Policy Issues of bangladesh

Executive Summary3Background6Policy Issue 1: Secondary Education7Pass rate increases in Secondary School Examination when quality falls: Happiness without satisfaction7Policy Issue 2: Population Growth9Population Growth in Bangladesh: One Miracle Happened, Time for Next Miracle9Policy Issue 3: Structural Change and Development Strategy11Bangladesh riding on manufacturing and export Sector to achieve goals of Vision 202111Policy Issue 4: Institutions and Economic Development13Institutions and Economic Development in Bangladesh: Some Work, Some Do Not13Policy Issue 5: Fiscal Institution15Tax Reform and Success in Bangladesh: Still need to go a Long Way15Policy Issues 7: Property Rights and Efficiency in Urban Areas19Privatization Requirements in Different Sectors of Bangladesh19Policy Issue 8: Economic Analysis of Investments21Investment Climate in Bangladesh: A Serious Effort by GOB is Required21Policy Issue 9: The Role of Credit Market in Development23Microcredit in Bangladesh: An Unfinished Idea23Policy Issue 10: Health Care Delivery in Developing Countries25Current Situation of Health Care Service in Bangladesh25Final Report on Major Policy Issues of BangladeshMd. Saidur Rahman

SPEA V 573Development Economics21

Executive SummaryThis report is a compilation of 10 different policy memos on Bangladesh from the weekly Facebook posts of the V573 course on Development Perspective. All the policy issues draw on the class discussions and reading materials and focus on Bangladesh. Each policy memo focuses on specific policy issue, portrays the present condition, analyzes the relevant policy and provide further recommendations. For the purpose of analysis, economic concepts like equity and efficiency has been applied in most areas. However, my most recommendation recognizes the importance of government in fostering the economic development of a country and so, I advocated for moderate government interventions in my suggestions.The first policy memo is written on Secondary Education, which states that even the success rate in recent secondary school examination is high, the quality of education is poor. Recently, development partners like Asian Development Bank (ADB) and the World Bank (WB) have decided to invest heavily on secondary education; the memo provides recommendations to channel the money to enhance the quality of education through paid internships to graduate students and nationwide education campaign.The second policy area addressed here is Population Growth. Since independence Bangladesh has achieved a remarkable success in population control. Recent population policy has addressed the emerging needs like reducing net reproductive rate, addressing the causes of maternal mortality rate, reducing adolescent marriage and pregnancy, developing human resources, reducing child mortality rate and providing nutritional knowledge. However, the policy has not included issues like revised family planning program with broader focus, specific focus to reduce fertility rate in rural areas, decentralized and equitable industrialization across the country and large scale employment generation.The next policy memo is for Structural Change and Development Strategy. Bangladesh has maintained a decent economic growth in spite of global recession and national political turmoil. Booming export sector, particularly garments industry has accounted for majority of the growth. The country has formulated a separate export policy to foster the growth to achieve a middle income country status. Now, the country requires to focus to develop a peaceful political environment, promote vocational and technical education and build infrastructure to take advantage of globalization for a sustained economic growth.The fourth policy memo talks about Institutions and Economic Development, which is essential to coordinate different industries to achieve desired growth. Key government institutions like Ministry of Finance and Ministry of Planning and the Bangladesh Bank has been instrumental to develop economic stagey for countrys overall economic development. Over the years, Non-Bank Financial Institutions also emerged with a potential to fill the gap in management coordination. Numerous NGOs also contributed to various social and economic issues through innovation and expertise. However, traditional institutions has not been effective compared to the newer institutions. The policy memo has emphasized on enhanced coordination among different institutions for synergistic result.The next policy memo focuses on development and performance of Fiscal Institution in Bangladesh. Countrys prime tax regulatory body National Board of Revenue (NBR) is characterized by weak policy, lack of modernization, fragmented administration and unskilled and insufficient human resource. All these factors have contributed to make the tax system as one of the least effective systems in the world. Recent changes and innovation by NBR has stimulated the tax revenue but the growth has been slow. In order to increase the tax revenue, NBR needs to decentralize tax/ VAT offices, introduce electronic cash register system, develop physical monitoring system for the businesses etc.Corruption is one of the major reasons for the underdevelopment of Bangladesh, an effective Social Accountability mechanism can be useful to reduce the corruption, which is the focus of sixth policy memo. The country has passed the Right to Information Act (RTIA) in 2009. While the number of information request in the country has been quite low compared to the large population, the response from these request have been really satisfactory. However, political elites and powerful businessmen can easily escape from the hand of law. The policy memo recommends for stringer and equitable implementation of RTIA.Next policy are addressed here is Property Rights and Efficiency in Urban Areas, a major issue in developing countries like Bangladesh. The privatization process initiated in the early 1980s when the State Owned Enterprises (SOEs) had been suffering loss due to inefficiency and corruption. Though privatization in the country has produced a mixed result, significant progress has been achieved in textile and education sector in terms of employment generation. The policy memo supports governments intended further privatization in areas like energy, railway, infrastructure, communication and agriculture.A favorable investment climate is fundamental to encourage entrepreneurship by citizens and foreign direct investments by foreign firms. The policy memo on Economic Analysis of Investments identifies the weaknesses in the investment climate in Bangladesh. According to Doing Business Report, Bangladesh ranks 132 among 189 countries, which is due to electricity shortage, bureaucratic problems and weak enforcement of contracts. The policy memo reinforces the importance of additional electricity generation, infrastructure development, transparent regulatory system and peaceful political environment to stimulate the business environment.The Role of Credit Market in Development is another critical area addressed by one of the policy memos. In developing countries, a major barrier to economic development is limited size of credit market. Bangladesh has been successful to achieve a breakthrough to this problem by introducing microfinance to the poor people. Though the impact of microfinance has been debated long enough, the policy memo considers microfinance as a potential sector to eradicate poverty if complemented by market linkage, skill development and government support.The final policy addresses the situation of Health Care Delivery in Developing Countries. In last few decades, the health indicators in Bangladesh has shown positive improvement. Both government and non-government actors have been instrumental to expand the health sector. Recent health policy has been formulated keeping in mind the current concerns like inadequate antenatal delivery and post-natal services, gender discrimination, HIV prevalence, insufficient health facilities in rural areas and urban slums, limited number of health professionals and scarce medical resources. However, there is significant policy gaps identified in the areas of quality of health care, expense of private health care services and limited number of health insurance. The policy memos in this report have tried to focus narrowly on different sectors. Most government agencies in Bangladesh are still in the process electronic documentation, as a result, the available online information sometimes fail to capture the accurate scenario. I have tried to collect information from different types of agencies to get as much real picture of various issues. I am grateful to my professor Anh Ngoc Tran and fellow classmates for their valuable feedbacks.

