Rumana Huque

The introduction of SWAp transformed Bangladesh’s health sector from a fragmented collection of donor-funded projects into a coordinated, government-led programme.

Bangladesh’s health budgeting system remains centralised and input-driven. Budgets are prepared and approved according to detailed expenditure codes, leaving managers with little flexibility to respond to changing needs during implementation.

The spread of Covid-19 has critically exposed the long-standing weaknesses of Bangladesh’s health system.