Health, education neglected yet again

Health and education are the two areas that needed the best of efforts during this pandemic - the first one overwhelmed with patients, and the second now shut down for more than a year. But the proposed budget shows allocations in these two areas have decreased both in terms of percentage of the budget - compared to this fiscal year's revised allocation - and GDP as well.

It was a natural expectation that allocations in these two areas would increase drastically in comparison with the GDP.

But the proposed budget falls short in both areas, keeping Bangladesh in the unenviable spot of one of the lowest spending countries in South Asia, in reference to the GDP.

In health, Tk32,731 crore has been proposed, which is only 0.95% of GDP, which is even less than this year's revised budget of 1.02%. 

The World Health Organisation sets at least 5% of GDP spending on health as a minimum requirement for a country to fare well.

If one looks at South Asia, Bangladesh's proposed health spending as a percentage of GDP is just above Pakistan and Afghanistan. The Maldives spends as much as 9% of its GDP.

Ever since Covid struck, Bangladesh and the weakness of its health sector has been exposed, and experts and economists have been demanding at least 2% of GDP be spent on health.

Finance Minister AHM Mustafa Kamal has proposed 5.42% of the budget to health for the next year, while the allocation is 5.84% of this year's revised budget.

Similarly, in education, Bangladesh's spending in relation with GDP has actually gone down in the proposed budget.

This year, 2.09% of GDP has been earmarked on education. But the proposed budget ticks only 2.08%.

Education received 12.28% of the budget this year which it has slid to 11.92% in the proposed budget. 

Unesco suggests a spending of 4-6% of GDP in education.

However, health got a 12% increase in absolute terms, and education 8.5%, in the proposed budget.

Health allocations

Though Finance Minister AHM Mustafa Kamal in the budget speech said the health sector got the highest priority, he did not bring forth any out-of-the-box plan to ride out the pandemic woes.

The budget could propose health insurance facility or financial protection to the poor who are disproportionately affected by the out-of-pocket expenditure on healthcare, said Dr Shafiun Nahin Shimul, associate professor at the Institute of Health Economic, Dhaka University.

Had the government considered bringing one crore people under health insurance, a new avenue of expenditure would have opened, he said. "Nothing has been perceived in the budget as out of the ordinary. I think the government will fail to spend the fund allocated as has been the case in this fiscal year."

The minister proposed setting aside Tk10,000 crore as an emergency fund to deal with unexpected situations arising out of the pandemic.

Research will help design effective measures to control the contagion and mitigate health aspects influenced by it. The budget for fiscal year 2021-22 puts forward Integrated Health Science Research and Development Fund to improve health education and technology as did the previous budget.

To assure that the fund will not remain unused this time, the minister said necessary steps will be taken to operationalise the fund.

To improve healthcare in the peripheries, modern equipment, such as ECG machines, nebuliser machines, autoclave, ultrasonogram machines and blood collection monitors will be installed in upazila health complexes.

The finance minister also said more adolescent-friendly health corners would be set up at the union level in the next fiscal year to support physical and mental development of adolescents.

At present 603 such centres are providing adolescent healthcare, which will be increased to 979 by 2022.

The budget also suggests an expansion of the maternal health voucher programme for the poor, destitute and pregnant mothers to 20 more upazilas. At present, the programme is on in 53 upazilas.

Tax measures to improve healthcare

The paramount urgency to decentralise healthcare seems to have been taken into consideration while formulating the budget as the government, for the first time, proposed tax waiver for private healthcare facilities to be established in districts other than Dhaka, Narayanganj, Gazipur and Chittagong.

There are conditions to be met to enjoy the tax exemption for 10 years. General hospitals should have minimum 250 beds and offer child and infant care, women and mother care, oncology and wellbeing and preventive medicine units while specialised hospitals should accommodate at least 200 in-patients at a time.

The tax exemptions on imports of testing kits, special types of masks, raw materials for sanitisers, masks and personal protective equipment and raw materials required for the preparation of the virus detection RT-PCR kit have been extended to 30 June 2022.

There will be no duty as well on the import of implantable "occluder" used for the treatment of children born with heart defects.

In order to strengthen the pharmaceutical industry and the health sector, the minister proposed tax concessions on imports of raw materials for the local production of Active Pharmaceutical Ingredients and medical products.

Education budget

The proposed budget comes at a time when all educational institutions remained shut for nearly one and a half years. There is a concern over digital divide depriving a large number of children of education, which has been leading to child marriage, school dropouts and child labour.

But the budget does not mention any measure to recover the learning loss and bring back students to school, colleges and universities. 

Prof emeritus of Brac University Dr Manzoor Ahmed said, "We have insisted on special allocations to recover the learning losses and check dropouts but the government did not listen to us."

Lack of attention to the major problems may jeopardise the education sector as a whole, he added.

New school meal project to be launched

During the Covid-19 pandemic, the government has continued the school feeding programme in poverty-stricken areas. Despite the closure of all primary schools in the country since March 2020, biscuits rich with vitamins and minerals are delivered to children at home.

This helps meet children's nutritional needs.

A new primary school meal project will be launched in July this year in line with the National School Mill Policy to ensure nutrition of children.

Stipend and "kit allowance"

In an effort to encourage students to attend school, Tk1,000 will be given to each student as "kit allowance" for dress, a pair of shoes and bag. Each student will also receive Tk150 instead of Tk100 as a monthly stipend from the next fiscal year.

The finance minister proposed an allocation of Tk3,712 crore for both stipend and kit allowance.

To ensure the continuity of the stipend programme which is set to be completed on 30 June 2021, this will be transferred to the revenue budget from the next fiscal year.

Secondary teachers to be trained

ICT training of 80,800 teachers and general training of 50,000 secondary school teachers are underway in the current fiscal year. Around 2.10 lakh secondary school teachers and 2.75 lakh ICT teachers will be trained in the next fiscal year.

Tuition fees to be waived in phases

Tuition fees were waived for students of grade 6 in 2020. Tuition fees for students of other grades will be waived in phases.

Internship programme for graduates

A large number of students in the country graduate every year and become eligible for employment in the job market. To ensure that these new graduates can easily get jobs in their respective fields, the government will launch an internship programme in public and private sectors. To that end, a 'Policy Framework' will be formulated.

Madrasa education development programme to be continued

The government has undertaken extensive activities for the development and modernisation of madrasas. To enhance the quality of madrasa education, construction of new buildings for 1,800 madrasas, setting up multimedia rooms for 653 madrasas and capacity building of madrasa teachers will continue.

"We have undertaken a project named 'Training of Madrasa Teachers to Enhance Teaching Skills', which will continue in the coming fiscal year," the minister said.

This will make madrasa education compatible with the basic education system and facilitate modernisation of madrasa education. Steps will be taken to ensure transparency in the utilisation of funds mobilised from different sources in the private sector.

15% tax imposes on private universities, colleges

The finance minister proposed imposing a 15% corporate tax on incomes of private universities, medical, dental, engineering college and ICT institutes from 2021-22 fiscal year.