Ensuring value-for-money in public spending for social sectors
Friday, 9 July 2010
Zafar Iqbal
RESOURCES are scarce and there are competing demands on the same by different sectors. Bangladesh for some years have been allocating a lion's share of the country's budgeted resources on education and health sectors. But allocations are one thing while the manner of spending them is another.
The growingly higher allocations for education and health sectors over the years are noted to be going mainly to maintaining routine services and to providing for pay and other benefits for the govt. personnel working in both sectors. Higher salaries, subventions and other operational expenditures of recurring types do mostly account for growing budgetary allocations. But the outcome of such expenditures, in terms of benefits for the people who are intended to be the beneficiaries thereof, remain doubtful in many areas, providing enough reasons for raising questions about value-for-money. Thus, in the government-administered health facilities, particularly in the countryside, the services being provided to the people at large remain poor and the coverage has hardly expanded, in real terms, over the years. Even the doctors and health personnel who are posted at such hospitals and health centres, are found absent in many cases. Medicines are not available. Available healthcare facilities, developed at the cost to public exchequer, do largely remain unutilised. Likewise, in education sector, it needs an assessment how much has been going to creation of physical or infrastructural facilities like buildings, laboratories , etc. to add to real capacities in this sector.
Increasing the spending in a sector, specially on one as vital as education or health, creates the expectation of a similar enhancement of the payoff or returns from it. For example, in the context of Bangladesh, satisfaction need not be taken that higher allocations and spending on education or health is leading to advancement of the underlying objective behind such spending : improving the general conditions of health and nutritional status of the people at the grassroots and ensuring them access, in greater numbers, to public healthcare facilities on both preventive and curative sides, the creation of quality human resources or even human resources in general.
Particularly in education sector, it is worthwhile to note that technical education has remained a neglected area. A great deal of the resources spent on education are wasted on creating only generalists of a modern economy. And, spending on health that has been at the top of allocations for a long time, has also really not meant any significant improvement of services in the publicly-run medical and health care system. This heightens the need for improving efficiency in the publicly-run medical and health care facilities. It is not that the number of such facilities is grossly insufficient. But it is the standard of service or care in them which falls far short of the expectation.
Besides, it is also a pressing need to increase spending to create awareness among people about the preventive sides in the health sector to major diseases and also about nutritional needs. Targeted spending is necessary to increase health and nutritional awareness. Programmes such as large scale distribution of nutritional supplements and advice should be introduced. Furthermore, the population control and related services call for higher spending as well as the greatest care to ensure true efficiency in their operations.
The spending in social sectors are often underestimated for their worth. The same may not immediately reflect value in the form of tangible output. Health gains or vitality of the workforce and creation of human resources are intangibles that form over periods of time and their impacts are not readily noted. But the same are critically important for making economic advancement over the long run. Therefore, appropriate spending on them but with quality is fully justified.
RESOURCES are scarce and there are competing demands on the same by different sectors. Bangladesh for some years have been allocating a lion's share of the country's budgeted resources on education and health sectors. But allocations are one thing while the manner of spending them is another.
The growingly higher allocations for education and health sectors over the years are noted to be going mainly to maintaining routine services and to providing for pay and other benefits for the govt. personnel working in both sectors. Higher salaries, subventions and other operational expenditures of recurring types do mostly account for growing budgetary allocations. But the outcome of such expenditures, in terms of benefits for the people who are intended to be the beneficiaries thereof, remain doubtful in many areas, providing enough reasons for raising questions about value-for-money. Thus, in the government-administered health facilities, particularly in the countryside, the services being provided to the people at large remain poor and the coverage has hardly expanded, in real terms, over the years. Even the doctors and health personnel who are posted at such hospitals and health centres, are found absent in many cases. Medicines are not available. Available healthcare facilities, developed at the cost to public exchequer, do largely remain unutilised. Likewise, in education sector, it needs an assessment how much has been going to creation of physical or infrastructural facilities like buildings, laboratories , etc. to add to real capacities in this sector.
Increasing the spending in a sector, specially on one as vital as education or health, creates the expectation of a similar enhancement of the payoff or returns from it. For example, in the context of Bangladesh, satisfaction need not be taken that higher allocations and spending on education or health is leading to advancement of the underlying objective behind such spending : improving the general conditions of health and nutritional status of the people at the grassroots and ensuring them access, in greater numbers, to public healthcare facilities on both preventive and curative sides, the creation of quality human resources or even human resources in general.
Particularly in education sector, it is worthwhile to note that technical education has remained a neglected area. A great deal of the resources spent on education are wasted on creating only generalists of a modern economy. And, spending on health that has been at the top of allocations for a long time, has also really not meant any significant improvement of services in the publicly-run medical and health care system. This heightens the need for improving efficiency in the publicly-run medical and health care facilities. It is not that the number of such facilities is grossly insufficient. But it is the standard of service or care in them which falls far short of the expectation.
Besides, it is also a pressing need to increase spending to create awareness among people about the preventive sides in the health sector to major diseases and also about nutritional needs. Targeted spending is necessary to increase health and nutritional awareness. Programmes such as large scale distribution of nutritional supplements and advice should be introduced. Furthermore, the population control and related services call for higher spending as well as the greatest care to ensure true efficiency in their operations.
The spending in social sectors are often underestimated for their worth. The same may not immediately reflect value in the form of tangible output. Health gains or vitality of the workforce and creation of human resources are intangibles that form over periods of time and their impacts are not readily noted. But the same are critically important for making economic advancement over the long run. Therefore, appropriate spending on them but with quality is fully justified.