Result lies in how govt spends
The proposed health budget is an increase, from the preceding one and in terms of its percentage in the total budget, but the plans do not specify where the money would be spent.
The proposition for 2017-18 is Tk 20,679 crore, a Tk 3,163 crore increase from last fiscal year's. It is 5.2 percent of the total budget. The previous one was 5.1 percent.
Experts take this yearly rise, though small, as a good sign. They, however, say there is room for augmentation as World Health Organisation (WHO) recommends the allocation be 15 percent of the total budget.
They say allocation increases and efficient spending are crucial as the government's National Health Account 2011 states that high healthcare costs yearly push 4 to 5 million Bangladeshis into poverty while many fail to avail it.
Finance Minister AMA Muhith said a five-year Health, Population, and Nutrition Sector Development Programme taken up this year would address, among others, communicable or non-communicable diseases, nutrition, food safety and human resource development.
He plans to establish 392 community clinics, while 13,339 already exist, and expand telemedicine services at district and upazila levels, where the shortage of health personnel is acute.
This health personnel shortage, along with non-communicable diseases, including cancer, heart diseases and diabetes, and the lack of urban primary healthcare facilities, especially for the poor, should be urgently addressed, said Dr Hossain Zillur Rahman.
The Power and Participation Research Centre's executive director also recommends strengthening the government's Essential Service Package, ensuring that all get access to essential primary healthcare, like drugs and screening facilities for blood sugar and pressure and cancer, at unions and upazilas.
He suggests providing medicine to chronically ill patients to lessen financial hardships.
WHO says non-communicable diseases account for 59 percent of deaths in Bangladesh and that there are 5.5 doctors and 2.1 nurses for every 10,000 people whereas it recommends the figures to be 10 and 30 respectively.
The situation is worse in upazila and district hospitals where government doctors often shirk responsibilities.
Dr Hossain stresses focusing on filling up vacant posts of doctors, nurses and healthcare technologists and training new ones, especially nurses.
He also suggests building in urban wards health infrastructures of rural areas such as upazila health complexes, union family and healthcare centres and community clinics.
Currently, an Urban Primary Health Project is run by the local government ministry, albeit with foreign funds, while non-government organisation activities focus only on mothers and children.
The urban poor, therefore, rely heavily on the expensive private sector and crowd tertiary hospitals like Dhaka Medical College Hospital.
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