Increased budget, spending capacity in health sector urged

The budgetary allocation for the health sector and its spending capacity need to be increased to develop the public health and medical system in the country, said participants in a pre-budget webinar on Saturday.

Unnayan Shamannay, in collaboration with Bangladesh Health Watch, organised the event "Public expenditure for the health sector: Proposals for FY2021-22", in light of a study entitled "Analysis of health budget allocation and expenditure in Bangladesh".

They said that the entire health management system requires reform and laws must be enforced to ensure universal health care.

Health experts, politicians and development workers present at the webinar expressed their belief that without first aid for everyone in the country being ensured, other development activities will be hampered.

Dr Mushtaque Raza Chowdhury initiated the discussion by highlighting the urgency of prioritizing an increase in allocation for the health sector and bringing about reforms in the health system.

The keynote paper was presented by Dr Atiur Rahman, former governor of Bangladesh Bank and chairperson of Unnayan Shamannay.

The paper emphasized the current trends of allocations and expenditures in the health budget, making note of the fact that Bangladesh has been falling behind its South Asian neighbours in terms of public-private health spending as a share of GDP and per capita health expenditure.

Dr Atiur Rahman proposed an increase in allocation in the health sector, stating that the public and private sectors together invest around 2.34% of GDP in the health sector, which is less than in other countries of South Asia. "For the last one decade, 5% of the budget has been allocated for the health sector but it needs to be 7 – 8% this year," he added.

Dr Atiur Rahman said that this year's budget should be health-centric. He said that in the budget of the current financial year, there is a total allocation of Tk10,000 crore for health expenditure. However, he suggested that in the next budget, there should be a specific allocation for vaccination.

He said that at least 60% of the country's population needs to be vaccinated in a year and only then can the country eliminate the risks to health.

Rahman also pointed out that 70% of the population avail primary healthcare services but only 25% of the total health budget is spent there, which must increase.

MA Mannan, minister of planning, who was present at the webinar as the chief guest, proposed to raise the allocation for primary healthcare to 50%. He also supported an increased budget for community clinics.

Former minister of health AFM Ruhal Haque said mismanagement is a dire problem in the health sector. He added that the allocation capacity of the health sector needs to be increased.

"Even in November-December, the first quarter money is not released to the ministries, which is an issue that needs to be addressed," Haque added.

He also recommended the formation of a health commission to formulate and change the management of the medical cadre system.

Discussants at the webinar emphasized the need to implement Universal Health Coverage (UHC) across the country immediately in order to make the country ready for Vision 2041.

They also emphasized increasing the allocation for family planning, strengthening the governance of the health system, recruiting skilled manpower, utilizing and maintaining sophisticated equipment in the hospitals and strengthening community clinics and primary healthcare (PHC).

In addition, they highlighted minimizing inter-ministerial complications and removing cadre discrimination. They also placed emphasis on an increased focus on non-communicable diseases and bringing people under health insurance, besides recruiting more healthcare workers to meet the need.

Dr Zafrullah Chowdhury, National Professor Dr Shahla Khatun, Maleka Begum of Mahila Parishad, Shirin Akhter, MP and Dr Md Habibe Millat, MP also spoke on the occasion, among others.