Health spends only 31% of its ADP allocation

The Health Service Division has recorded its worst performance in the history of implementing development projects this fiscal year - at a time when higher expenditure was needed to tackle Covid-19. 

It could only spend 31.38% of the allocation under the revised Annual Development Programme in 11 months, said the Implementation Monitoring and Evaluation Division of the planning ministry. That was the lowest performance among 15 ministries and divisions that had high ADP allocations.

At the beginning of the fiscal year, allocations of almost all ministries and divisions had been reduced, while a revised ADP was issued increasing the budget of the Health Service Division by Tk2,243 crore, according to an IMED report.

Officials at the health division said it could not spend on improving healthcare as much as was expected because of Covid-19 and the failure to procure vaccines under the World Bank-funded projects. 

Between July last year and May this year, the Health Service Division could spend only Tk3,759 crore against a revised ADP allocation of Tk11,979.34 crore.

On the other hand, the Medical Education and Family Welfare Division spent Tk1,164 crore against an allocation of Tk1,886 crore.

If both the divisions want to utilize their annual budgets by the end of this year, Tk8,942.21 crore will have to be spent in this month.

The IMED report says that since ADP implementation was slow over the last 11 months, ministries and divisions were facing a mounting expenditure pressure in the last month of the year.

It says the ADP implementation of all government bodies combined was 58.33% from July to May of Tk209,272 crore.  The implementation rate rose 1% compared to the previous year, but to attain an 100% implementation rate, more than Tk87,000 crore will have to be spent in this month.

Work on many projects have made good field-level progress but their financial progress is not that much because of non-disbursement of funds. The planning commission and the IMED urged ministries and divisions many times to speed up the implementation of slow-moving projects, Pradeep said.

Mentioning that the trend of excessive spending in the last month of a fiscal year is an old problem, Fahmida Khatun, executive director of the Centre for Policy Dialogue, said work standards could not be maintained because of the rush towards the end of a fiscal year.

What will be the budget of a particular ministry in the next few years is predetermined. Priorities in expenditure are also fixed, so no reason is there to keep work suspended at the beginning of a fiscal year, Fahmida said.

 "If the same person or organisation can work fast towards the end of the year, why cannot they do so at the beginning!".

To counter the pandemic, the Ministry of Health has taken up several new projects for building hospitals and procuring ICU ventilators, oxygen and various life-saving medical equipment. There was another project for the purchase of vaccines.

Additional Secretary (Planning) of the Health Services Division Md Helal Uddin said the implementation of a large project to procure vaccines had been stalled because vaccines were not available.

The purchase of vaccines depends on the international situation. Many parties, including lenders and the Economic Relations Division, are involved. Although it was decided that the vaccines would be purchased through an international tender, it was not possible.

Besides, work on other construction projects has been hampered due to the pandemic, he added.

Dr Syed Abdul Hamid, a professor at the Institute of Health Economics, Dhaka University, described the disruptions to health projects for Covid-19 as frustrating. 

"We need to spend more in the health sector at this time. In our country, the allocation in this sector is less and so is the implementation rate."

Hamid said that if the implementation of ADP had been possible, the projects would have progressed a lot and the public would have benefited.

Due to the stagnation in the development work, it will be difficult for people to get medical services. The out-of-pocket health expenditure will go up too.