The state of public health sector allocation

No policy can be implemented successfully without adequate financing. Policy implementation in the health sector is also no exception. Article 18(1) of the Constitution states: "The state shall regard raising the level of nutrition and improvement of public health as among its primary duties…" As per the Constitution and in view of the population as a resource, the government of Bangladesh makes an allocation in each national budget for the health sector with a view to expanding and improving the quality of health services. For the fiscal year 2003-04, an allocation of Tk 29.22 billion (2,922 crore) was made for the health sector. An allocation of Tk 37.32 billion was proposed for the FY 2004-05, but in the revised budget for the fiscal the allocation fell to Tk 31.75 billion. For the FY 2005-06, the allocation in the health sector was Tk 42.40 billion, 6.6 per cent of the total budget. The allocation was up by Tk 10.65 billion or 33.5 per cent from that of the previous fiscal's revised budget. Thus the health budget kept increasing. For the FY 2011-12 an allocation of Tk 88.89 billion was made, it was 5.4 per cent of the budget. For the FY 2012-13, the allocation was Tk 93.55 billion or 4.9 per cent of the national budget. Tk 94.95 billion or 4.3 per cent was allocated for the FY 2013-14. In the new national budget for the FY 2014-15 the allocation for the health sector is Tk 111.46 billion, which is about 4.4 per cent of the budget outlay.
The data shows that during the period from FY 2003-04 to FY 2014-15 the total amount of allocation for the health sector increased gradually in each fiscal year. But the health sector allocation in percentage points of the national budget had seen a negative trend since the FY 2007-08. The data shows that the health sector allocation was 5 per cent in the FY 2003-04, 7 per cent in FY 2004-05, 6.6 per cent in FY 2005-06, 6.8 per cent in FY 2006-07, 6.6 per cent in FY 2007-08, 5.9 per cent in FY 2008-09, 6.1 per cent in FY 2009-10, 6.0 per cent in FY 2010-11, 5.4 per cent in FY 2011-12, 4.9 per cent in FY 2012-13 and 4.3 per cent in the FY 2013-14 followed by 4.4 per cent in the current FY 2014-15. The health sector budget in terms of the percentage point of the national budget increased from 5 per cent in the FY 2003-04 to 6.8 per cent in the FY 2006-07. Later it saw the negative trend declining from 6.8 per cent in the FY 2006-07 to 4.3 per cent in the FY 2013-14.
We cannot deny the fact that the total amount of allocation for the health sector increases gradually in each fiscal year, but these are far below the requirement in terms of the large population and their demand for healthcare services. The allocation for the health sector should be at least 15 per cent of the total budget. The allocation for the sector in the percentage point has declined while the government has committed to provide its citizens with better healthcare facilities. So the government should increase allocation for the sector, not only in terms of value, but also in terms of percentage point in consideration of the large population and their requirement of healthcare services.
The writer is a post-graduate student (former) of the Department of Public Administration at the Jahangirnagar University.                bjdatta@yahoo.com