Only 5.43% of total budget allocated for health sector

The health sector was yet again neglected in the national budget, with Finance Minister AHM Mustafa Kamal earmarking around Tk 36,864 crore -- 5.43 percent of the total budget -- for the sector.

In the past decade, the allocation for the health sector consistently remained below six percent of the total budget. According to experts, it should be as much as 15 percent to ensure that quality service is accessible for all.

The finance minister's speech contains details about setting up specialised hospitals in all divisional headquarters, along with new intensive care units and dialysis centres in district hospitals.

He, however, said too little about the government's strategies to control non-communicable diseases, -- which account for 67 percent of the country's annual deaths -- and reducing out-of-pocket expenditures.

"As the government spent a lot on tertiary care -- making new hospitals and medical colleges -- primary healthcare has always been more neglected. This budget is no exception," Dr Muhammod Abdus Sabur, adjunct professor at the Institute of Health Economics (IHE) of Dhaka University, told this correspondent.

In a pre-budget discussion, Dr Atiur Rahman, former governor of Bangladesh Bank, said, "The majority of healthcare-seekers go to healthcare centres for primary services. So, the allocation for this segment should be as much as 30 percent of the total health budget."

In the past several years, around 25 percent of the health budget has been spent on primary healthcare, 39 percent on secondary and 36 percent on tertiary.

Allocating more than 60 percent of the health budget for primary care was recommended in the 1998 sector-wide approach (SWAP) for the health sector.

Meanwhile, the minister also abstained from mentioning any clear guidelines as to how the upazila health complexes and other such establishments in rural areas can be strengthened. 

He only mentioned that the government has started a screening system, including the formulation of a guideline for medication and control of the non-communicable disease.

Dr Shafiun Shimul, CDC Foundation fellow at Georgia State University, said, "I do not think the minister has proposed anything exciting in this part. It is more or less the same as the existing measures."

While the overall budget for FY 2022-2023 increased about 14.24 percent, the minister has proposed only a 12.62 percent increase for the health sector, which, according to experts, is a consequence of incremental and inflation-related issues.

This implies that the growth in the health budget is lower compared to the total budget, despite its share in the total budget increasing from 5.2 percent to 5.43 percent.

"Hence, we cannot expect any qualitative change in the healthcare service," Syed Abdul Hamid, professor of health economics at Dhaka University, told this correspondent.

Of the total amount, the finance minister has proposed an allocation of Tk 29,282 crore for the healthcare service division in the next fiscal. The health allocation was Tk 26,165 crore in the previous one.

However, the proposed budget has an allocation of Tk 7,582 crore for the Health Education and Family Welfare Division, which is Tk 1,472 crore more than the outgoing fiscal.

Maternal voucher scheme in some upazilas have been expanded.

The allocation for the Integrated Health Science Research and Development Fund remains the same, at Tk 100 crore.

When asked about the government's ability to spend the allocated funds properly, Dr Sabur, said there is a need for a reform to build this capacity.