BackgroundBangladesh is a developing country with a large population of 154.6 million people. Formed by a delta plain, the soil of Bangladesh is very fertile and the society is basically agrarian. The population density of the country is 1,174 per square kilometer. The urbanization rate in the country is really high. The country suffers from natural disasters every year, which in turn, slows down the economy and force people to migrate to urban centers.After the independence in 1971, the country desperately attempted to accelerate economic growth through massive reform. Bangladesh has achieved positive results in areas of population, education, health, women empowerment and industrialization. However, large population and scarce resource most often slowed down the economic progress.In terms of economic growth, Bangladesh has maintained a decent 6 percent growth rate during last decade. Readymade garment sectors and ship breaking industries have been the major drivers in the sustained growth rate of the country. Significant success has come through pharmaceutical industries as well. Over the years, important financial and non-financial institution emerge to strengthen the business and social development of the country. However, the country failed to take the full advantage of globalization because of persistent economic problems. The major problems country face is low education level, lack of skilled human resource, continuous shortage of electricity, inadequate infrastructure, weak commutation network, concentrated and urban focus development, unstable political environment, lack of transparency, huge corruption and vast poverty. The country suffers from management coordination problem, weak implementation of policies and scattered development interventions. The following ten policy memos try to address major issues that stagnate countrys economic growth. A variety of issues have been covered in this report, where some of the issues have mentioned repeatedly to reinforce their importance in different sectors. In analyzing issues, I have taken a mixed approach combining equity and efficiency perspective to comprehend, analyze and recommend different areas where there are major policy gaps.

Policy Issue 1: Secondary EducationPass rate increases in Secondary School Examination when quality falls: Happiness without satisfaction

To: Ministry of Education, BangladeshFrom: Md. Saidur RahmanSubject: Pass rate increases in Secondary School Examination when quality falls: Happiness without satisfaction.Date: 1/20/14Secondary school enrollment rate in Bangladesh remained low at 51 percent[footnoteRef:1] (World Bank 2011); however, recent success rate of 89.72 percent[footnoteRef:2] at Secondary School Examination has been really inspiring, which shows students have been studying and teachers have been teaching. Before we are satisfied with this achievement, there are a few issues that we have to consider. Institutional Self-Assessment Report 2013[footnoteRef:3] (DSHE 2013) says that 3,243 secondary schools out of about 18.5 thousand are either performing poorly or not performing at all in terms of overall performance[footnoteRef:4]. Students performance in mathematics and English have been reported poorly in the report as well. Most schools do not have enough assistant teachers, some do not have even a headmaster[footnoteRef:5] and two-third of the schools do not have labs[footnoteRef:6]. The salary of secondary teachers are poor and about one lakh teachers are not even in monthly pay order. Secondary education faces a serious challenge from both supply and demand side. [1: Source: http://data.worldbank.org/indicator/SE.SEC.ENRR] [2: Source: http://eprothomalo.com/index.php?opt=view&page=1&date=2013-05-10] [3: Source: http://pbm.emis.gov.bd/Home.aspx] [4: Khan, S. R. (2013, November 2). 3,243 secondary schools perform poorly. Dhaka: New Age Online Newpaper. Retrieved January 20, 2013, from http://www.newagebd.com/detail.php?date=2013-11-02&nid=71449] [5: Alamgir, M. (2013, June 3). No headteacher in 2 of every 3 govt secondary schools. Dhaka: New Age Online Newspaper. Retrieved January 20, 2014, from http://www.newagebd.com/detail.php?date=2013-06-03&nid=51456] [6: Alamgir, M. (2013, November 2). Two-thirds of schools do not have labs. Dhaka: New Age Online Newpaper. Retrieved January 20, 2014, from http://www.newagebd.com/detail.php?date=2013-11-02&nid=71450]

Recently ADB has approved a US $500 million Secondary Education Sector Program[footnoteRef:7] and World Bank has approved US$ 265 million[footnoteRef:8] for Secondary Education Quality and Access Enhancement Project. Both programs targeted at enhancing quality of education as well increasing the secondary school enrollment level. As we have been taught education is the backbone of a nation, and most economists believe that education can foster fast economic growth through creation of human capital, we must maximize the benefit of these investments and ensure a positive change in our secondary school education. [7: Bangladesh Sangbad Sangstha. (2013, November 22). $90m ADB support for skill development. Dhaka: New Age Online Newpaper. Retrieved January 20, 2014, from http://www.newagebd.com/detail.php?date=2013-11-22&nid=73908] [8: Bangladesh Sangbad Sangstha. (2013, December 6). WB provides $390m for education sector. Dhaka: New Age. Retrieved January 20, 2014, from http://www.newagebd.com/detail.php?date=2013-12-06&nid=75724]

For a making a good impact, it is imperative to invest in both supply and demand side. Building adequate educational infrastructures, better salary for school teachers, monitoring system for educational progress and incentives for better performance to institution can be some of major steps we should take. Till now, female education is free up to Higher Secondary Education, if male education is also incorporated, the enrollment rate will have a significant rise as most boys engage in child labor due to poverty.In addition to these, two new strategies can be adopted. The number of University graduates are growing and they do not get job immediately. A paid internship program can be introduced where graduates will teach at secondary schools for a specific period of time. They will enhance the quality of teaching as well as address the problems in secondary education. Secondly, an education campaign can be designed targeting the areas with highest dropout rates in secondary education, which can motivate parents to realize that education can give their a better future for their children; adding to that, government already has built infrastructures for education where more enrollment can ensure efficiency, maximize the outcome and prevent waste of resources.

