Out-of-pocket expenditure in the percentage of total health expenditure in Bangladesh is very high at 74 percent.
The government's contribution to the sector is only one-third which is the lowest compared to those of Sri Lanka, Malaysia and Thailand which subsidise 50 percent, 38 percent and 11 percent respectively.
Dr Selim Raihan, executive director of the South Asian Network on Economic Modeling (Sanem), mentioned all these during speaking at an online seminar (webinar) titled "COVID-19 and Health System of Bangladesh" on Saturday.
The webinar is the fifth in the series titled "SANEM SHONGJOG" which aims to foster meaningful academic discussions on domestic and global socio-economic issues.
The webinar was conducted by Dr Selim who is also a professor of Economics at University of Dhaka.
The online seminar was participated by Dr Shah Monir Hossain, former director general of Directorate General of Health Services, Dr Muhammod Abdus Sabur, adjunct professor at Institute of Health Economics of University of Dhaka, and Dr Rumana Haque, professor at Department of Economics, University of Dhaka.
Around 50 participants, including different professionals, development practitioners, researchers, journalists and students, joined the webinar through the videoconferencing.
In his introductory remarks, Dr Raihan presented some key statistics to compare the state of the Bangladesh health sector to those of some Asian countries.
He mentioned that the number of hospital bed per 1,000 people in Bangladesh is 0.8 while it is 3.6 in Sri Lanka, 1.9 in Malaysia and 2.1 in Thailand.
According to World Health Organisation, public health expenditure in the percentage of the size of economy in Bangladesh is only 0.4 percent while it is 1.6 percent in Sri Lanka, two percent in Malaysia and almost three percent in Thailand, he said.
Dr Raihan explained that the current crisis shows there is no alternative to public health services; yet, the sector has received little attention.
He also said there is a serious lack of accountability in the private health sector which creates significant obstacles in ensuring quality health services for the people.
Dr Raihan recommended that necessary infrastructure and human capital, along with an increase in budgetary allocation for the sector, have to be developed and management capacity must be expanded.
Discussing the policy response to the Covid-19 Pandemic, Dr Rumana Haque said proper planning was absent although there was time for preparation.
She remarked that improvement in the health sector will require a unit for health technology assessment and assessment of area-wise health needs and healthcare needs; without these assessments, an increase in the budget would not bear any fruit.
Dr Haque added that the involvement of public health experts and coordination with local government is crucial to tackling the pandemic.
Dr Muhammod Abdus Sabur discussed the lack of management efficiency in the health sector.
He said policymakers are over-enthusiastic about constructing infrastructure where there is a huge lack of human capital to operate those infrastructures.
Dr Shah Monir Hossain said the public, private and NGO health enterprises need to work together for the improvement of the whole scenario. A forum is required to assess the impacts of these enterprises.
The health department should not be functioned through a cadre service; rather it should be separate with its own distinct features.