Bangladesh’s Health Ministry spends just 2.34% and 14.9% of its budget allocations. Poor management and project delays stall healthcare improvement.
Dhaka, May 31, 2025:
With just two months remaining in the current fiscal year, the Ministry of Health and Family Welfare in Bangladesh has once again failed to utilize a significant portion of its development budget. Official data reveals a severely low rate of budget execution, raising concerns over the future of public healthcare in the country.
The Ministry, divided into two operational wings—Health Services Division and Medical Education and Family Welfare Division—has reported some of the lowest spending across all government agencies. As per the Implementation Monitoring and Evaluation Division (IMED), the Medical Education and Family Welfare Division has spent only 2.34% of its Tk 2,283.16 crore revised development budget. Meanwhile, the Health Services Division used only 14.9% of its Tk 5,673.51 crore allocation.
In comparison, the national average for development budget utilization across all ministries and divisions stands at 41.31%, indicating that the health sector lags far behind in executing critical projects and services.
Years of Poor Budget Execution Continue
This trend is not new. Since the Ministry of Health was split into two divisions in 2017, poor development budget execution has become the norm. The only year with noticeable improvement was during the COVID-19 pandemic in FY 2020–21, when emergency funds were quickly deployed to manage the national health crisis.
Experts argue that the structural division did little to improve efficiency. Instead, it created more bureaucratic layers, resulting in delayed project approvals, slow fund releases, and poor coordination between departments.
Root Causes: Inexperience and Inefficiency
The primary reasons for this persistent underperformance are administrative weaknesses, mismanagement, and lack of capacity. Many development projects are assigned to directors who lack technical and project management experience. There is also a notable dependence on the Public Works Department (PWD) for health infrastructure development, which is frequently criticized for delayed and poor-quality work.
Frequent transfer of officials, delayed fund disbursement, and absence of accountability mechanisms have further compounded the issue. In many cases, project planning does not align with ground realities, leading to flawed execution or abandonment.
Health Budget Among the Lowest in South Asia
Despite the growing healthcare needs of a population exceeding 170 million, Bangladesh allocates a very small portion of its national budget to the health sector. In the current fiscal year, only 5.2% of the total budget has been earmarked for health, which is just 0.74% of the GDP. This is the lowest in the South Asian region, where countries like Nepal and Sri Lanka allocate significantly higher percentages.
According to the Health Sector Reform Commission, such low allocations are insufficient to provide basic health services to citizens. The commission recommends raising the health sector budget to at least 15% of the national budget or 5% of GDP to ensure sustainable healthcare delivery.
The Commission also emphasized that corruption, poor monitoring, and a lack of transparency are further eroding the impact of the limited funds that are available.
Delayed Projects Affect Millions
One of the most glaring examples of the ministry’s inefficiency is the Tk 2,030 crore project to establish specialized cancer, cardiac, and kidney treatment centers in eight divisional cities. Approved in 2019, the project was scheduled for completion by June 2022 but has faced major delays.
Officials involved in the project have requested another extension—until June 2026—but even that deadline is unlikely to be met. According to the project director, challenges include delays in contractor mobilization, material procurement, and poor coordination between departments.
These delays have real-world consequences. Thousands of patients across the country are left without access to specialized treatment, forcing many to seek expensive private care or travel to Dhaka, where facilities are overburdened.
Consequences for Public Health
This persistent failure to utilize development budgets is not just a technical or financial issue—it directly affects the lives and wellbeing of citizens. The inability to complete health infrastructure projects or upgrade existing facilities means millions remain underserved, particularly in rural and semi-urban areas.
Experts warn that if the current situation persists, Bangladesh may fall short of achieving Universal Health Coverage (UHC)—a core goal under the UN’s Sustainable Development Goals (SDGs).
There is also growing concern that inefficient use of foreign aid in the health sector may lead to reduced donor confidence, further complicating the financial picture.
A Call for Urgent Reform
There is an urgent need for reform in the way the health ministry manages its development programs. This includes appointing qualified project managers, establishing performance-based accountability, strengthening monitoring mechanisms, and increasing inter-agency coordination.
Unless bold steps are taken, Bangladesh’s public health infrastructure will continue to fall behind, widening the gap between policy ambition and on-the-ground impact. Ensuring better budget utilization is not just about numbers—it is about delivering essential health services to every citizen, regardless of location or income.