Policy Issue 2: Population GrowthPopulation Growth in Bangladesh: One Miracle Happened, Time for Next MiracleTo: Ministry of Health and Family Welfare, BangladeshFrom: Md. Saidur RahmanSubject: Population Growth in Bangladesh: One Miracle Happened, Time for Next Miracle Date: 1/26/14At the time of independence in 1971, Bangladesh has a fertility rate of 6.9 children per women with a child mortality rate before age 5 of 22.1% per hundred children[footnoteRef:9] (Gapminder, 2013). Currently, the country has a fertility rate of 2.2 children per women and child mortality rate before the age is 4.1% per hundred children[footnoteRef:10] (Gapminder, 2013; World Bank, 2013). Currently, the population of Bangladesh is 154.7 million[footnoteRef:11] (World Bank, 2012) with a population growth of 1.19%, a significant reduction from 2.82% in 1979 (World Bank, 2012). Life expectancy has also increased to 70 years[footnoteRef:12] (World Bank, 2012). The country has accomplished significant success in the areas of child marriage, infant mortality rate, teen fertility rate and maternal mortality rate. A miracle has happened over the years in the worlds most densely populated country. The countrys population density is 1,174 per square kilometer[footnoteRef:13] (World Bank, 2012). [9: Source: http://www.youtube.com/watch?v=jAJC2YAJw_A] [10: Source: http://www.gapminder.org/] [11: Source: http://data.worldbank.org/country/bangladesh?display=default] [12: Source: http://data.worldbank.org/indicator/SP.DYN.LE00.MA.IN/countries/BD-8S-XM?display=default] [13: Source: http://data.worldbank.org/indicator/EN.POP.DNST]

Nationwide large scale Family Planning Program and awareness campaigns both by government helped the country to improve the demographic statistics in the country. Bangladesh family planning program, led by the Directorate General of Family Planning throughout the 1970 and 1980s, has become one of the most successful such programs in the world[footnoteRef:14]. In private sector, BRAC, Marie Stopes International and NGOs funded through USAID projects like the NGO Service Delivery Project and the Smiling Sun Franchise Program also been instrumental to bring positive demographic changes in the country[footnoteRef:15] (USAID, 2013). These programs have trained large-scale of health workers and service promoter networks to provide family planning services to the citizen[footnoteRef:16] (USAID, 2013). [14: SHOPS Project. 2013. Bangladesh Family Planning Private Health Sector Assessment. Brief. Bethesda, MD: SHOPS Project, Abt Associates, Available at: http://www.shopsproject.org/sites/default/files/resources/Bangladesh%20Family%20Planning%20Private%20Health%20Sector%20Assessment%20Brief.pdf] [15: Ibid.] [16: Ibid.]

However, the country still suffers from population problem despite the tremendous effort of the government. Family Planning programs lately failed to achieve the set target in the absence of dedicated field workers and leadership. With the increase of elderly population, countries dependency burden is also rising which will exacerbate the unemployment problem of the country[footnoteRef:17]. A considerable difference in fertility rare exist between rural and urban area where the total fertility rate is 3 among rural women and 2.4 for urban women[footnoteRef:18]. Migration to urban areas is also posing a serious problem by increasing the urban density; 85% of the rural migration are concentrated in the four major cities in the country[footnoteRef:19]. Even though, the population growth rate has been controlled significantly; countrys target to achieve a net reductive Rate of 1 by 2016 seems like unachievable due to the lack of policy implementation and resources. [17: Abdullah, M. M. (2013, January 7). Controlling the population boom. Dhaka: The Daily Star Online Newspaper. Retrieved January 26, 2014, from http://archive.thedailystar.net/newDesign/news-details.php?nid=264090] [18: Ibid.] [19: Ibid.]

Current Population Policy of the country[footnoteRef:20] (MoHFW, 2004 under revision), considered these issues seriously and set important objectives to achieve progress in the demographic areas where the country is lagging behind. The policy focuses at reducing Net Reproductive Rate, addressing the causes of maternal mortality rate, reducing adolescent marriage and pregnancy, developing human resources, reducing child mortality rate and providing nutritional knowledge. The policy took into account current health situations of the country adequately and set their agenda accordingly. With the country entering into an inertia of population problem, governments timely respond will help the country to deal with it properly. [20: Source: http://www.mohfw.gov.bd/index.php?option=com_docman&task=doc_download&gid=3986&lang=en]

Yet, the policy failed to formulate strategies on issues like revised family planning program with broader focus, specific focus to reduce fertility rate in rural areas, decentralized and equitable industrialization across the country and large scale employment generation. Some of these issues require a coordination among different ministries and government agencies which has been absent in the policy as well. An effective implementation strategy to maximize the resources for effective and efficient use of already existing resources has not been considered within the policy framework. A revised policy incorporating these emergent issues will be more instrumental to combat the population problems Bangladesh facing; a more comprehensive population policy may lead the country to next miracle.

Policy Issue 3: Structural Change and Development StrategyBangladesh riding on manufacturing and export Sector to achieve goals of Vision 2021To: Ministry of Industries and Ministry of Commerce, BangladeshFrom: Md. Saidur RahmanSubject: Bangladesh riding on manufacturing and export Sector to achieve goals of Vision 2021 Date: 2/2/14If a Bangladeshi walks into any Walmart Store in the USA or Canada today, they will find some clothes have tags with Made in Bangladesh; nothing can be compared with the proud feeling to find the name of homeland in the foreign soil. Over the years, Bangladesh has significantly increase their export earnings, the knitwear and woven garments being the two largest export earners. In the first half of the fiscal year 2013-14, Bangladesh earned US $ 14.68 billion, despite the political turmoil and constant RMG labor unrest for wage hike[footnoteRef:21]. [21: Dhaka Tribune. (2014, January 10). Exports rise 17% despite political unrest. Dhaka. Retrieved February 2, 2014, from http://www.dhakatribune.com/economy/2014/jan/10/exports-rise-17-despite-political-unrest]

Bangladesh, formed by a delta plain, has been predominantly an agriculture based society[footnoteRef:22]. Though alluvial soil of the country is highly fertile, it suffers from flood and drought every year. In the past two decades, the growing manufacturing sectors, specially RMG sector, pharmaceutical industry and ship-breaking industry, have been significantly contributing to the accelerating economic growth of the country; countrys annual GDP growth at present stands at 6.2%[footnoteRef:23] (World Bank 2012). [22: Source: http://en.wikipedia.org/wiki/Geography_of_Bangladesh] [23: Source: http://data.worldbank.org/indicator/NY.GDP.MKTP.KD.ZG]

