Optimal funding crucial for effective healthcare services: Experts

Experts warn that the country’s health sector is struggling due to insufficient fund allocation and poor spending efficiency, leading to heightened out-of-pocket expenses for people and impediments to the implementation of Universal Health Coverage (UHC).

They are now urging for a revamp of the budgetary allocation to ensure optimal utilization of the allocated resources and enhanced public health services.

Prof. Dr. Sharfuddin Ahmed, Vice-Chancellor of Bangabandhu Sheikh Mujib Medical University (BSMMU), stated that Bangladesh’s budgetary allocation for the health sector lags behind other countries.

“I demand at least 10 percent of the total budget for the health sector,” he said.

He also advocated for a comprehensive health insurance policy to cut down on out-of-pocket expenditure and to ensure UHC.

Echoing these sentiments, Prof Dr. Syed Abdul Hamid, former director of the Institute of Health Economics of Dhaka University, indicated that the World Health Organization (WHO) recommends setting aside at least 15 percent of the budget for the health sector.

He further underscored the need of performing comprehensive needs assessments for the country’s health sector to guide budgetary allocations accurately.

Hamid suggested a shift from input-based budgetary allocation to an output-based system to ensure effective use and health services for the people.

In his view, financial autonomy should be granted to public hospitals, allowing them to spend funds according to the needs of the patients, after which the government should compensate the healthcare facilities based on their expenditure.

Healso emphasized the need to identify the shortcomings in the existing budgetary line items and the missing line items in the health sector prior to assigning funds according to requirements.

Finance Minister AHM Mustafa Kamal proposed the 51st national budget for the 2022-2023 fiscal year, setting aside roughly Tk 36,864 crore or 5.4 percent of the total national budget for the health sector.

This falls short of the WHO’s recommendation of 15 percent of the total national budget for optimal health services.

Dr. Ehteshamul Haque Chowdhury, secretary-general of the Bangladesh Medical Association (BMA), suggested that the health budget for the 2023-24 fiscal year should constitute at least 3-4 percent of the GDP, in line with the WHO’s recommended minimum of 5 percent of GDP allocation for the health sector.

Experts expressed concern that the health sector is unable to fully utilize the budgetary allocation within the stipulated time. This, they argue, is attributable to insufficient planning, delayed funding, a lack of skilled manpower, and insufficient accountability among authorities.

The underfunding and inefficient utilization of resources in the fiscal 2022-23 budget allocation for the health sector has exacerbated the out-of-pocket expenditure, they warn.

This could significantly impede the nation’s efforts to curb mortality rates from non-communicable diseases, minimize the out-of-pocket expenditures of people in accessing health services, and improve the quality and scope of the health services.

According to the Finance Ministry, Tk19,278 crore was initially earmarked for the health sector in the current fiscal year’s Annual Development Programme (ADP), but was later reduced by Tk 7,200 crore in the revised ADP.

Despite this reduction, it is feared that the entire revised allocation may still not be fully expended by the end of the fiscal year.

As it stands, only 33 percent of the allocated funds have been utilized in the first ten months of the current fiscal year, underlining the gravity of the situation.