American Journal of Economics, Finance and Management
Articles Information
American Journal of Economics, Finance and Management, Vol.1, No.5, Oct. 2015, Pub. Date: Jul. 29, 2015
Health System Financing in Bangladesh: A Situation Analysis
Pages: 494-502 Views: 4332 Downloads: 4420
[01] Anwar Islam, School of Health Policy and Management, York University, Toronto, Ontario, Canada.
[02] G. U. Ahsan, School of Life Sciences, North South University, Dhaka, Bangladesh.
[03] Tuhin Biswas, Department of Public Health, North South University, Dhaka, Bangladesh.
The financing of health care in Bangladesh primarily comes from three sources - the public exchequer, out-of-pocket payments by the users, and foreign aid from the development partners. Social and private insurance and official user fees comprise a very small proportion of the total funding. Using available secondary data, the paper is aimed at providing a comprehensive analysis of the dynamics of health care financing in Bangladesh. Bangladesh spends only about 3.5% of its Gross Domestic Product (GDP) on health. The per capita per annum health expenditure is about USD 27. It is important to note that about 63% of the total health expenditure is out-of-pocket expenses. Over the years the government’s share in the total health expenditure has declined considerably and it currently stands at around 35% of the total. Budget analysis shows that the national budget as a per cent of GDP has increased from 14.5 per cent in FY 2008-09 to 18.4 per cent in FY 2012-13. However, the health sector budget as a per cent of the national budget has declined from 5.71 per cent in FY 2008-09 to 4.87 per cent in FY 2012-13. On the other hand, financial allocation for the health sector remained stagnant at 0.9 per cent of the GDP over the last three fiscal years (2010-11 to 2012-13). Evidence suggests that district and sub-district level allocations for health under the revenue budget are determined by norms that relate to the number of beds (for food and drugs) and staff in facilities (for salaries) rather than the population size and other demographic and epidemiological measures reflecting health needs giving rise to serious inequity in resource distribution. It is apparent that Bangladesh needs to spend more on health care and at the same time make every effort to use its existing health care resources more effectively and efficiently. Exploring alternative sources of funding for the health system including social and other forms of insurance should be a priority for Bangladesh. Moreover, exploring alternative sources of funding must go hand in hand with increasing the overall health budget. In order to achieve and sustain Universal Health Care (UHC), Bangladesh has no alternative but to significantly increase public funding for the health system and at the same time promote and protect equity.
Healthcare Financing, Gross Domestic Product, Equity, Pressure Groups
[01] Islam, M.S. and M.W. Ullah, People's participation in health services: A study of Bangladesh's rural health Complex. 2009: Bangladesh development research center (BDRC).
[02] Gwatkin, D.R., A. Bhuiya, and C.G. Victora, Making health systems more equitable. The Lancet, 2004. 364(9441): p. 1273-1280.
[03] Health, W.C.o.S.D.o. and W.H. Organization, Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health: Commission on Social Determinants of Health Final Report. 2008: World Health Organization.
[04] Vaughan, J.P., E. Karim, and K. Buse, Health care systems in transition III. Bangladesh, Part I. An overview of the health care system in Bangladesh. Journal of Public Health Medicine, 2000. 22(1): p. 5-9.
[05] Bhatia, S., et al., The Matlab family planning-health services project. Studies in family planning, 1980: p. 202-212.
[06] Uddin, J., S. Momtaz, and M.S. Islam, State Obligation towards the Fulfillment of the Right to Health: A Study in Bangladesh Perspective. Mediterranean Journal of Social Sciences, 2013. 4(13): p. 73.
[07] El Arifeen, S., et al., Community-based approaches and partnerships: innovations in health-service delivery in Bangladesh. The Lancet, 2013. 382(9909): p. 2012-2026.
[08] Xu, K., et al., Household catastrophic health expenditure: a multicountry analysis. The lancet, 2003. 362(9378): p. 111-117.
[09] Saksena, P., et al., Health services utilization and out-of-pocket expenditure in public and private facilities in lowincome countries. World health report, 2010.
[10] Green, A., The role of non‐governmental organizations and the private sector in the provision of health care in developing countries. The International Journal of Health Planning and Management, 1987. 2(1): p. 37-58.