With limited resource base, low technology, constraints of the domestic market, increasing unemployment and emerging global opportunities, the fundamental challenge is to formulate a strategy to address both national and global market simultaneously in an adept manner. The importance of manufacturing sector, with an increasing return to scale, is significantly reinforced by the backward and forward linkages of agriculture and service sectors.The country is aiming at an 8% growth target by 2015 though fostering the industrialization, as stated in the Perspective Plan of Bangladesh 2010-2021[footnoteRef:24]. The Perspective Plan[footnoteRef:25] ambitiously sets target to reach an annual growth rate of 10% and to gain middle income status by, where manufacturing would be a driving force with an expected 37% contribution to the GDP. The Plan has identified the main growth generating manufacturing activities sector like food processing; leather and footwear, textile and clothing, pharmaceutical, ship building, toys, ceramics and furniture and consider, where low-labor cost with skill development will be the potential comparative advantage. The strategies, mentioned in the plan, to achieve the targets are utilization of preferential market access treatment, SME-based industrialization, promotion of emerging sectors, encouraging FDI, tourism development, further liberalization of capital market, privatization of identified SOEs and product diversification. Recognizing export as the driver of manufacturing growth, the plan also focuses on export strategies on export diversification, China opportunity and export restructuring. [24: C.Nath, D. N. (2012). Manufacturing Sector of Bangladesh-Growth, Structure and Strategies for Future Development. Paper for Presentation at the Biennial Conference Global Economy and Vision 2021 during 12-14 July,2012, Dhaka. Retrieved February 2, 2014, from http://bea-bd.org/site/images/pdf/47.pdf] [25: Government of Bangladesh. (2012). Perspective Plan of Bangladesh 2010-2021: Making Vision 2021 A Reality. Dhaka: Planning Commission, GOB. Retrieved February 2, 2014, from http://www.plancomm.gov.bd/wp-content/uploads/2013/09/Perspective-Plan-of-Bangladesh.pdf]

The importance of export sector has been emphasized in a separate export policy[footnoteRef:26], which ascertains governments intention to accelerate growth and to reduce poverty rate in shortest time. The policy focuses on availability of raw materials, quality of products, efficiency of e-Commerce and e-Governance, infrastructure development and human capital generation. The policy has identified highest priority sectors and special development sectors to achieve faster growth. Remarkable performance by the industrial sector as well as export sector shows a positive result of different policies in the past years; following their footsteps both the policy and plan mentioned intends to replicate the economic result with greater success. [26: Government of Bangladesh. (2009). Export Policy 2009-2012. Dhaka: Ministry of Commerce, GOB. Retrieved February 2, 2014, from http://www.bdembassyusa.org/uploads/Bangladesh%20Export%20Policy%20(2009-2012).pdf]

However, political unrest in recent times has slowed down the growth and government has been failed to address the issue effectively, which requires serious attention to provide industrialist a good economic environment. The country has also been lacking from the shortage of high-skilled labors, as technical and vocational education has been continuously ignored by low quality of education and inadequately infrastructure. An effective collaboration with the Ministry of Education to formulate a combined strategy to increase the human capital to catch up with the growing need to exploit emerging global opportunities is an immediate necessity. At the same time, concentration of industrial areas has not been equally distributed across the country, so there is a shortage of necessary infrastructure all over the country which most often affects communication process. The policy also requires to address the infrastructure gap and create a country wide communication and transport system.

Policy Issue 4: Institutions and Economic DevelopmentInstitutions and Economic Development in Bangladesh: Some Work, Some Do Not To: Government of BangladeshFrom: Md. Saidur RahmanSubject: Institutions and Economic Development in Bangladesh: Some Work, Some Do Not Date: 2/16/14One of the key challenges faced by Bangladesh in terms of achieving desired economic growth is full utilization of institutions to promote sustained and equitable development. Having enormous potential and massive population, the country often lacks to provide necessary environment for business and human capital generation. Different institutions emerged with different roles in the country with mixed results. Monetary, fiscal and other policies requires management coordination to formulate workable economic models based on the macroeconomic financial and real economic variables. In the absence of proper coordination, overlapping jurisdiction and functional linkages, key institutions like Ministry of Finance and Ministry of Planning fail to accomplish its objective. At the same time, Bangladesh Bank, also suffers from lack of coordination, in implementing its policies. The country requires an immediate push in the infrastructure and energy sector, which most often, delayed by political reasons and investment shortage. While leading government agencies are acknowledged of these issues, a proper synchronization from their part is still absent, which has created stagnation in many sectors that depend on communication and energy. On the other hand, Fundamental limitations of banking sector also gave rise to Non-Bank Financial Institutions (NBFI) in the country, which complements commercial banks (Shrestha 2007[footnoteRef:27]; Sufian 2008[footnoteRef:28]; Vittas 1997[footnoteRef:29]) though their ability to meet the various financial requirements of business enterprises (Islam & Osman 2011)[footnoteRef:30]. Licensed and regulated under the Financial Institutions Act, NBFIs are involved in lease financing, term lending, house financing, merchant banking, equity financing, venture capital financing, project financing, etc (Gupta et el. 2013)[footnoteRef:31]. The service of NBFIs are also extended to various sectors like textile, agriculture, small and cottage, chemicals, trading, pharmaceuticals, transport, food and beverage, leather products, and construction and engineering (Gupta et el. 2013). 6% contribution to the GDP and increasing number of NBFIs stresses the importance and acceptability of the sector, which can positively add to the economic development of the country. [27: Shrestha, M. B. (2007). Role of non-bank financial intermediation: Challenges for central banks in the SEACEN countries. Malaysia: The South East Asian Central Banks (SEACEN).] [28: Sufian, F. (2008). The efficiency of non-bank financial intermediaries: Empirical evidence from Malaysia. The International Journal of Banking and Finance, 5(2), 149-167] [29: Vittas, D. (1997). The role of non-bank financial intermediaries in Egypt and other MENA countries.World Bank Policy Research Working Paper 1892, 1-41.] [30: Islam, M. A., & Osman, J. B. (2011). Development impact of non-bank financial intermediaries on economic growth in Malaysia: An empirical investigation. International Journal of Business andSocial Science, 2(14), 187-198.] [31: Gupta, A. D., Yesmin, A., & Khan, M. O. (2013). Growth of Non Bank Financial Institutions Over and Contribution to Economy: Evidence. Global Journal of Management and Business Research, 13(6), 16-24. Retrieved from https://globaljournals.org/GJMBR_Volume13/3-Growth-of-Non-Bank-Financial.pdf]

Over the years, microfinance institutions like Grameen Bank, BRAC and ASA has provided banking facilities to the poor who were previously left out from the mainstream financial institutions and exploited by money lenders. These NGOs created employment opportunities in rural areas and enabled rural women to be self-sufficient (Ocasio, 2012)[footnoteRef:32]. When large population, traditional agricultural activities, inadequate education and infrastructure limited the growth, supply driven microfinance approach matched the existing demand for credit and schooling, which in turn, increased their production, consumption and investment (Khandker 1998)[footnoteRef:33]. However, these NGOs mobilized women to form village groups where they would commit to various issues like sending children to schools, building a good house, keeping families small, taking joint action for community activities, not accepting or giving dowry at weddings, drinking clean water etc (Yunus 2004)[footnoteRef:34]. Such commitments have freed them from the religious taboos and patriarchal dominancy. [32: Ocasio, V. M. (2012). Essays on the Role of Microfinance Institutions in Financial Deepening, economic Growth and Development. In partial fulfillment of the requirements For the Degree of Doctor of Philosophy Colorado State University Fort Collins, Colorado during Fall 2012. Retrieved February 16, 2014, from http://digitool.library.colostate.edu///exlibris/dtl/d3_1/apache_media/L2V4bGlicmlzL2R0bC9kM18xL2FwYWNoZV9tZWRpYS8xODY1MzQ=.pdf] [33: Khandker, S. (1998). Fighting Poverty with Microcredit: Experience in Bangladesh. Washington DC: World Bank Publications.] [34: Yunus, M. (2004). Grameen Bank, Microcredit and Millennium Development Goals. Economic and Political Weekly, 39(36), 4077-4080.]

