‘𝗛𝗲𝗮𝗹𝘁𝗵 𝗕𝘂𝗱𝗴𝗲𝘁 𝗗𝗶𝘀𝗰𝘂𝘀𝘀𝗶𝗼𝗻 : 𝗘𝘅𝗽𝗲𝗰𝘁𝗮𝘁𝗶𝗼𝗻𝘀 𝗮𝗻𝗱 𝗢𝘂𝘁𝗰𝗼𝗺𝗲𝘀, 𝗣𝗮𝗿𝘁-𝟮’

The amount of allocation for the Health sector was Tk 292.45 billion (5.14 per cent of the budget) in 201-20FY, which was raised to Tk 380.52 billion in the ongoing budget of 2023-24FY. The allocation in the budget remains close to 5 percent of the budget and 1 percent of the GDP.The amount could be raised to Tk 420 billion in the next budget said by finance ministry sources.

About 7.8 per cent (nearly Tk 206.82 billion) of the ADP will be allocated to the health sector in the next budget. The 8th Five Year Plan spoke about raising the allocation to 11 percent of the ADP.

Currently, 56 development projects related to the health sector are being implemented. Twenty eight of them are about construction of hospital, clinic and other buildings while the remaining are involving research, enhancing efficiency and making services automated.Many new hospital buildings are built,100-bed hospitals are upgraded to 200 beds but human resources are not recruited accordingly. As a result, buildings and equipment remain unused.

The most common problem in the health sector is the manpower crisis.According to the Directorate General of Health Services’ Health Bulletin 2020, there are 108,000 registered physicians in Bangladesh, meaning the country needs 3.24 lakh nurses.World Health Organization (WHO) guidelines suggested the doctors and medical paramedic ratio of 1:5. But the situation is almost reverse in Bangladesh. In Bangladesh, the ratio is 4:1. However, the number of the registered nurses in the country was 77,838 as of February in 2023, according to the Bangladesh Nursing and Midwifery Council (BNMC).The number of nurses working in government hospitals is only 42,330, which is quite insufficient compared to the requirement, according to data from the Society for Nurses’ Safety and Rights.

Also by global standards, Bangladesh is currently short of at least 91,000 doctors, 280,000 nurses and 483,000 other medical workers (technologists). Deficits are widening and creating widening disparities by geographic location. Although 70 percent of people live in rural areas, there are 18 times more doctors in urban areas. A further concern is the absence of doctors in government health centres in rural areas. 30-50 percent posts are vacant in health centres against government approved posts. Manpower shortage is not the only problem. Imbalances exist in the composition of different skilled segments of the workforce. For example, a surgical team is well staffed but a combination of different skills makes the entire team ineffective if one is deficient (eg: anaesthetist). The general lack of required skills of health care workers, coupled with acute shortage of skilled manpower, has become a chronic crisis. Besides, various specialist doctors, public health experts are not being prepared in accordance with the state requirements. Acute shortage of skilled manpower including anaesthetists, radiologists, nurses is not being met. For 12 long years since 2008, diagnostic technologists have not been given any government jobs.

According to the official data, the X-ray machine which has been imported for Rs 87,672 lakh was installed in the hospital in August 2020. Due to lack of technologists, no X-rays have been done on the operating machine till date.

There is a severe crisis of teachers in all the medical colleges. It is not possible to run academic activities and classes properly without an adequate number of teachers. In this way, around a few thousands of students are starting their professional life as physicians without having proper knowledge every year. According to the latest figures of the Directorate General of Medical Education (DGME), some 42 per cent of the posts of teachers at medical colleges across the country are vacant at the moment.

5,920 posts of teachers of basic and clinical subjects. Of them, 2,459 posts are vacant, including 29 per cent posts of teachers of basic subjects and 48 per cent posts of teachers of clinical subjects. Overall, some 42 per cent of the posts of teachers in the medical colleges are vacant at the moment.

𝗖𝗿𝗶𝘀𝗶𝘀 𝗶𝗻 𝟴 𝗯𝗮𝘀𝗶𝗰 𝘀𝘂𝗯𝗷𝗲𝗰𝘁𝘀

There are eight subjects in the medical studies known as basic subjects. They are – anatomy, physiology, biochemistry, community medicine, pharmacology, medical laws, pathology and microbiology. There is a lack of teachers in these eight subjects in almost every medical college in the country.Speaking to specialist physicians and persons relevant to medical studies, it has been learnt that the students are less interested in higher studies on basic subjects. They are more interested in medical practice and there is ample chance of practice in clinical subjects. Besides, there is both money and honour in clinical subjects.Therefore, the students are more interested in becoming heart specialists, cancer specialists, neurologists and ophthalmologists as compared to the eight basic subjects. But these eight subjects are the basis of medical science. It’s not possible to become a specialist without having a good command over these subjects.

Though an initiative has been taken to recruit 6,000 new doctors (MBBS and Dental) to fill the vacant posts of doctors in all health services institutions across the country.But we need to fill the vacant posts of skilled nurses , midwives, medical technologists besides Doctors. Since,recent tragic incidents shows us how crucial it is to have proper skilled manpower in medical services. Our budget needs more allocations in the manpower sector to ameliorate overall health care service.