Launch socially-dedicated health programmes to check poverty
Experts tell city discussion
FE Report | Monday, 11 June 2018
Speakers at a programme on Sunday said although 5.2 million people are at risk of slipping into poverty, there is no dedicated social protection programme on health.
They also said separate social protection programmes should be launched to tackle chronic and transient poverty in the country.
On the other hand, a top government official said 20 per cent of rich people get the benefits of the poor which is a 'targeting error or leakage'.
The speakers recommended devising new plans and target approach for the safety net programmes with setting new targeting criteria.
The observations came at a discussion on the findings of a study 'Targeting the poor for Universal Health Coverage (UHC) programme inclusion: Exploring a more effective pro-poor targeting strategy' at the CIRDAP auditorium in the city.
Dr Shamsul Alam, member (senior secretary), General Economics Division (GED), attended the programme as the chief guest.
Power and Participation Research Centre (PPRC) conducted this review of targeting approaches in Bangladesh with support from USAID's Health Finance and Governance (HFG) project.
The study was based on a qualitative review of targeting strategies in operation in six selected social protection programmes, covering the areas of health, workfare and food assistance.
The larger objective of the study was to draw appropriate lessons for designing a new generation of social protection programmes in the context of UHC.
PPRC executive chairman Hossain Zillur Rahman said there are so many social safety net programmes in the country.
But those are mainly designed for employment generation, food assistance and health (on a limited scale like allowance for lactating mothers and poor pregnant women), he added.
"There are 5.2 million people who are at risk of slipping into poverty. New social protection programmes are required for them," said the noted economist.
"The targeting and approaches should be taken into reconsideration when designing those programmes," he added.
Citing an example, Mr Zillur said there are small health-focused safety net programmes, but those are not on a larger scale. For example, the healthcare cost of the urban poor is a huge burden. Satellite clinics are limited in the papers, he added.
Besides, there are some outdated criteria for selecting and targeting beneficiaries, he said. Outdated indicator, leakage and cost inefficiency are the major problems in safety net programmes, Mr Zillur added.
"Leakage is a problem for the government programmes while cost inefficiency is a problem for NGO programmes as NGOs' service delivery cost is bigger," he said.
International Food Policy Research Institute (IFPRI) country director Akhter Ahmed said land is no longer a very good targeting criterion as people are leaving agriculture. They are engaging themselves in more productive areas within rural areas, he added.
Citing a panel survey conducted between 2011 and 2015, he also said the present safety net programmes target the female-headed households.
But it was found that either their husbands or some other members are earning or their husbands are living abroad and sending remittance, he added.
"The targets should be landless and female-headed HHs who are widows or destitute," he suggested.
He said the HHs without electricity in a village where there is electricity connections may be a good target criterion. Also the HHs without latrines can be targeted. It was found in the survey that only 4.0 per cent of the poor HHs have separate latrine, he added.
Regarding different types of poverty, Mr Akhter said 59 per cent of people were non-poor in 2011. Their condition remained unchanged even in 2015. About 17 per cent of people who were poor in 2011 remained poor in 2015 which means "they are in chronic poverty," he said.
He added: "This is the chronic poor group who are the main target of safety net programmes."
Besides, 16 per cent of people who were poor in 2011 moved out of poverty in 2015 while 9.4 per cent of people who were non-poor in 2011 fell into poverty in 2015.
"We need to be careful about the last group or transient poor who fell into poverty due to various reasons as they may eventually become chronic poor if their problems are not addressed," said Mr Akhter.
Mr Shamsul Alam said there are 3.9 million absolute poor in the country. But the number of poor is always 0.25 per cent more as some people fall into poverty, he added.
He said there were 145 safety net programmes and the government reduced it to 136 in two years.
Mr Alam laid emphasis on measuring poverty, not only by income or calorie intake rather by multi-dimensional poverty index (MPI).
Mursaleena Islam, Country Manager of HFG project, Bangladesh, moderated the programme.