94 lines
3.5 KiB
Markdown
94 lines
3.5 KiB
Markdown
**Health Financing and Programs in Bangladesh**
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**1\. Health Financing Overview**
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- **Household Out-of-Pocket (OOP) Expenditure**: Largest financing area, accounting for 68.5% of Total Health Expenditure (THE) in 2020.
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- Majority spent at pharmacies/retail drug outlets (64.6%), followed by medical and diagnostic labs (11.7%).
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- **Total Health Expenditure (THE)**:
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- BDT 777 billion in 2020 (2.8% of GDP).
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- Per-capita THE: BDT 4,578 ($54).
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- Current Health Expenditure (CHE): BDT 719 billion (2.6% of GDP), Per-capita CHE: BDT 4,239 ($50).
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- Pharmaceutical Expenditure: BDT 389 billion (50% of THE).
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- **Bangladesh’s Health Budget**:
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- FY 2023-2024: BDT 38,052 crore (5% of the national budget).
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- Increment: 3.23% higher than the previous fiscal year.
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- **Trends in THE**:
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- Per-capita THE increased from $10 to $54 over 20 years.
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- Steady share of GDP: 2.8%-3% in the last decade.
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**2\. Disease-Specific Expenditures (2020)**
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- Total recurrent expenditure: BDT 69,000 crore.
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- **Top Disease Categories** (ICD-10 classification):
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1. Diseases of musculoskeletal system: BDT 9,461 crore.
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2. Digestive system: BDT 8,872 crore.
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3. Circulatory system: BDT 8,865 crore.
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4. Symptoms/signs not elsewhere classified: BDT 8,010 crore.
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5. Respiratory system: BDT 5,395 crore.
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- These categories represent 65% of the total disease burden.
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**3\. Pharmaceutical Expenditure (2020)**
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- Household financing: 93.89% of total pharmaceutical expenditure.
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- Major contributors to expenditure:
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1. Musculoskeletal diseases.
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2. Circulatory diseases.
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3. Digestive diseases.
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- Gender-based share:
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1. Male: 39%
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2. Female: 61%
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**4\. Bangladesh Essential Service Package (ESP)**
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- Total expenditure in 2020: BDT 380 billion (48.8% of THE).
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- Core services:
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1. Maternal, neonatal, child, and adolescent health: 42% of ESP.
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2. Non-communicable diseases: 25%.
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3. Communicable diseases: 6%.
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4. Family planning: 4%.
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5. Nutrition: 3%.
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- Public vs Private Spending:
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1. Public: 27%.
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2. Private: 73%.
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- **Per-Capita ESP Spending (2020)**:
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1. Public: BDT 593.
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2. Private: BDT 1,642.
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**5\. Shasthyo Surokhsha Karmasuchi (SSK)**
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- Social health protection scheme for households below the poverty line (BPL).
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- Services provided via:
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- Upazila health complexes.
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- Urban hospitals (e.g., Mugda Medical College Hospital).
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- Innovations:
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- Biometric SSK cards.
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- IT integration for Electronic Health Records (EHR) and cashless transactions.
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- **Progress (till March 2024)**:
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- Registered households: 307,593.
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- IPD patients served: 54,056.
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**6\. Social Security Programs**
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- Share of government expenditure: 17.81% (2.65% of GDP).
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- Coverage:
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- 50% of households benefited in 2022, up from 28.7% in 2016.
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- Programs include:
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- Maternal and child health.
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- Communicable and non-communicable disease control.
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- Nutrition services.
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**7\. Historical Trends in Health Programs**
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- **4th Health, Population, and Nutrition Sector Program (HPNSP)** (2017-2022):
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- Total allocation: BDT 2,633,893.5 lakh.
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- Total expenditure: BDT 2,050,238.7 lakh.
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- Yearly progress (2023-2024): 42.57% of allocation utilized.
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- Shift in financing:
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- Increased demand-side financing for efficiency and equity.
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**8\. Key Challenges and Insights**
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- High reliance on OOP expenditure poses financial risks.
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- Significant gender disparities in disease-specific spending.
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- Slow increase in public health expenditure as a share of GDP.
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- Rising focus on IT-based solutions for healthcare delivery (e.g., SSK program). |