Money ideal for health ministry goes elsewhere

The government has been allocating resources for health to 16 other ministries even as the core ministry responsible for overall health outcome struggles to find money.

Health experts suggested integrating all these resources spent in a scattered manner into the health ministry to help achieve universal health coverage (UHC).

They also suggested making the primary healthcare network of the government including upazila health complex, community clinics and other facilities functional to help achieve the goal of healthcare for all.

The government must ensure quality healthcare services by establishing National Health Protection Authority as envisaged in the healthcare financing strategy (2012-2032), they said.

Talking to the FE, public health expert Dr Abdus Sabur said apart from the hospitals run by the health ministry, there are Combined Military Hospital (CMH), Border Guard Bangladesh (BGB) Hospital, Police Hospital, Jail Hospital, Central Drug Addiction Treatment Hospital, Government Employees Hospital, and Railway Hospital.

Local government authorities run health centres.

People of three districts under the Chittagong Hill Tracts (CHT) get health care service by hill district council, social welfare ministry can donate money to any patient if they are eligible to get the fund for treatment.

The ministry also donates money for the construction of various non-profit or philanthropic hospitals.

Moreover, women and children affairs ministry has constructed the second unit of BIRDEM, especially for the healthcare services of women and children.

Fire Brigade will construct a 500-bed burn hospital near its headquarters, he added.

"The main challenge for Bangladesh in ensuring universal coverage is insufficient resources. But the government has been distributing resources in a scattered way, ultimately producing hardly any significant outcome," Mr Sabur said.

He said the government itself had been wasting money but the health ministry is the authority accountable for health.

Mr Sabur wondered why the health ministry does not claim the budgetary allocations diverted elsewhere.

The health minister, however, remains vocal, and has long demanded boosting budgetary allocations for his ministry.

Mr Sabur's comments come as Bangladesh observes World Health Day today (Saturday) with low budgetary allocation for health, high out-of-pocket expenditure (67 per cent), which is gradually rising.

While this year's theme is "Universal Health Coverage For All, Everywhere", the country suffers from insufficient health workforce and low-quality healthcare service.

Out-of-pocket expenses account for some 67 per cent of total health expenditure, which is associated with low government health budgets.

The disproportionate out-of-pocket cost falls on the poor.

According to a recent data of the World Health Organisation, about 5.2 million people slip below the poverty line every year in Bangladesh due to health expenditure.

About 22.5 million people have been facing sudden shock of health expenditure in the country. In this context, an increase in the health budget is one of the major requirements for achieving universal coverage.

Regarding the role of the state in ensuring quality healthcare service, Dr Sabur said the state must monitor the service quality at government hospitals and health centres and regulate the service of private hospitals and clinics.

But the government facilities are always kept beyond the law and the laws and regulations are meant for the private sector only, he added.

Director of the Institute of Public Health of Dhaka University Professor Hamidur Rahman said if the resources spent by the civil administration for health can be integrated with the budget of the health ministry, then the resource constraints would be reduced to some extent.

The hospitals under other ministries can be brought under the purview of the health ministry, he argued.

Regarding the achievement of universal coverage, he said Bangladesh must focus on primary healthcare network like upazila health complex, community clinics as outpatients are going to quacks or private hospitals and clinics as they do not receive proper treatment at the public facilities.

In case of in-patients, the patients are overcrowding the district and tertiary hospitals, a situation he blamed for the declining quality of services and rising healthcare costs.

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