Kamrangirchar and Hazaribagh are the largest slum area in Dhaka, Bangladesh. In 2013 Médecins Sans Frontières (MSF) started an urban healthcare program responding to needs identified amongst the factory worker population and for sexual and reproductive healthcare for young women. Little in-depth information is available on the perceptions of health and health seeking behaviour of this population. MSF conducted a qualitative study aiming to inform MSF activities and policy discussion toward better health provision for this and similar communities. It concludes that improving health in Kamrangirchar and Hazaribagh demands a comprehensive and collaborative health system, with improved access to secondary level care and referral systems. A combination of increased regulation and capacity building is necessary to improve existing pharmacy practice. Community-based mechanisms with an emphasis on health education for decision making will facilitate access to information and services, particularly for vulnerable groups.