The project to establish a medical college capable of admitting 100 students annually, alongside a 500-bed hospital in Kushtia, was finally completed last fiscal year, a full twelve years after receiving approval from the Ministry of Health and Family Welfare, at a total cost of Tk640 crore.
Ironically, during the same fiscal year, the ministry returned nearly ten times this amount from its development allocation under the Annual Development Program (ADP).
These unutilised funds could have been directed towards building infrastructure to accommodate 1,000 medical students annually and creating 5,000 additional hospital beds.
In the last fiscal year, the Health Services Division and the Medical Education and Family Welfare Division of the Ministry of Health and Family Welfare utilised Tk8,392 crore, achieving 80% of the revised ADP allocation, and only 57% of the original allocation.
The ministry surrendered Tk6,370 crore, which is over 43% of its ADP allocation, according to a report by the Implementation Monitoring and Evaluation Division (IMED) of the Planning Ministry.
Moreover, the ministries and divisions responsible for education services exhibited an even slower implementation of development activities in the last fiscal year.
The Ministry of Primary and Mass Education, Secondary and Higher Education Division, and Technical and Madrasa Education Division utilised merely 84% of their revised ADP allocation, which is considerably lower than other sectors such as the Power Division, Energy and Mineral Resources Division, Ministry of Industry, and Information and Communication Technology Division, all of which spent over 100% of their revised allocations.
The review revealed that these three education-related agencies were allocated Tk26,689 crore from the original ADP in the last fiscal year but managed to spend only Tk13,656 crore, equating to a mere 51%. Consequently, these ministries surrendered Tk13,033 crore from their original development allocation.
Documents from the Planning Commission disclosed that the Technical and Madrasa Education Division is currently implementing a Tk2,520.34 crore project aimed at establishing 100 technical schools nationwide, with the goal of enrolling 108,000 students annually in technical education at the secondary level.
Proper utilisation of the funds returned by the education sector could have facilitated the establishment of 517 technical schools, enrolling over 558,000 students annually.
The IMED report highlighted that a total of Tk19,403 crore remained unutilised by the ministries of health and education in the last fiscal year.
Comparatively, the underutilised amounts were Tk24,812 crore in FY-2023 and Tk10,940 crore in FY 2021-22. Over the last three fiscal years, these ministries surrendered an alarming Tk55,155 crore, representing about 44% of their original allocation.
Economists, academics, and experts have noted that the education and health sectors in Bangladesh were among the hardest hit during the COVID-19 pandemic.
They advocate for a significant increase in development allocations for these sectors to facilitate recovery and address the extensive damage inflicted.
While development expenditure in both sectors has risen sharply in the post-COVID-19 years, actual spending has increased at a sluggish pace due to limited implementation capacity.
Experts assert that effective utilisation of government allocations for health and education could alleviate the financial burden on the general populace.
According to the review, the ADP allocation for the ministries of health and education in the last fiscal year was Tk41,451 crore, a substantial increase from Tk22,262 crore in the 2017-18 fiscal year.
However, the actual ADP expenditure in these two sectors only rose modestly, from Tk19,088 crore to Tk22,048 crore during the same period.
While ADP allocations for the health and education ministries surged by 86% over seven years, the implementation rate increased by only about 15%.
A comprehensive seven-year review of data revealed that Tk158,206 crore was expended on development projects in health and education against an allocation of Tk234,275 crore. This indicates that over 32% of the allocated funds—approximately Tk76,069 crore—were returned unspent by these ministries.
The review further emphasised that the ministries of health and education returned Tk24,812 crore from the ADP in the 2022-23 fiscal year alone, constituting around 54% of their total allocation for that year. In the last fiscal year, approximately 47% or Tk19,403 crore of the allocated funds for these sectors were returned, compared to 14% of the allocation in the 2017-18 fiscal year and 7% in the following year.
Division-wise implementation performance
The Secondary and Higher Education Division of the Ministry of Education received an allocation of Tk13,193 crore in the last fiscal year, but this was reduced to Tk5,502 crore after a Tk7,691 crore deduction.