[11] Carrin, G., M.P. Waelkens, and B. Criel, Community‐based health insurance in developing countries: a study of its contribution to the performance of health financing systems. Tropical Medicine & International Health, 2005. 10(8): p. 799-811.
[12] Ensor, T., A. Hossain, and N. Miller, Funding health care in Bangladesh–assessing the impact of new and existing financing. facilities, 1998.
[13] Akin, J.S., N. Birdsall, and D.M. De Ferranti, Financing health services in developing countries: an agenda for reform. Vol. 34. 1987: World Bank Publications.
[14] Rahman, H., Structural adjustment and macroeconomic performance in Bangladesh in the 1980s. The Bangladesh Development Studies, 1992: p. 89-125.
[15] Mustafa, A. and T. Begum, Universal Health Coverage Assessment People’s Republic of Bangladesh. 2014.
[16] Ahmad, A., Provision of Primary Healthcare Services in urban areas of Bangladesh: the case of urban primary healthcare project. Working Papers, Department of Economics, Lund University, 2007(9).
[17] Ensor, T., et al., Geographic resource allocation in Bangladesh. Health Policy Research in South Asia, 2003: p. 101.
[18] Rahman, R.M., Human rights, health and the state in Bangladesh. BMC international health and human rights, 2006. 6(1): p. 4.
[20] Lewis, M., Informal payments and the financing of health care in developing and transition countries. Health Affairs, 2007. 26(4): p. 984-997.
[21] Khan, A.R. and B. Sen, Inequality and its sources in Bangladesh, 1991/92 to 1995/96: an analysis based on household expenditure surveys. The Bangladesh Development Studies, 2001: p. 1-49.
[22] Buse, K. and C. Gwin, The World Bank and global cooperation in health: the case of Bangladesh. The Lancet, 1998. 351(9103): p. 665-669.
[24] Adams, A.M., et al., Innovation for universal health coverage in Bangladesh: a call to action. The Lancet, 2014. 382(9910): p. 2104-2111.
[25] Lester, R., Eco-economy: building an economy for the earth. 2002: Orient Blackswan.
[26] Hoque, Z. and T. Hopper, Political and industrial relations turbulence, competition and budgeting in the nationalised jute mills of Bangladesh. Accounting and Business Research, 1997. 27(2): p. 125-143.
[27] Ensor, T. and S. Cooper, Overcoming barriers to health service access: influencing the demand side. Health policy and planning, 2004. 19(2): p. 69-79.
[28] Mondal, M.A.H., L.M. Kamp, and N.I. Pachova, Drivers, barriers, and strategies for implementation of renewable energy technologies in rural areas in Bangladesh—An innovation system analysis. Energy Policy, 2010. 38(8): p. 4626-4634.
[29] Baqui, A.H., et al., Effect of timing of first postnatal care home visit on neonatal mortality in Bangladesh: a observational cohort study. Bmj, 2009. 339.
[30] Thornalley, P.J., et al., High prevalence of low plasma thiamine concentration in diabetes linked to a marker of vascular disease. Diabetologia, 2007. 50(10): p. 2164-2170.
[31] Creese, A.L., User charges for health care: a review of recent experience. Health policy and planning, 1991. 6(4): p. 309-319.
[32] Islam, A. and T. Biswas, Health System Bottlenecks in Achieving Maternal and Child Health-Related Millennium Development Goals: Major Findings from District Level in Bangladesh.
[33] Islam, A. and T. Biswas, Chronic Non-Communicable Diseases and the Healthcare System in Bangladesh: Current Status and Way Forward. Chronic Dis Int, 2014. 1(2): p. 6.
[34] Islam, A. and T. Biswas, Health System in Bangladesh: Challenges and Opportunities. American Journal of Health Research, 2014. 2(6): p. 366-374.
[35] TANJILA TASKIN, T.B., ALI TANWEER SIDDIQUEE, ANWAR ISLAM, AND DEWAN ALAM, Chronic Non-Communicable Diseases among the Elderly in Bangladesh Old Age Homes. 2014. 3(4).
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