The performance of various institutions in the country has been mixed. Though, newer institutions have showed better performance than traditional government institutions in term of service delivery and innovation, the country still requires its traditional and key public institutions to work efficiently to provide the necessary environment for growth and development. One of the approach could be providing performance based incentives to public employees and increase their salary relative to their working district. Similarly, public office can identify best practices by NGOs and collaborate together to provide certain services. However, the performance of many NGOs is not satisfactory; a strong monitoring mechanism should be developed in place to analyze the difference between target and achievement of various programs. When all institutions work in a synergy, the aggregate outcome can provide the country its desired progress.Policy Issue 5: Fiscal InstitutionTax Reform and Success in Bangladesh: Still need to go a Long WayTo: National Board of Revenue, BangladeshFrom: Md. Saidur RahmanSubject: Tax reform and success in Bangladesh: Still need to go a long wayDate: 2/23/14In spite of high profile tax reform attempts, Bangladesh has one of least effective tax systems in the world[footnoteRef:35] (Hasan and Prichard 2013). Manual administration, low revenue and high levels of discretion and corruption is associated with the tax system in Bangladesh[footnoteRef:36] (Hasan and Prichard 2013). Within the context of political settlement, key economic actors enjoys low and predictable tax rates in the country and protests any reform. [35: Hassan, M., & Prichard, W. (2013). The Political Economy of Tax Reform in Bangladesh: Political Settlements, Informal Institutions and the Negotiation of Reform. Institute of Development Studies. Brighton: Institute of Development Studies. Retrieved from http://www.ictd.ac/sites/default/files/ICTD%20WP14.pdf] [36: Ibid]

National Board of Revenue, countrys prime tax regulatory body, is characterized by a weak policy framework, very limited administrative modernization, a high degree of administrative fragmentation, significant human resource constraints and weak enforcement mechanisms[footnoteRef:37] (Hasan and Prichard 2013). [37: Ibid]

While significant reforms in tax system has taken place in the countries like introduction of Value Added Tax (VAT) in 1991, the World Bank-supported Customs Administration Modernization (CAM) project in 1999, Modernization and Automation Program (MAP) in 2005 and DFIDs Reforms in Revenue Administration (RIRA) project the country follows an old tax regulation, The Income Tax Ordinance 1984 (Mozumder 2012; World Bank 2006). All these efforts have been delayed, altered and ineffective.Despite above factors, the country has experienced a slow growth in tax revenue as a percent of GDP, from 5.20 per cent in 1979-80 to 10.49 per cent in 2010-11[footnoteRef:38] (Yusuf and Huq 2012). Recent attempts by NBR though income tax fairs and other efforts have also been successful in tax registration and revenue[footnoteRef:39] (BBC 2010). Even the country tax reform have been praised by IMF[footnoteRef:40] (The Daily Star 2013) and rated stable in recent rating Moody's Investor Service[footnoteRef:41] (Moodys 2011). [38: Yousuf, M., & Huq, S. M. (2013). Elasticity and Buoyancy of Major Tax Categories: Evidence from Bangladesh and Its Policy Implications . Ministry of Finance. Dhaka: Ministry of Finance. Retrieved from http://mof.gov.bd/en/budget/pathprosperity/chapter3.pdf] [39: Source: http://www.bbc.co.uk/news/world-south-asia-11436554] [40: Source: http://archive.thedailystar.net/beta2/news/imf-praises-reform-efforts/] [41: Source: https://www.moodys.com/research/Moodys-Tax-reforms-and-infrastructure-measures-back-Bangladeshs-Ba3-rating--PR_217690]

Until recently, the tax reform in the country has been irregular way. Recently VAT law has been drafted along with a VAT implementation plan[footnoteRef:42]. NBR has also formulated modernization plan (2011-16) emphasizing on introduction of new Income tax act, modernization of the Customs Act, electronic system for tax registration and filing by 2016, empowering and restructuring of NBR, enforcement improvement and human resources and institutional development. [42: Smith, A. M., Islam, A., & Moniruzzaman, M. (2011). Consumption Taxes in Developing Countries:The Case of the Bangladesh VAT. Centre for Accounting, Governance and Taxation Research, School of Accounting and Commercial Law. Wellington: Centre for Accounting, Governance and Taxation Research. Retrieved from https://www.victoria.ac.nz/sacl/centres-and-institutes/cagtr/working-papers/WP82.pdf]

However, NBR also requires to address other issues simultaneously. Decentralization of tax/VAT offices, electronic cash register system, use of secondary information, effective operationalization of physical monitoring of business, computer assisted audit and automated tax payer identification such issues require to be include within the existing strategy of NBR (Yusuf and Huq 2013[footnoteRef:43]). Most importantly a strong transparency and accountability mechanism is required to break the tri-party syndicate formed by firms, tax officials and lawyers and auditors. At the same time, political intrusion should be restricted by empowering NBR to increase the efficiency and effectiveness in tax system of Bangladesh. [43: Yousuf, M., & Huq, S. M. (2013). Elasticity and Buoyancy of Major Tax Categories: Evidence from Bangladesh and Its Policy Implications . Ministry of Finance. Dhaka: Ministry of Finance. Retrieved from http://mof.gov.bd/en/budget/pathprosperity/chapter3.pdf]