By the end of the fiscal year, the division managed to spend only Tk4,956 crore, which is less than 38% of the original allocation. Consequently, Tk8,237 crore remained unutilised, marking the lowest ADP implementation for the division in the past seven years, both in percentage terms and absolute spending.
From an original ADP allocation of Tk2,698 crore, the Technical and Madrasa Education Division spent just Tk1,456 crore, resulting in an implementation rate of 54%, the lowest since the division’s inception in 2017.
The Ministry of Primary and Mass Education spent Tk7,244 crore out of an allocated Tk10,798 crore in the last fiscal year, achieving an implementation rate of 67%. This is a notable improvement from the previous year’s 56%; however, in earlier years, the ministry consistently implemented nearly 100% of its ADP allocation.
The Health Services Division spent Tk7,175 crore in the last fiscal year, achieving 60% of its original ADP allocation.
Although this is an improvement from the previous year’s 42%, it is still considerably lower than the division’s historical average, where it consistently spent over 85% of its allocation since 2017. In contrast, the Health Education and Family Welfare Division spent just 44% of its ADP allocation in the last fiscal year, marking the lowest implementation rate since the division was established in 2017.
Projects stalled for a decade
The project to establish a dental college in Gopalganj, initiated in 2014, has had its timeline extended until December this year.
Despite this extension, only around Tk80 crore has been spent out of the total Tk139.3 crore budget to date. The Patuakhali Medical College and Hospital project, initially estimated at Tk651 crore in 2016, has also encountered significant delays.
Other projects within the Health Services Division are similarly delayed, including the expansions of the National Institute of Neurosciences and Hospital, Jamalpur Medical College and Hospital, and Sunamganj Medical College and Hospital.
The Health Education and Family Welfare Division began a population-based cervical and breast cancer screening programme with electronic data tracking in 2017.
However, despite extending the timeline twice, the project remains incomplete.
Timelines for the Shaheed Tajuddin Ahmed Medical College and Hospital project and the modernisation and expansion project of the Bangladesh College of Physicians and Surgeons have also been extended.
In the Secondary and Higher Education Division, the “Development of Selected Private Colleges” project, launched in 2012 with a budget of Tk5,569 crore, has been ongoing without completion.
The Rangamati Science and Technology University establishment project, started in 2013 with an estimated cost of Tk146 crore, remains incomplete.
Similarly, the Paikgacha Agricultural College establishment project, approved in 2014, is still unfinished, and the Secondary Education Investment Programme (SEIP), approved for a four-year period in 2014, has yet to be completed.
In total, five projects under this division have been progressing slowly since 2014.
The Technical and Madrasa Education Division’s Tk2,520 crore initiative, launched in early 2014 to establish 100 technical schools nationwide, has faced delays and has been extended twice.
A 2018 project with a Tk403 crore budget to set up women’s polytechnic colleges in four divisional towns has spent less than Tk100 crore, while another 2018 project with a Tk3,829 crore budget to establish polytechnic colleges in 23 districts has yet to commence construction.
Additionally, the development project for selected madrasas, approved in 2018 with a budget of Tk6,314 crore, has been revised once, with nearly half of the allocation already spent.
Household health and education spending on the rise exponentially
Average household expenditure on healthcare in Bangladesh has surged to Tk2,115 in 2022, a significant increase from Tk700 in 2016, according to the Household Income and Expenditure Survey by the Bangladesh Bureau of Statistics.
This dramatic rise is attributed to inadequate government spending, which has led to a tripling of health costs per family over the past few years.
Education sector has also seen a considerable uptick in household expenses, with average annual spending reaching Tk34,635 in 2021, compared to Tk12,600 in 2016.
Experts warn that as government allocations for health and education diminish, households face even greater economic burdens.
The current situation, where essential services like health and education are inadequately funded, poses challenges for both the population and the government.
Ensuring effective utilisation of the available funds is critical in bridging the gaps within these sectors and alleviating the financial pressures faced by families across the nation.
