Speakers at a programme on Thursday suggested the government raise allocation for primary healthcare in the 2022-23 national budget to ease the burden of out-of-pocket health expenditure on the public.
They also called for forming a health commission and introducing universal health insurance to broaden health coverage and ensure access to healthcare for marginalised communities.
The suggestions were made at a 'National Dialogue on Health Budget' hosted virtually by the Bangladesh Health Watch (BHW) jointly with BRAC University's James P Grant School of Public Health and Unnayan Shamannay (UnSy).
Bangladesh Institute of Development Studies senior research fellow Dr SM Zulfiqar Ali, Institute of Health Economics Prof Dr Syed Abdul Hamid and BHW convener Dr Mushtaque Raza Chowdhury spoke as expert panellists.
UnSy chairman Prof Dr Atiur Rahman presented a keynote at the event moderated by BHW Budget Thematic Group Chair Prof Dr Rumana Haque.
State minister for disaster management and relief Dr Md Enamur Rahman, parliamentarians Dr Shamil Uddin Ahmed Shimul, Dr Md Habibe Millat, Dr Pran Gopal Datta, Dr AFM Ruhal Haque and Dr Md Abdul Aziz also spoke.
Referring that the people below the poverty line spend over 33 per cent of their income on healthcare, Dr Zulfiqar emphasised introducing a health insurance programme to bring the poor under health coverage.
He also suggested forming a 'health commission' and increased cooperation among the government, private sector and NGOs to reduce the burden of high health expenditure on marginalised population.
Presenting the keynote, Dr Atiur said an estimated 2.3 per cent of the country's GDP is spent on current health expenditure (CHE) in Bangladesh which is lowest in the South Asian region.
The per-capita annual CHE in Bangladesh is around $45 while it is $58 in Nepal, $73 in India, $103 in Bhutan and $157 in Sri Lanka, he disclosed.
Comparing to average GDP growth of 6.0 per cent for the last couple of years, growth in health expenditure is higher at over 7.0 per cent in the meantime, according to Dr Atiur.
Urging the government to shed the practice of 5.0-6.0 per cent allocation of the total budget for health sector, he said allocations for primary healthcare should be increased to at least 30 per cent in the next fiscal from existing 25 per cent and enhanced gradually to 35-40 per cent in the near future.
Citing a recent report of the Bangladesh National Health Accounts, the former central bank governor said at least 68 per cent of the total health expenditure here is coming out of the citizens' pockets.
Meanwhile, an estimated 23 per cent of the health cost is provided by the government and the rest is supported by development partners and other sources.
If the allocations for providing free-of-cost medicine for people can be tripled, he said, the out-of-pocket health expenditure can be reduced to 58 per cent from current position.
Meanwhile, the state minister said the government's commitment to quality healthcare for all is reflected in Covid-19 vaccination for 80 per cent of the population within a short time.
If the efficiency shown in vaccination programme can be replicated in the entire health sector, there is a possibility of ensuring quality healthcare for all in the country, he hoped.
Former health minister Dr Ruhul laid emphasis on the decentralisation of the health sector management to improve service delivery.
He said the country needs at least 0.5-million doctors to serve the huge population, whereas there are less than 0.1-million doctors available right now.
Besides, Dr Datta highlighted the need to enhance the drug administration's capacity to ensure quality control of the medicines sold in the local market.