Post-Budget Analysis on Allocation in Healthcare

Written by: Prokriti Das Srishti

As the annual budget was announced only recently, Youth Policy Forum is here to offer its two cents in discussion with some leading experts in the Healthcare sector. In accordance with last year, YPF has organized the first session of its Post-budget Analysis of Fiscal Year 2021-22. This episode also marks the inaugural session of Road to Reforms, and aims to work towards a youth-led reform matrix for policymakers and young members of this forum to follow. It focuses on ways the youth can be informed and inspired to get involved and better the quality of work in the health economic development sector.

YPF had organized this discussion in collaboration with Platform, Shastho Shurokkha Foundation, and UNDP.

The esteemed panelists include Prof. Dr. Md Habibe Millat, MP, Chairman, Bangladesh Parliamentary Forum for healthcare and well being. (Chief guest), Prof. Zahidul Quayuum, PhD, Director Research, BRAC James P Grant school of Public health, YPF Senior fellow, Economics, Health and Wellbeing, and, Ms. Tahmina Begum, Heath Financing Expert.

The discussion was moderated by Dr. Mohib Nirob, Medical Officer, DHGS, YPF fellow Healthcare and Well Being, alongside presenter Puspita Hossain, Health Policy PhD student, McMaster University.

YPF acts as a representative of the young generation and conveys their expectations to the policymakers of the country as well as help build up the youths as leadership assets of the nation. YPF’s works include year long policy analysis about different sectors of the country. In line with that, it  aims to put light onto the idea and perception of the youth in terms of the proposed budget.

The discussion began with a brief yet highly informative presentation from Puspita Hossain, that seemingly covered  relevant statistics of the budget  regarding the allocation in the Healthcare sector. Though the budget aims to tackle the ongoing pandemic and still maintain stable economic growth there seem to be some areas that need more effort. For example, t although there is a slight rise in the allocated healthcare budget compared to last year, it is still far from the recommended 15% of the overall budget that should be allocated to healthcare.  Healthcare makes a meagre 5.42% of the total budget of the fiscal year 2021-2022 with the allotment of only 0.95% of GDP

The main theme of the budget this year is Priority on Lives and Livelihood. The pandemic is an inevitable part of the budget analysis discussion and the presentation tells us that despite the availability of the vaccine, COVID-19 still poses threats that can only be fended off by lockdowns. However, prolonged lockdown  poses a threat to  the nation’s economic growth. Some notable steps taken by the government to fight challenges of  the pandemic are schemes to benefit frontline workers, vaccinating 80% of the population systemically and signing loan agreements to bring as many vaccines as possible from various sources and countries.

Despite such attempts, one of the prime drawbacks seems to be the effective utilization of the budget as findings suggest 24% of the budget remaining unused. Comparatively, other ministries  could utilize  over 41% of their designated budget in the initial 10 months. Findings also suggest that more than 52% of the allocation is spent on operational revenue rather than developmental issues. Strengthening public healthcare, reducing out of pocket-expenditure (which seems to contribute to poverty) and expanding healthcare insurance still remain as major challenges.

When asked, Prof Dr. Md Habibe Millat said “there is no alternative to research”. He stated that Bangladesh’s out-of-pocket-expenditure is one of the highest in the world and suggested it is possible to to lower it down with an increase in the budget itself. However, Ms Tahmina Begum suggested that without utilizing the full of the allocated budget, it is unlikely that budget allocation in health will increase.

He also suggested that the administrative procedure surrounding the release of funds  needs to improve in order for better implementation. ” Without implementing Universal Health Care  in Bangladesh there is no way to ensure proper healthcare services to our large population. “-Prof. Dr. Habibe Millat.

Ms Tahmina Begum advises to prioritize budget utilization and applauds the imposed tax upon confectionery and tobacco products.

” We need to investigate why the utilisation of the health budget is decreasing over the years.”- Dr. Tahmina Begum. She pinpoints the adversity that comes with out-of pocket-expenditure and says, “We need to change our process of prescription as the majority of our out-of-pocket-expenditure is spent on medication”.

She also suggests training for healthcare workers who might not have  professional exposure as well as the establishment of proper guidance manuals to compare and contrast and maintain an even quality of the training throughout the country. She also offers insight on why the implementation process is slowed down in most classes, “” The fourth installment for the health budget often arrives in late May which makes it difficult to spend the entire budget on time ” she said.

She explains how every year the  procurement of drugs and equipment takes away a significant amount of time which results in the incomplete utilisation of budget. As per her suggestion, this can be tackled if the country can go for a 5/3years contractual procedure in procuring.

Moving on to the healthcare insurance section, Prof. Dr. Zahidul Quayyum emphasizes on the importance of a proper infrastructure, ” Who will be the provider, who will be the consumer and how will it be consumed. These 3 have to be considered to develop a structure and much more discussion is needed to create this structure”, he said.

All in all, the key takeaway from the webinar was that, Bangladesh possesses the capability to excel in the healthcare sector even in the given budget but significant effort is needed in some key  concerning areas that seemingly poses harm from inside the infrastructure.

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