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Experts suggest more allocation for health, human capital, management capacity


Published : 07 Jun 2020 08:22 PM | Updated : 28 Aug 2020 11:18 AM

Experts at a webinar on national budget recommended that along with an increase in allocation of budget for the health sector, necessary infrastructure and human capital have to be developed and management capacity must be expanded. 

They said that the current crisis shows that there is no alternative to public health service; yet, the public health sector has not been paid attention to. There is a serious lack of accountability in the private health sector, which creates significant obstacles in ensuring quality health service for the people. 

The webinar titled “COVID-19 and Health System of Bangladesh”, was organized by South Asian Network on Economic Modeling (SANEM) on Saturday as part of it's continued series of webinar titled “SANEM SHONGJOG”.

Conducted by SANEM’s Executive Director and Professor of Economics at University of Dhaka, Dr. Selim Raihan, the webinar hosted a panel discussion which was attended by Professor Dr. Shah Monir Hossain, Former Director General, Directorate General of Health Service, Government of People’s Republic of Bangladesh, and one of the eight members of a government-formed expert committee to supervise, monitor and support the coronavirus response, Dr. Muhammod Abdus Sabur, Public Health Expert, and  Adjunct Professor, Institute of Health Economics, University of Dhaka and Dr. Rumana Haque, Health Economist, and Professor, Department of Economics, University of Dhaka. 

 In his introductory remarks Dr. Selim Raihan presented some key statistics to compare the state of the health sector of Bangladesh with other countries.  He mentioned that hospital bed per 1000 people in Bangladesh is 0.8, while it is 3.6 in Sri Lanka, 1.9 in Malaysia and 2.1 in Thailand. 

Referring to  WHO data he said the Public health expenditure in the percentage of GDP in Bangladesh is only 0.4% while it is 1.6% in Sri Lanka, 2% in Malaysia and almost 3% in Thailand. Out-of-pocket expenditure in the percentage of total health expenditure in Bangladesh is 74%, which means a person has to bear 74% of health expenditure on his own. It stands at 50% in Sri Lanka, 38% in Malaysia and 11% in Thailand. 

Dr. Raihan explained that the current crisis shows that there is no alternative to public health service; yet, the public health sector has not been paid attention to. There is a serious lack of accountability in the private health sector, which creates significant obstacles in ensuring quality health service for the people. 

Dr. Raihan recommended that along with an increase in allocation of budget for the health sector, necessary infrastructure and human capital have to be developed and management capacity must be expanded. 

 Discussing the policy response to the COVID-19 Pandemic, Dr. Rumana Haque, said that although there was time for preparation, proper planning was absent. Channeling the budget allocations for addressing the pandemic was necessary. 

She pointed out that the improvement of the health sector would require a unit for health technology assessment and assessment of area-wise health needs and health care needs; without these assessments, an increase in budget would not bear fruit. 

She said disbursement of the budget often takes one quarter of a financial year, thus leaving a significant portion of the development budget unused. 

Dr. Muhammod Abdus Sabur pointed out that the revenue budget for the ministries is fully utilized as it is for salaries; on the other hand, the development budget faces delay and often remains unused. 

He said that while development partners have been quick to provide aid to tackle the COVID-19 Pandemic, there has been a delay in the utilization of the aid as well. 

Discussing the lack of management efficiency, he said that without putting an end to the illegal activities of dishonest contractors, the procurement processes in the health sector can’t be turned effective. 

Dr. Shah Monir Hossain identified bureaucratic interference as a reason behind the lack of decentralization. 

He said that plans are often results of “table talks” and not based on evidence. The public, private and NGO health enterprise need to work together for the improvement of the whole scenario. A forum is required to assess the impacts of these enterprises.