Experts blame underuse of resources, poor budget

People are not getting the healthcare they expect because of an inadequate budget allocation, underutilisation of resources in the health sector and inefficiency, experts said yesterday.

At the same time, the quality of health services is dropping, they said.

The observations came at a seminar on "issues related to health expenditure in Bangladesh", organised by the Policy Research Institute of Bangladesh (PRI) at its office in the capital.

According to the experts, a high level of absenteeism persists among the healthcare providers, especially doctors, while a lack of coordination between development and non-development expenditures causes suboptimal utilisation of resources.

Prof Kaniz Siddique, a researcher of PRI, said there must be a "critical amount" of money in the health sector before it could make an impact.

"For the 16 crore people, the government has allocated only Tk 78 crore for nutrition services in the current fiscal year, which is very inadequate," she said in a presentation.

The cost for secondary and tertiary medical care is increasing, while it is increasing modestly for the primary care, she added.

Prof Kaniz said, "Our health spending is $32 per capita. But our government provides only $11 and $21 goes out of our pocket."

Referring to the World Bank's 2013 data on public health expenditure as a share of GDP, she said Bangladesh had the second lowest ranking, just above Pakistan, among nine developing countries.

Uganda tops the list with a score of 4.34 while Bangladesh scored 1.31, the data shows.

Prof Kaniz pointed out that the government's spending for non-development activities in the health sector was increasing but it was declining for development activities.

Speaking as chief guest, Health and Family Welfare Secretary Syed Monjurul Islam said it was true to some extent that the government's health policy always did not reflect the people's expectations but health was getting high priority.

"We have challenges of the unfinished agenda of MDGs. It's really challenging to complete the agenda but our activities are going on."

The secretary, however, said the healthcare service could not be improved until the doctors performed their duty properly despite enjoying all government benefits.

Sadiq Ahmed, vice chairman of PRI, called for introducing health insurances for people.

Executive Director of PRI Ahsan H Mansur chaired the seminar, while Prof Rumana Huque of the Department of Economics at Dhaka University, spoke, among others.