Health budget based on local needs demanded

The People's Health Movement Bangladesh (PHM), a network of grassroots health activists, has demanded formulation of the health sector budget in the light of local needs and coordination at the district level.

The organisation presented 21 demands at a pre-budget dialogue titled "Bangladesh's Healthcare Sector: Perspective National Budget", organised at the Nagarik Udyog Conference Hall in the capital on Friday.

Demands made by PHM include a more equitable, participatory and multidimensional approach to healthcare; quality healthcare for the people not based on their purchasing power but on their needs; public participation in all health and social policy and programme formulation, implementation and evaluation; and equal production and distribution of medicines and medical equipment.

They also demanded formulation of all economic policies by taking into consideration the issues of health equality, gender equality and impact on the environment.

The organisation further demanded that the government adopt and implement national health and medicine policy, recruit employees at all vacancies in the health sector without delay, and eliminate inequality in medical expenditure at the individual level and at the government level.

"The allocation for the health sector in this year's budget must be increased. The most worrying thing is – the way the price of medicine and the cost of treatment are going up, it will be difficult for us to survive if it continues. Lack of healthcare facilities is also causing people more suffering," said Ataur Rahman Miton, country director of Hunger Free World, at the programme.

"Healthcare provided at our community-based clinics should be improved and regularly monitored by the government. Meetings of the management committee should be started in every hospital to ensure quality improvement and accountability of healthcare institutions at all levels," he added.

Aminur Rasul Babul, coordinator of PHM, said the quality and prices of medicines produced by the country's pharmaceutical companies need to be controlled. At the same time, it is necessary to ensure proper allocation for folk knowledge and evaluation and improvement of doctors.

"Healthcare for all is a priority in all our national plans, but addressing the major issues in this sector does not get much priority in our national budget," he said.

Among the issues raised by PHM at Friday's programme was the fact that the out-of-pocket healthcare expenditures in Bangladesh is the highest among the Saarc countries, and this is rising further.  

Currently, the government bears only 23% of the country's healthcare expenditure, which was 37% in 1997. NGOs and volunteer organisations bear up to 3% and donors up to 7% of these expenses.

Per capita health expenditure in Bangladesh is only $27, which is the lowest by international standards. It is $61 in India and $410 in Malaysia. According to the World Health Organisation, per capita health expenditure should be at least $40 to improve the quality of healthcare.

In the 2009-10 budget, the health sector accounted for 6.2% of the total budget and 0.9% of GDP, while the budget for 2021-22 allocated to the health sector 5.47% of the total budget and 0.9% of the GDP.

The amount of money allocated to the health sector has increased, but that amount is disappointing, considering the proportion of the total budget and the GDP.