‘Digging deep for healthcare expenses’
As citizens bear two-thirds of the healthcare expenditure, increasing the budget is important to reduce out-of-pocket spending.
People bear 68 percent of the country's healthcare expenses out of their pocket, while the government bears only 23 percent, said speakers at a pre-budget roundtable yesterday.
Special aid, NGO spending and contributions by other institutions make up the rest of the expenditure.
Stressing the need to keep seven to eight percent of the total budget for the health sector in the upcoming national budget, they said 45 percent of the total healthcare allocation should be kept for primary treatment.
They also emphasised on proper use of the allocation, as only 51 percent of the health budget's development allocation was spent in the 2019-2020 fiscal; 84 percent of the management allocation was used.
The roundtable was jointly organised by Bangladesh Health Watch, Brac James P Grant School of Public Health, Brac University, and Unnayan Shamannay. It was held at the capital's The Daily Star Centre.
"As citizens bear two-thirds of the healthcare expenditure, increasing the budget is important to reduce out-of-pocket spending," said Prof Atiur Rahman, former governor of Bangladesh Bank, who presented the keynote paper in the programme virtually.
Atiur, also chairperson of Unnayan Shamannay, said 67 percent of out-of-pocket expenditure is spent to purchase medicine and other perishable medical products, and 33 percent goes to other healthcare-related expenditure.
Barrister Rumeen Farhana, a BNP lawmaker from the reserved seat, claimed that a person's out-of-pocket expenditure was 60 percent in 2012, which has reached 72 to 74 percent.
According to a policy paper of the government dating back to 2012, the government's plan is to bring personal expenditure on healthcare down to 32 percent by 2032. But it is increasing continuously, she said.
Rumeen said according to the WHO, 49 percent of people do not get quality healthcare services in the country. Besides, in the last 10 months of the current fiscal (2021-2022), only 41 percent of the allocated health budget has been spent so far.
Dr Syed Abdul Hamid of Dhaka University (DU) said the main obstacle to efficient expenditure is procurement-related complexities.
Stressing the need to bring back the centralised system for expenditure, he said the government is failing to spend efficiently after decentralisation.
Dr Habibe Millat, lawmaker from Sirajganj-2, said the health budget definitely needs to be increased, but its proper expenditure in every sector is also essential.
Emphasising the need to establish specialised hospitals for women's health issues, Maleka Banu, general secretary of Bangladesh Mahila Parishad, said there are many specialised hospitals in the country, but none to address these problems.
Shamim Haider Patwary, lawmaker from Gaibandha-1, said health cadres should be separated from the existing system, and they should take decisions when appointing workforce.
Prof Rumana Haque of DU moderated the programme. Morsheda Chowdhury, director of Brac's Health, Nutrition and Population Programme; Dr AM Zakir Hussain, working group member of Bangladesh Health Watch; Dr Zahirul Islam, health advisor of Swedish International Development Cooperation Agency; and DU Prof Syed Abdul Hamid addressed the programme among others.