The government should introduce a robust health-sector plan for the upcoming FY 2020-21 by increasing the budgetary allocation and bring reforms to ensure proper healthcare services amid the coronavirus pandemic and face the challenges posed by the crisis to the efforts to achieve Universal Health Coverage (UHC), experts said.
“A master plan should be prepared to bring reforms in the country’s public health sector. The budgetary allocation for the health sector also will have to be increased in phases gradually to 15 per cent of the total budgetary allocation to ensure proper health care for people,” said Professor Dr. Syed Abdul Hamid, former director of the Institute of Health Economics (IHE) of Dhaka University.He said the health budget should be increased to ensure prevention, control and proper treatment both for COVID-19 and non-COVID-19 patients.
Mentioning that the allocation of Tk 257.33 billion for fiscal 2019-20 in the health sector was not enough to meet the needs of the country’s growing public health sector, he said insufficient budgetary allocations and lack of efficient use of the resources will further accelerate the out-of-pocket expenditure in the health sector.
“The out-of-pocket (OOP) health expenditure in Bangladesh is around 67 per cent of the total health spending, which is much higher than that of the world average,” Prof Hamid said.
“The government should increase budgetary allocation for the health sector to help achieve the Sustainable Development Goal (SDG) and Universal Health Coverage by 2030. The country’s previous health budgets over the last few fiscal years were not adequate to meet the needs,” he said.
According to National Health Account reports, every year the OOP health expenditure pushes four to five million people into poverty, while many of the poor fail to afford minimum healthcare.
Placing the national budget of a Tk 5.23 trillion in the national parliament for last fiscal year, Finance Minister AHM Mustafa Kamal proposed to allocate Tk 257.33 billion for the Health Services Division, and the Health Education and Family Welfare Division.The finance minister will place the budget for 2020-21FY in parliament on June 11. The fifth highest allocation for the upcoming budget is for the health sector. The expenditure has been estimated at Tk 278.50 billion, recent media reports suggest.
Eminent economic analysts and experts at a pre-budget discussion webinar organized by the Institute of Cost and Management Accountants of Bangladesh (ICMAB) on May 29 said the next national budget should focus on ensuring the survival of people through strengthening health, medical and social security sectors.
Experts said though the proposed health budget for fiscal 2019-20 was not sufficient to achieve Universal Health Coverage in line with the Sustainable Development Goals.
Health economics experts said Bangladesh’s health budget has always been much lower than the 15 per cent budgetary allocation recommended by the World Health Organisation (WHO).
Talking to the Daily Sun about the upcoming health budget, Dr Kamrul Hasan Khan, former vice-chancellor of Bangabandhu Sheikh Mujib Medical University (BSMMU), said the health sector should get 10 per cent of the total national budget to meet the needs of the health sector.
“We are pushing for increasing the allocation for the health sector in the budget. At the same time, the budget allocation should be properly utilised and strong monitoring and supervision should be ensured. Funds should be released on time and corruption must be checked,” Kamrul Hasan Khan said.
Dr Ehteshamul Haque Chowdhury, secretary-general of Bangladesh Medical Association (BMA), said the health budget for FY 2020-21 should be at least 3-4 per cent of the GDP.
Justifying his suggestion about increasing the health budget, he said a large number of necessary manpower should be appointed, enough medical instruments will have to be set up at hospitals and the entire health system should be recast to ensure proper healthcare amid the coronavirus crisis.
Dr Ehteshamul Haque Chowdhury also expressed hope that the government has already realized the necessity of increasing the health budget for the upcoming fiscal.
Referring to the WHO’s recommendation for allocating minimum 5 per cent of the GDP for the health sector, he said sadly the country’s health budget remains within one per cent of the GDP, which was not ideal to ensure the Universal Health Coverage.
“The budgetary allocation for the health sector should be increased to achieve Sustainable Development Goal (SDG), to reduce Out of Pocket Expenditure and to ensure health services for poor people,” the BMA secretary-general said.