Healthcare in the country has become a poor state. There is a huge shortage of equipment for expensive tests including MRI, echo and CT scan in major hospitals including Dhaka Medical College. Necessary medicines are not available. Beds are not available during patient admission.
When this situation continues in government hospitals, the money allocated for the health sector is lying due to the inefficiency of government officials. As a result, the health sector is lagging behind in terms of services as well as financial expenditure.
In the first five months of the 2024-25 fiscal year, the health sector has seen the lowest expenditure in the Annual Development Program (ADP). Even though there was an allocation of money, the government could not spend it. However, it is said that health is the most important sector in the country. On the other hand, due to lack of confidence in the country’s medical system, many people are going abroad for treatment. As a result, a huge amount of money is going out of the country.
According to ADP data, a total of 46 projects are ongoing in the health sector. Tk 20,697 crore 54 lakh was allocated for these projects.
Of this, the organization has allocated Tk 146.6 million from its own funds. However, in the current fiscal year, the budget allocation for the health sector was Tk 30,125 crore. Which is only 3.78 percent of the total budget.
The report of the Implementation Monitoring and Evaluation Department (IMED) of the Ministry of Planning says that the Health Ministry spent Tk 544 crore from July to November of the current fiscal year. This is one-third compared to the expenditure during the same period of the last fiscal year. In the 2023-24 fiscal year, the Health Ministry, which consists of the Health Services and Family Planning Departments, spent Tk 1,480 crore.
The report also says that among the 15 ministries and departments, the Health Services Department spent the most at Tk 325 crore. This is only 2.91 percent of the total allocation of Tk 11,153 crore. Among the 15 departments that received the highest allocation, the Local Government Department spent the most at Tk 7,711 crore. This is 20 percent of the total allocation. However, it is less than the previous fiscal year.
On the other hand, when asked about the reason for the low implementation of the ADP in the health sector at the briefing after the meeting of the Executive Committee of the National Economic Council (ECNEC) on November 25, Planning Advisor Wahiduddin Mahmud told reporters that there is a big chaos in the health sector. This chaos will be resolved very soon.
He said that there are many technologies in health centers in the districts and upazilas. Which are not being used. Therefore, the Planning Advisor opined that efficiency should be increased before using these technologies.
The then Secretary of IMED, Abul Kashem Md. Mohiuddin, mentioned the ongoing austerity measures and the economic recession caused by the political unrest in July-August as the reasons for the slow implementation of projects in the health sector. He said that the low capacity of the Health Ministry is a common reason behind the low rate of project implementation. Stating that the lack of proper project selection is responsible for the weak implementation, he said that the health sector is a very important issue. One has to be careful in project selection.
Professor Mostafizur Rahman, Honorary Fellow of the Center for Policy Dialogue (CPD), a private research institute, told Daily Industry that there are several reasons behind the low implementation of ADP in the health sector. Among them are the instability in July-August, cost reduction in projects, elimination of unnecessary projects and low spending in the first quarter of the fiscal year. This has a tendency. He also said that the health sector is important for the country, but its (budget) implementation rate is always the worst. The government should review why they are not able to spend year after year.
On the other hand, a seminar on ‘Increasing domestic capacity to reduce foreign dependence in the health sector’ was organized by the Dhaka Chamber of Commerce and Industry (DCCI) on November 23. Experts suggested increasing the quality and trust of the country’s medical services in the seminar. At the same time, suggestions were also given to reduce dependence on foreign-sourced treatment.
It was informed in the seminar that due to the inadequacy of the country’s healthcare system, a large population of the country seeks services in different countries of the world. Through this, about $4 billionor about Tk 48 thousand crore goes abroad on healthcare annually.
While presenting the keynote speech at the seminar, the then Senior Vice President of DCCI, Malik Talha Ismail Bari, said that Bangladesh’s per capita expenditure on healthcare is $110, while other South Asian countries spend $401.
He said that due to the inadequacy of necessary healthcare, a large population of the country seeks services from other countries of the world and in 2012, the amount spent by Bangladeshis on healthcare abroad was about $4 billion.
Former President of Dhaka Chamber Ashraf Ahmed said, according to WTO data, 49 percent of Bangladeshis do not receive quality healthcare. In addition, the tendency to seek healthcare abroad is constantly increasing due to the lack of necessary international standards in local services. The then DCCI President emphasized on the development of this sector, especially ensuring the use of advanced infrastructure and modern technology, increasing budget support, launching international hospital chain activities in Bangladesh, simplifying the registration process for foreign doctors and nurses to operate in Bangladesh, eliminating the procedural complications of obtaining and renewing all types of licenses in the health sector, introducing a digital system, and providing tax exemption facilities to encourage the establishment of hospital activities in the private sector in remote areas of the country.
According to data, there are currently 5,461 private hospitals and clinics in Bangladesh. Of which 1,810 are located in Dhaka division. In addition, as 19 out of 36 specialized hospitals are located in Dhaka, people living in remote areas of the country are being deprived of advanced healthcare. Pressure on Dhaka is constantly increasing.
Bangladesh Diabetic Association President National Professor AK Khan Azad said that due to lack of facilities, lack of trust in the medical system and above all lack of comfort, many people are seeking medical services outside the country. It is possible to reduce the foreign orientation of patients by properly identifying and solving these. The quality of laboratories operating in the country needs to be improved.
Experts are suggesting that a holistic approach should be considered to emphasize the development of other sectors including the health sector in the current context of the country. They say that not only the health sector, but all important sectors should be emphasized. Although there is some tension in the economy. At the same time, chaos is going on in all sectors.
When asked about what kind of steps can be taken in the implementation of the project, Dr. Mustafa K. Mujeri, Executive Director of the Institute for Inclusive Finance and Development (INM), said in the light of time, we need to think holistically for the development of the country. Since the government is currently suffering from a financial crisis, we need to think of alternatives. In addition to cuts in projects, we also need to be economical in costs.
He also opined that emphasis should be placed on revenue collection to make progress in project implementation.
