Crescent Gastroliver and General Hospital, Dhaka, Bangladesh.
Sir Salimullah Medical College and Hospital, Dhaka, Bangladesh.
Int J Health Plann Manage. 2019 Jan;34(1):e11-e20. doi: 10.1002/hpm.2666. Epub 2018 Sep 20.
Bangladesh has attained notable progress in most of the health indicators, but still, health system of the country is suffering badly from poor funding. Issues like burden of out-of-pocket expenditure, low per capita share in health, inadequate service facilities, and financial barriers in reducing malnutrition are being overlooked due to inadequacy and inappropriate utilization of allocated funds. We aimed to review the current status of health care spending in Bangladesh in response to national health policy (NHP) and determine the future challenges towards achieving universal health coverage (UHC). National health policy suggested a substantial increase in budgetary allocation for health care, although government health care expenditures in proportion to total public spending plummeted down from 6.2% to 4.04% in the past 8 years. Overall, 67% of the health care cost is being paid by people, whereas global standard is below 32%. Only one hospital bed is allocated per 1667 people, and 34% of total posts in health sector are vacant due to scarcity of funds. The country is experiencing demographic dividend with a concurrent rise of aged people, but there seems no financial protection schemes for the aged and working age populations. Such situation results in multiple obstacles in achieving financial risk protection as well as UHC. Policy makers must think effectively to develop and adapt systems in order to achieve UHC and ensure health for all.
孟加拉国在大多数卫生指标方面都取得了显著进展，但该国的卫生系统仍因资金不足而严重受损。由于资金不足和分配资金的使用不当，诸如自费支出负担、人均卫生支出份额低、服务设施不足以及减少营养不良方面的资金障碍等问题被忽视。我们旨在审查孟加拉国卫生保健支出的现状，以响应国家卫生政策（NHP），并确定实现全民健康覆盖（UHC）的未来挑战。国家卫生政策建议大幅增加卫生保健预算拨款，尽管政府卫生保健支出在过去 8 年中占总公共支出的比例从 6.2%骤降至 4.04%。总体而言，67%的卫生保健费用由个人支付，而全球标准低于 32%。每 1667 人仅分配一张病床，由于资金短缺，卫生部门总岗位中有 34%空缺。该国正在经历人口红利，老年人口同时增加，但老年人口和劳动年龄人口似乎没有财务保障计划。这种情况导致在实现财务风险保护和全民健康覆盖方面存在多种障碍。政策制定者必须认真思考，制定和调整制度，以实现全民健康覆盖并确保全民健康。