Policy Issue 6: Social AccountabilityRight to Information Act and Social Accountability in BangladeshTo: Government of Bangladesh, BangladeshFrom: Md. Saidur RahmanSubject: Right to Information Act and Social Accountability in BangladeshDate: 3/2/14Right to Information Act[footnoteRef:44] (RTIA) has been passed in March 29, 2009 in Bangladesh. The objective of the law was to ensure free flow of information and people's right to information. The RTIA, in its preamble, states that the right to information shall ensure that transparency and accountability in all public, autonomous and statutory organizations and in private organizations run on government or foreign funding shall increase, corruption shall decrease and good governance shall be established. The RTIA also states that since all powers of the Republic belong to the people, it is necessary to ensure right to information for their empowerment. [44: Government of Bangladesh. (2009). Right to Information Act 2009. Dhaka: Government of Bangladesh. Retrieved from https://www.caluniv.ac.in/Global%20mdia%20journal/WINTER%202010%20DOCUMENTS/Document%202.pdf]

A citizen survey undertaken by Right to Information Forum has revealed that while a significant number of respondents were unaware of RTI and RTIA, majority of the information seekers received information (Right to Information Forum 2012)[footnoteRef:45]. The report has stated positively in terms of completeness and delivery of information. The problems identified by the report are lack of available information, unnecessary visits to collect the information, lack of awareness and weak information system. [45: Right to Information Forum. (2012). Right to Information Act (RTIA) In Bangladesh: Challenges of Implementation. Dhaka: Right to Information Forum. Retrieved from https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CCkQFjAA&url=http%3A%2F%2Fdnet.org.bd%2FFiles%2F24042013045156pmE_book_Right_to_Information_Act_Challenges_Nov_2012.pdf&ei=9gYUU6CaLuKe2AXenoGYBQ&usg=AFQjCNE2j589dkDXnAZLpr9VBEr_XM8y-g]

The recent annual report by Information Commission, established in 2009, also stated a significant improvement in number of information complain, area of complains and delivery of information (Information Commission 2012)[footnoteRef:46]. The commission has taken a massive awareness campaign, especially sending text message in collaboration with countrys two largest cell phone network providers Grameen Phone and Rabi and telecasting about RTI though television channels[footnoteRef:47]. [46: Information Commission. (2012). Information Commission Annual Report 2012. Dhaka: Information Commission. Retrieved from http://www.infocom.gov.bd/ic/index.php?option=com_content&view=article&id=155&Itemid=170&lang=en] [47: Source: http://www.youtube.com/watch?v=kcZIDrC1iKc]

Initiatives taken by the World Bank (WB), as a partner for Access to Information Program, also resulted in significant improve in information request as a result of RTIA[footnoteRef:48] (The World Bank 2012). The WB referred such success as overcoming the culture of silences and secrecy. Simultaneously, several Non-Governmental Organizations (NGOs) are also working for broader coverage of RTIA awareness[footnoteRef:49]. [48: Source: http://wbi.worldbank.org/wbi/multimedia/RTI] [49: The World Bank. (n.d.). The Power of Using the Right to Information Act in Bangladesh: Experinces from the Ground. The World Bank Institute. The World Bank. Retrieved from http://wbi.worldbank.org/wbi/Data/wbi/wbicms/files/drupal-acquia/wbi/Final%20version%20-%20The%20Benefits%20of%20Using%20the%20RTI%20Act%20in%20Bangladesh.pdf]

While different sources have showed an overall improvement in information disclosure by public offices, the number of information requests is quite low compared to the large population in the country. Most of the public offices in Bangladesh has been successful in adopting digital environment; however, lack of skilled officials, shortage of human resources and inadequate information are the barriers for free flow of information. The most challenging task is to apply RITA to politicians, who are in effect, also holds public offices. In recent times, the World Bank has withdrawn their loan commitment from Padma Multipurpose Bridge due to the corruption by Communication Minister of that period[footnoteRef:50]. Information Commission and Anti-Corruption Commission failed to act immediately and the project got stuck. Later a Railway Minister has also been alleged of corruption[footnoteRef:51], and yet, no necessary action taken by any of these agencies. Even though RITA has been effective, but to ensure transparency and prevent corruption, the scope of RITA should be expanded to get rid of all kind of corruption be it by a public officer, be it by a minister. [50: Source: http://archive.thedailystar.net/beta2/news/abul-hasan-chy-among-3-charged-by-canada-cops/] [51: Source: http://www.thedailystar.net/mridha-2-other-officials-indicted-12144]

Policy Issues 7: Property Rights and Efficiency in Urban AreasPrivatization Requirements in Different Sectors of BangladeshTo: Government of Bangladesh, BangladeshFrom: Md. Saidur RahmanSubject: Privatization Requirements in Different Sectors of BangladeshDate: 3/9/14In Bangladesh, privatization process initiated in the early 1980s in response to the need for deregulation, de-nationalization and de-control when state-owned enterprises (SOEs) had been suffering loss due to inefficiency and corruption (GOB 2013). In the course of privatization, Government of Bangladesh (GOB) established the Privatization Board in 1993 (currently the Privatization Commission - PC) and formulated the Privatization Policy in 2001[footnoteRef:52] and Privatization Regulation in 2007[footnoteRef:53] (GOB 2013). Till date 74 SOEs have been privatized, and under current privatization program 22 SOEs have been included for privatization. Most privatization occurred in the textile, jute, paper and banking sectors (BOI 2013)[footnoteRef:54]. GOB is considering sectors like industry, power, gas, water, transport, communication, agriculture etc. for further privatization[footnoteRef:55]. [52: Government of Bangladesh. (2001). Privatization Policy 2001. Dhaka: Government of Bangladesh. Retrieved from http://www.bizbangladesh.com/privatization_policy.php] [53: Momen, M. N. (2007). Implementation of Privatization Policy: Lessons from Bangladesh. The Innovation Journal: The Public Sector Innovation Journal, 12(2). Retrieved from http://www.innovation.cc/scholarly-style/momen_privatization4e.pdf] [54: Source: http://www.boi.gov.bd/index.php/investment-climate-info/privatization] [55: Source: http://www.dcci.org.bd/economic_policy/Privatization_Policy-F.pdf]

According to the PC Report published in 2010[footnoteRef:56], significant progress has been achieved in textile and education sector with noticeable amount of employment generation (GOB 2010). However, different researches showed some mixed results; significant disemployment of employees and continuous underperformance of many industries have been evident (Sobhan 2002)[footnoteRef:57]. In spite of that, privatization has been a driving factor for the economic and social development in the country. Textile sectors have achieved substantial growth in export and employment generation. The growth of telecom sector is also the result of privatization. A growing demand in education and health sectors have also been served by private universities and private hospitals. Though, most of the education institutes and health facilities suffer from high cost and low quality, nonetheless the overall impact from broader perspective has been positive. [56: Source: http://www.pc.gov.bd/study%20report.pdf] [57: Sobhan, R. (2002). Privatisation in Bangladesh: An Agenda in Search of a Policy. Centre for Policy Dialogue. 2002: CPD. Retrieved from http://www.cpd.org.bd/pub_attach/op16.pdf]

