to poor quality of services. The findings from the quantitative and qualitative data reveal that government efforts to improve health service delivery have not yet produced the desired results. Rebuilding hope among the patients requires that urgent governance issues be addressed to ensure that service providers are available at the facilities, minimum amount of drugs reach the patients and unofficial payments are at the lowest possible levels.