Siyam Hoque

2020-06-16 22:19:36 BdST

Revitalising the health sector

Common sense dictates that the health sector should be a top priority one in the national budget, especially at a time when a lethal pandemic, the covid-19, has made the country's healthcare system go through its paces. Already into the fourth month of its encounter with this mortal threat to  public health, which has meanwhile stretched the existing health service resources to their limits, it was only expected that public health will receive a shot in the arm in the proposed budget for the FY 2020-21.

However, looking at the pattern of allocation of funds for the health sector, one discerns a modest increase by Tk 55.55 billion over the current fiscal's revised budget of Tk 236.92 billion. This comes to around 5.4 per cent of the just proposed national budget for FY21.  

What makes one sit up and take note is a highly placed government official's observation that the level of allocation pointed to the ministry's lack of capacity to utilize funds earmarked for it as evidenced from the records of its performance in the preceding financial years. Actually he has spelt out a hard truth however unpalatable it may be. And this should serve as a trigger for a serious appraisal of the barriers to raising the money absorption capacities in the health sector in order to remove them with time bound corrective measures. When money is available and allocated to certain heads why should any part of it remain unutilised and be returned to the finance ministry? This could mean either of the two things: First the sector is caught up in a stagnation trap or there is lack of due diligence in living up to the emerging demands of public health concerns.

There may be other cogent underlying factors cutting across the healthcare spectrum such as the private sector hospitals and the mounting out-of-pocket medical expenses of the citizens here which are perhaps the highest in the region.

In the present case, the first priority of the government should have been to embark on a crash programme to identify the major points of weakness of the health ministry coming in the way of its ability to deliver and take all necessary measures to address those as soon as possible.

So the considerations that should first come to mind include  utilisation of the existing public health infrastructure which is regarded as one of the best in the region. But in terms of service delivery, except for child and maternal healthcare it has deplorably fallen short of meeting a growing requirement in other areas. There are needs for professional motivation, new recruitment, extensive training of health professionals and modernising equipment base comprising testing/screening facilities, more specialised beds, ventilators and ICUs. Importantly, while meeting the needs created by the pandemic-induced present health emergencies, the authorities in question must also not lose focus on the traditional, non-Covid-19, public health requirements.

In sum, nothing short of a national strategy comprising public and private healthcare sectors with increased institutional responsibilities and supported by sufficient budgetary resources and fiscal incentives would serve the broad spectrum health concerns going forward. The virus should set in motion a new learning curve leading to advanced research in virology to devise ways out of being entrapped by any future cataclysm.

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