The Financial Express

Health sector -- money and management

| Updated: June 12, 2020 22:30:58

Health sector -- money  and management

The Covid-19 pandemic has exposed multiple fault lines in the health sector. Inadequate allocation of resources on an annual basis by the government is one of those.

With the pandemic wreaking havoc on life and livelihood in the country as elsewhere in the world, the demand for increased allocation of resources for the health sector has only become louder.

The country's health infrastructure has undergone notable changes in recent years and this is clearly manifest in the decline in infant and maternal mortality rates and increase in average life expectancy. But all these positives do not depict the whole picture.

While primary healthcare facilities are plagued by irregularities of different sorts, intermediate and tertiary levels have been deficient in proper planning and management. All these together are forcing the people to make out-of-pocket expenditure -- more than 60 per cent -- on medicare.

The relevant authorities have paid scant attention to the need for increasing allocation for health and addressing the weaknesses therein.

However, following the outbreak of deadly Covid-19, it has truly become difficult for the government to keep its eyes and ears shut as far as the health sector deficiencies are concerned. It has become difficult to ignore the growing demand to boost allocation for the sector.

According to media reports, allocation for the health sector in the proposed budget for the fiscal year (FY) 2020-21 will be nearly 24 per cent higher over that of the revised budget for the outgoing fiscal.

However, the resource allocation figure appears somewhat misleading because of the fact that the comparison is being made with the revised budget, not the original one. If compared with the resources earmarked in the original budget, the increase in allocation will be 13 per cent, not 24 per cent.

There is also another twist in it. The health ministry has two divisions --Health Services Division and Medical Education and Family Welfare Division. Out of the recurrent and capital expenditure -- Tk 134.65 billion -- earmarked in the original budget for fiscal '20, the health services division got around Tk 100 billion. The division got identical amount in the original annual development programme (ADP) for the same fiscal.

The higher allocation for the health sector, undoubtedly, is a necessity, but it is equally important to see how and where the money is spent. The quality of spending is an issue that has received little attention of the relevant policymakers.

The ongoing health crisis over the Covid-19 pandemic has come as an eye-opener. There is no denying that the country's health management system has never encountered a crisis like the ongoing one. So, initial hiccups in dealing with it are very much natural. Even with the world's most resources and medical expertise under their command many countries were found to be clueless in managing the crisis at the initial stage. But, most of them later started managing the crisis well.

Unfortunately, Bangladesh not only has failed to impose restrictions necessary to contain the disease, but also in many cases, is not being able to provide treatment to Covid patients. The health management system is in a total disarray even 92 days after the detection of the first case on March 08 last. 

 There are not enough dedicated hospitals for Covid patients, isolation beds, ICU beds, centralised oxygen facility etc. The non-Covid patients are also experiencing serious problems as hospitals are refusing to admit them and doctors are skipping their regular chambers.

A number of government hospitals declared as dedicated Covid hospitals are yet to be ready after three months. The plight of patients is hard to describe. People having connections with high places have been managing admissions in hospitals. Overall, this is a pitiable sight.

What is happening with lockdown or any type of restriction does not need any mention. It is hard to say who is overseeing the Covid management as indecision and lack of coordination have become order of the day.


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