Health ministry spending: Thousands of crores left untouched

Of its Tk 35,090cr ADP allocation, only Tk 209cr spent so far

The government has nearly doubled the health ministry’s development allocation this fiscal year, but the ministry spent less than 2 percent of its project funds in the first quarter, raising concerns about its capacity to utilise the increased funding.

Between July and September, the Health Services Division (HSD) spent just Tk 107 crore of its Tk 6,014 crore Annual Development Programme (ADP) allocation, or 1.78 percent.

The Medical Education and Family Welfare Division (MEFWD), the ministry’s other division, spent Tk 102 crore of its Tk 5,499 crore allocation, or 1.86 percent.

The figures cover only direct ADP allocations for development projects, excluding Tk 23,577 crore in block allocations to the two divisions.

Both fell below the overall ADP implementation rate of 3.89 percent during the period, according to data from the Implementation Monitoring and Evaluation Division (IMED).

The IMED report is available on its website. Although the IMED website does not specify how much of the block allocations was spent, health ministry sources said no funds had been spent from these allocations.

The two health divisions also recorded the lowest fund utilisation rates among the 10 ministries and divisions with the highest ADP allocations, data shows.

The poor first-quarter performance reflects a years-long trend of low ADP implementation at the ministry.

Since the health ministry was split into two divisions in 2017, neither has met the national average ADP implementation rate in any fiscal year, except for the MEFWD in 2020-21, according to IMED documents.

That year, the MEFWD only marginally exceeded the national average of 82.11 percent.

Last fiscal year, the HSD utilised just 31.15 percent of its ADP allocation, and MEFWD utilised 37.92 percent. Both fell well below the national average of 67.52 percent.

Health experts and campaigners have long called for greater investment in the sector, where public spending has remained below 1 percent of GDP for over a decade.

The now-defunct Health Sector Reform Commission, formed under the interim government, recommended raising health expenditure to 5 percent of GDP. The BNP also pledged to meet this target in its election manifesto.

This fiscal year, the government allocated Tk 69,409 crore to the health sector, equivalent to 1.01 percent of GDP, crossing the 1 percent threshold for the first time.

Of this, Tk 62,852 crore was allocated to the health ministry, with the rest earmarked for health-related activities under other ministries.

The HSD received Tk 6,014 crore for 18 projects, along with a block allocation of Tk 20,800 crore.

The MEFWD received Tk 5,499 crore for 15 projects and a block allocation of Tk 2,722 crore.

Together, the two divisions received Tk 35,090 crore under the ADP, more than double the original allocation of Tk 17,520 crore last fiscal year.

Prof Rumana Huque of Dhaka University’s Economics Department attributed the slow spending to inadequate preparation, project planning and coordination.

“We had anticipated that unless new development project proposals [DPPs] were prepared quickly, the large allocations, particularly the block allocation, would remain unused without a sector programme.”

She said the health ministry had so far prepared only a handful of DPPs, while key steps, including the appointment of project staff, consultants and contractors, remained incomplete.

“As a result, implementation has not begun in many cases.”

Rumana said the ministry could have involved experienced professionals and sought technical assistance from development partners to expedite project preparation.

“Better coordination between the ministry’s planning wing and project-implementing agencies was also needed to identify priorities and align projects with government plans.

“Although it is still early in the fiscal year, the slow progress raises questions about whether the remaining allocation can be utilised. The government needs to prioritise projects, strengthen implementation capacity and develop a clear roadmap.”

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Contacted, HSD Secretary ANM Bazlur Rashid said he had yet to review the IMED report on ADP implementation and would comment after doing so.

MEFWD Secretary AKM Benjamin Riazi could not be reached for comment despite being sent a message.

Health Minister Sardar Md Sakhawat Husain could not be reached by phone either.