Interim govt seeks to rationalise health sector funding in ADP

Aiming to bring discipline in the health sector, the government has taken a move to rationalise the budget allocation for development projects in the coming days.

According to the planning ministry sources, decision has been taken to improve the medical services across the country through appointing skilled manpower for running the existing machineries and give priority for budget allocation to prepare skilled manpower for these machineries.

"There is huge indiscipline in the health sector, if we want to increase allocation we have to put it on a proper way," Planning Adviser Dr Wahiduddin Mahmud told a recent briefing at ECNEC.

According to the adviser, there are many expensive machines in many district level health centres, but these are not in service.

"If we want to spend, then we have to see whether there is any skilled health workers or technicians," he told.

He also mentioned that giving allocation and the purpose of allocation is different thing.

The sources in planning ministry and health ministry said during the Awami League regime the budget allocation for the health sector was good, but not up to the mark.

But due to the irregularities and corruption mass people failed to get proper services from the public hospitals, he said.

The National Economic Council (NEC) approved the Annual Development Programme (ADP) for the fiscal year of 2024-2025 with an outlay of Tk 265,000 crores.

The total allocation against the top 10 sectors is some Tk 242,093 crore (90.25pc of the total ADP).

According to the new ADP for FY25, the highest 10 allocation recipient ministries and divisions are Local Government Division with some Tk38,809 crore (15% of allocation), Road Transport and Highways Division with Tk32,042 crore (12.39%), Power Division with Tk29,177 crore (11.28%), primary and mass education ministry with Tk16,136 crore (6.24%), Health Services Division with Tk13,741 crore (5.31%), Railways Ministry with Tk13,726 crore (5.31%), science and technology ministry with Tk12,887 crore (4.98%), Secondary and Higher Education Division with Tk11,388 crore (4.40%), shipping ministry with Tk10,373 crore (4.01%) and water resources ministry with Tk8,687 crore (3.36%).

The total allocation against the 10 ministries or divisions is around Tk186,965 crore, which is some 72% of the overall ADP outlay.

But the healthcare sector in Bangladesh remains in a precarious state, plagued by systemic challenges that hinder the delivery of quality medical services to its citizens.

Despite notable economic growth and advancements in other areas, the country's health system continues to grapple with inadequacies in infrastructure, staffing, and resource allocation, leaving millions vulnerable to preventable diseases and inadequate care.

One of the most pressing issues is the severe shortage of healthcare facilities and professionals.

According to recent statistics, there is only one doctor for every 1,800 people in Bangladesh, far below the World Health Organization's recommended ratio of one doctor per 1,000 individuals.

This scarcity is compounded by an uneven distribution of healthcare services, with rural areas bearing the brunt of neglect. While urban centers have access to better-equipped hospitals, rural clinics often lack basic amenities, trained staff, and essential medicines.

The lack of funding in the public health sector exacerbates the crisis. Bangladesh allocates less than 1% of its GDP to healthcare, one of the lowest in the world.

This chronic underfunding has led to dilapidated facilities, outdated medical equipment, and insufficient resources to meet growing demands.

Patients are frequently forced to turn to private healthcare, which is prohibitively expensive for the majority of the population, pushing many into financial distress.

Moreover, corruption and mismanagement within the healthcare system undermine efforts to improve service delivery.

Reports of embezzlement of funds and irregularities in the procurement of medical supplies are not uncommon, further eroding public trust in the system.

The COVID-19 pandemic exposed the fragility of the healthcare infrastructure, revealing critical gaps in emergency response mechanisms, testing facilities, and intensive care units. While the government has made efforts to address these shortcomings, progress remains slow, and systemic issues persist.

To address these challenges, health sector insiders said that comprehensive reform is urgently needed.

This includes increasing healthcare funding, improving training programs for medical professionals, and prioritizing equitable access to quality services.

Additionally, stronger governance and accountability measures must be implemented to curb corruption and ensure resources reach those who need them most.

"Without decisive action, the health sector's current state will continue to impede the country's development and compromise the well-being of its people. A robust and equitable healthcare system is not just a necessity—it is a fundamental right that must be upheld for all citizens," said a physician who works for a district level hospital.