Yet, the country failed to perform efficiently in energy, railway, infrastructure, agriculture and other vital sectors. Current electricity generation limit is much less than the demand and the country suffers from severe amount of load shedding, which in turn, results in inefficiency in every sector. Moreover, the corruption at the local level makes the situation worse. Railway is one of most burdensome sector for the government which has been undergoing through loss for a long time. Though, several flyovers has been built in the capital to accommodate the railway road, the inefficiency of railway sectors poses a serious question to all these large investments. As a result, traffic congestion in the capital is one of the worst in the entire world. Energy and communication has been long regarded as the main drivers of economic growth, which at the moment requires massive transformation. The success in other privatization efforts can also be replicated in energy and communication sectors as well. Even the tourism sector, which has a great potential[footnoteRef:58], has failed to generate expected economic growth due to lack of investment and associated factors. Though GOB has been considering these options for a long time, but no significant progress have been made so far. In order to provide the necessary growth environment, the country requires to act immediately before it falls behind. [58: Source: http://www.youtube.com/watch?v=JZu8qV2IgRI]

Policy Issue 8: Economic Analysis of InvestmentsInvestment Climate in Bangladesh: A Serious Effort by GOB is RequiredTo: Government of Bangladesh, BangladeshFrom: Md. Saidur RahmanSubject: Investment Climate in Bangladesh: A Serious Effort by GOB is RequiredDate: 3/30/14For any countrys economic growth, investment is a fundamental aspect which promotes entrepreneurship by its citizen and encourage foreign firms to invest in that country. In the 2014 Doing Business Report[footnoteRef:59], Bangladesh ranked 132 among 189 countries in the world[footnoteRef:60] (WB 2013). Bangladesh ranked 189 in terms of getting electricity which illustrates the severe electricity shortage in the country[footnoteRef:61] (WB 2013). The whole country suffers a permanent electricity shortage all around the year, the situation becomes uncontrollable during the summer, which slows down productivity at one end and increases cost at other end. The country also ranked very poorly in enforcing contracts (185 among 189 countries) due to weak institutions and inefficient regulatory framework. Access to land in Bangladesh poses another challenge for new investment and the corresponding ranking for registering property is also very low (177)[footnoteRef:62] (WB 2013). Ranking for Bangladesh in areas like construction permits (93), paying taxes (100), trading across borders (130) and resolving insolvency (119) also reflect the weak investment climate in the country[footnoteRef:63] (WB 2013). [59: International Finance Corporation. (2013). Doing Business 2014: Bangladesh. Washington DC: IFC. Retrieved from http://www.doingbusiness.org/data/exploreeconomies/bangladesh/~/media/giawb/doing%20business/documents/profiles/country/BGD.pdf] [60: Ibid.] [61: Ibid.] [62: Ibid.] [63: Ibid.]

However, Bangladesh has relatively better ranking in terms of business startup. For starting any business, it requires to go through 7 procedures which takes 10.5 days and a cost of 19.9% of the per capita income[footnoteRef:64] (WB 2013). This has become possible due to automated registration process and reduced time to acquire trading license and tax and VAT registration (WB 2013). In order to improve the business environment, a program - the Bangladesh Investment Climate Fund (BICF) is being carried out by IFC, UKs Department for International Development and Government of Bangladesh[footnoteRef:65]. Till to date, BICF has been successful in areas of automation of business and license process, enactment of a comprehensive Economic Zones Law 2010, reduced property registration fee and better working environment (WB 2013). The country has also been successful in promoting women entrepreneurship to some extent which has a great potential to accelerate the economic growth[footnoteRef:66]. [64: Source: http://www.doingbusiness.org/data/exploreeconomies/bangladesh/] [65: Source: https://www.wbginvestmentclimate.org/advisory-services/investment-generation/special-economic-zones/ifc-helps-create-conditions-for-socially-responsible-investment-in-bangladesh.cfm] [66: Source: http://www.youtube.com/watch?v=zLV1MTpC5qA]

Though, Bangladesh has eased the startup of business process, an extensive development in many areas is required to foster economic growth. One of the key areas is electricity generation. Government has already taken an ambitious plan to double the power generation by 2015[footnoteRef:67] (U.S Department of State 2013). But, the viability of this target is doubtful due to inefficiency, corruption and inappropriate projects in power sector. The country is still struggling to reduce the infrastructure gap as large projects are delayed due to corruption and unavailability of investors. In addition to these, the bureaucratic procedure and financial limitations is still problematic and the countrys effort to minimize these constraints is not satisfactory. Ineffective judiciary or absences of alternative dispute resolution mechanisms fails to enforce contracts and resolve business disputes, which further exacerbates the situation[footnoteRef:68]. Transparency of the regulatory system is another issue where the country is performing very poorly. Last but not the least concern for investment climate in Bangladesh is political violence which most often stagnates production and other business activities. GOB requires to address all these issues through innovating practical solutions toward power shortage, strengthening judicial system, enforcing rule of laws, ensuring transparency maintaining a favorable political environment and promoting women entrepreneurship. [67: Source: http://www.state.gov/e/eb/rls/othr/ics/2013/204599.htm] [68: Source: http://www.thedailystar.net/business/reforms-improve-economic-climate-10092]

Policy Issue 9: The Role of Credit Market in DevelopmentMicrocredit in Bangladesh: An Unfinished IdeaTo: Government of Bangladesh, BangladeshFrom: Md. Saidur RahmanSubject: Microcredit in Bangladesh: An Unfinished IdeaDate: 4/06/14When new ideas emerge, they are contested by predominant institutions and structure within a society. But, ideas survive on its own accord and shape the world. Much has been talked about the impact of microfinance in recent decades; at one hand, it has faced severe criticisms by academicians and fundamentalists, and sometimes by liberal minded people; on the other hand, some academicians have supported microfinance vigorously.While proponents of microcredit have found significant improvements in women empowerment (Habib and Jubb 2012[footnoteRef:69]) as a result of micodredit loan, opponents have harshly asserted that microcredit is neither a solution to poverty nor a tool to empower women (Melik 2010[footnoteRef:70] and Hashemi 2012[footnoteRef:71]). Before I dig down, I think, the definition of poverty is relevant. The World Bank has defined poverty as whether households or individuals have enough resources or abilities today to meet their needs[footnoteRef:72]. With changing notion of resources, money is not perhaps the only resource a person needs to maintain a good life. When the intended goal of microcredit to eradicate poverty is yet to be analyzed and justified, the unintended accomplishment is nothing less than substantial. [69: Habib, Mohshin and Christine Jubb (2012). Role of Microfinance in Political Empowerment of Women: Bangladesh Experience. OIDA International Journal of Sustainable Development, Vol. 5, No. 5, pp. 99-110] [70: Melik, James (2010). Microcredit Death Trap for Bangladeshs Poor. BBC News Online, BBC News of November 2, 2010; available at: http://www.bbc.co.uk/news/business-11664632] [71: Hashmi, Taj (2012a). Microfinance and its Discontents: Women in Debt in Bangladesh by L. Karim A Review Article. Journal of Bangladesh Studies, Special Issue: Microfinance, pp. 54-60.] [72: Source: http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTPOVERTY/EXTPA/0,,contentMDK:20202198~menuPK:435055~pagePK:148956~piPK:216618~theSitePK:430367,00.html]

