Bangladesh Defense Forum- Copy to clipboard
- Thread starter
- #31
Universal health coverage: a reality or mirage?
The aspiration for universal health coverage (UHC), where everyone can access the necessary healthcare without facing financial hardship, remains a distant dream due to the excessive commercialisation of the health sector and a disproportionately high out-of-pocket healthcare expenditure. The UHC e
Universal health coverage: a reality or mirage?
Published :
Feb 16, 2025 23:00
Updated :
Feb 16, 2025 23:00
The aspiration for universal health coverage (UHC), where everyone can access the necessary healthcare without facing financial hardship, remains a distant dream due to the excessive commercialisation of the health sector and a disproportionately high out-of-pocket healthcare expenditure. The UHC envisions both comprehensive service coverage for the entire population and financial protection against the high costs of medical care. While Bangladesh has made significant progress in expanding healthcare facilities, financial protection remains a major challenge. According to a World Bank study, over 73 per cent of total health expenditures in Bangladesh are borne directly by households, one of the highest in the world. This extremely high out-of-pocket spending has severe consequences. According to a study by the Bangladesh Institute of Development Studies (BIDS) soaring out-of-pocket healthcare expenses pushed 61 lakh Bangladeshis, or 3.7 per cent of the population, into poverty in 2022. Experts in a recent view exchange meeting have called for implementing a robust regulatory framework, ethical pricing mechanisms, and stronger supply chains to address the issue.
For Bangladesh to progress on the financial protection agenda, two key actions are necessary. Firstly, a significant increase in the health budget is essential. The World Health Organization suggests allocating at least 15 per cent of the total budget to the health sector, but Bangladesh allocates only around 5.0 per cent. The country's health budgetary support is one of the lowest in the South-East Asia region. The less a government spends on health, the higher out-of-pocket payment is sure to be. So, increased budgetary allocation is indispensable, particularly for ensuring access to healthcare for the poor, vulnerable, young, old, and informal workers - in essence, the majority of the population.
Secondly, the government must ensure optimum utilisation of the health budget by increasing allocation for government hospitals, health centres and healthcare professionals. However, increased allocation will not translate into enhanced facilities if corruption and some other irregularities in the health sector are not properly addressed. Absenteeism of doctors in government hospitals, particularly in rural areas has been an endemic problem. Many doctors exhaust their time and energy attending private clinics which leaves them with hardly any time for government hospitals where they are appointed to serve. It is the poor patients who mostly seek treatment at government hospitals and bear the brunt of these irregularities. Moreover, facilities in these hospitals like free medicines are scarce and those that exist do not come to the benefit of the poor due to mechanisms of vested quarters. So, to protect the poor from skyrocketing healthcare costs, public healthcare facilities must be better equipped with the necessary resources and logistics, and healthcare providers must be held accountable.
The country's high out-of-pocket healthcare expenses are not only pushing more people into the vicious cycle of poverty but also widening the gap between the rich and the poor. Globally, countries with robust government healthcare systems have achieved more equitable growth. For Bangladesh, allocating more resources to the health sector and implementing a strong strategy for enhancing financial protection for the poor and vulnerable will be crucial in ensuring access to basic healthcare for all. Otherwise, the vision of achieving universal health coverage will remain a mirage, not a reality.
Published :
Feb 16, 2025 23:00
Updated :
Feb 16, 2025 23:00
The aspiration for universal health coverage (UHC), where everyone can access the necessary healthcare without facing financial hardship, remains a distant dream due to the excessive commercialisation of the health sector and a disproportionately high out-of-pocket healthcare expenditure. The UHC envisions both comprehensive service coverage for the entire population and financial protection against the high costs of medical care. While Bangladesh has made significant progress in expanding healthcare facilities, financial protection remains a major challenge. According to a World Bank study, over 73 per cent of total health expenditures in Bangladesh are borne directly by households, one of the highest in the world. This extremely high out-of-pocket spending has severe consequences. According to a study by the Bangladesh Institute of Development Studies (BIDS) soaring out-of-pocket healthcare expenses pushed 61 lakh Bangladeshis, or 3.7 per cent of the population, into poverty in 2022. Experts in a recent view exchange meeting have called for implementing a robust regulatory framework, ethical pricing mechanisms, and stronger supply chains to address the issue.
For Bangladesh to progress on the financial protection agenda, two key actions are necessary. Firstly, a significant increase in the health budget is essential. The World Health Organization suggests allocating at least 15 per cent of the total budget to the health sector, but Bangladesh allocates only around 5.0 per cent. The country's health budgetary support is one of the lowest in the South-East Asia region. The less a government spends on health, the higher out-of-pocket payment is sure to be. So, increased budgetary allocation is indispensable, particularly for ensuring access to healthcare for the poor, vulnerable, young, old, and informal workers - in essence, the majority of the population.
Secondly, the government must ensure optimum utilisation of the health budget by increasing allocation for government hospitals, health centres and healthcare professionals. However, increased allocation will not translate into enhanced facilities if corruption and some other irregularities in the health sector are not properly addressed. Absenteeism of doctors in government hospitals, particularly in rural areas has been an endemic problem. Many doctors exhaust their time and energy attending private clinics which leaves them with hardly any time for government hospitals where they are appointed to serve. It is the poor patients who mostly seek treatment at government hospitals and bear the brunt of these irregularities. Moreover, facilities in these hospitals like free medicines are scarce and those that exist do not come to the benefit of the poor due to mechanisms of vested quarters. So, to protect the poor from skyrocketing healthcare costs, public healthcare facilities must be better equipped with the necessary resources and logistics, and healthcare providers must be held accountable.
The country's high out-of-pocket healthcare expenses are not only pushing more people into the vicious cycle of poverty but also widening the gap between the rich and the poor. Globally, countries with robust government healthcare systems have achieved more equitable growth. For Bangladesh, allocating more resources to the health sector and implementing a strong strategy for enhancing financial protection for the poor and vulnerable will be crucial in ensuring access to basic healthcare for all. Otherwise, the vision of achieving universal health coverage will remain a mirage, not a reality.