First of all, microcredit has become one of the largest employment sectors in the Bangladesh, where thousands of people are employed. According to Microcredit Regulatory Authority (MRA)[footnoteRef:73], the total number of employees is 111,828 (MRA 2011). The other numbers are also amazing: total loan outstanding is around TK 248 billion, total savings is TK168 billion, total clients of this sector is 35 millionand total asset in this sector is around 3 percent of GDP in 2011[footnoteRef:74] (MRA 2011). This are real numbers and real people, even if a single person is recipient of multiple loans, the number is quite significant in a country of 160 million people. [73: Source: http://www.mra.gov.bd/index.php?option=com_content&view=category&layout=blog&id=29&Itemid=80] [74: Ibid.]

Secondly, the women of Bangladesh have never been involved in family accounting other than household expenditures. The society has been patriarchal as always and religion has been negative about womens financial role. So, for women from poor households, the inability to contribute to the familys income was perhaps equally important as to provide feed them regularly. With the microcredit, women have fought against the society and borrowed money to contribute to the familys well-being. But for a poor family, any extra earning is really important. Some other studies show improvements in contraceptive use, fertility rate, food intake, domestic violence, education etc. (Loro 2013[footnoteRef:75]; Ahsanullah 2011[footnoteRef:76]). [75: Loro, L. (2013). Womens Empowerment as a Result of Microcredit Loans in Bangladesh? Falls Church: Bangladesh Development Research Center. Retrieved from http://www.bangladeshstudies.org/files/WPS_no18.pdf] [76: Ahshanullah, M., Karim, R., & Haq, E. (2011). Reaching the Poor: Microcredit Experience in Bangladesh. ASA University Review, 5(2), 11-31. Retrieved from http://www.asaub.edu.bd/data/asaubreview/v5n2sl2.pdf]

Lastly, the critics have argued that the loan has not been used properly due to lack of skill, small amount of loan, high interest rate, multiple loan etc. All these issues require government intervention to shape it in a better way. If government has enough resources to provide them skill and loan with a soft interest, microfinance would not emerge at the first place. I think, microfinance cannot solve the problem of poverty alone; it requires proper institutions in place, linkage with manufacturing industry, rigorous skill development of the clients, massive smooth communication network and favorable business environment. The non-economic aspects of microcredit is fascinating, and it has certainly changed the landscape of Bangladesh and it has a huge potential to achieve the goal it intended; but it requires necessary adjustments that can only be provided by the government.

Policy Issue 10: Health Care Delivery in Developing CountriesCurrent Situation of Health Care Service in BangladeshTo: Ministry of Health and Family Welfare, BangladeshFrom: Md. Saidur RahmanSubject: Health Care Service in BangladeshDate: 4/21/14In spite of lack of resource, Bangladesh has shown promising success in health sector with significant improvement in key health indicators like life expectancy and coverage of immunization, infant mortality, with decreasing rate of infant mortality, maternal mortality and fertility. Such progress has been possible due to the effort by state and non-state actors. The government, in the 1970s, established various health care infrastructures like hospitals, health complexes, family welfare centers, sub-centers, and Expanded Programmed for Immunization Outreach clinics (Hashim 2012)[footnoteRef:77]. Simultaneously a parallel network of family planning and maternal and child welfare centers was established by the government. NGOs have also contributed significantly by providing health care services in rural areas which has recently expanded to semi-urban and urban slums. Recent health policy[footnoteRef:78] (MoHFW, GOB 2011) has been formulated to tackle the health issues more comprehensively. The policy addresses present health problems like inadequate antenatal delivery and post-natal services, gender discrimination, HIV prevalence, insufficient health facilities in rural areas and urban slums[footnoteRef:79], limited number of health professionals and scarce medical resources. [77: Hashim, S. M. (2012, May 8). Bangladesh's commendable advances in healthcare. Dhaka: The Daily Star Online Newspaper. Retrieved April 21, 2014, from http://archive.thedailystar.net/newDesign/news-details.php?nid=233141] [78: Government of Bangladesh. (2011). Health Policy 2011. Dhaka: MoHFW, Government of Bangladesh. Retrieved from http://www.mohfw.gov.bd/index.php?option=com_docman&task=doc_download&gid=1475&lang=en] [79: Source: http://videos.huffingtonpost.com/health-service-facilities-in-the-slums-of-bangladesh-460501781]

However, the human resources in health sector is inadequate with considerable shortage of doctors and nurses along with absenteeism of physician in public health care facilities (Mahmood 2012[footnoteRef:80]). The health care expense is still relatively high in the country, which is most often, beyond the reach of poor population. The quality of health care service possess a serious question in the overall health care system of the country; rich people most often travel abroad to receive medical treatment. The negligence of government health professional towards poor population is another issue which the government overlooks most often. In spite of the recent success in the pharmaceutical industry in Bangladesh, vital medicines are still expensive. The overall health condition of the citizen further deteriorated by water pollution, unsafe drinking water, air pollution, poor living condition and unhygienic working condition. Most of these issues require inter-ministerial coordination, another areas that government should consider. Another issues that predominantly absent in the country is that most people do not have health insurance due to lack of knowledge and affordability; government should address the issue to encourage the market to provide affordable health premium to the citizen. Finally, the health governance system in the country needs to be decentralized in a manner that is accessible to all citizen irrespective of their income or geographic location. [80: Mahmood, S. A. (2012). Health System in Bangladesh. iMedPub Journals, 1(1), 1-3. Retrieved April 21, 2014, from http://imedpub.com/ojs/index.php/hspr/article/download/487/353]