Education, health, and public spending: Synchronizing pathways for development
Dr. Nasim Ahmed :
Bangladesh has made significant progress in areas such as poverty reduction, literacy, gender equality, and primary healthcare.
However, ongoing structural challenges still limit its ability to sustain and fairly distribute these accomplishments.
Three key pillars: education, health, and public spending, stand out as the main drivers of socio-economic change.
While each sector contributes independently, the real challenge is aligning them to reinforce each other for sustainable growth.
Combining these areas can improve human capital, boost productivity, and reduce inequalities.
Education and health are deeply connected. A well-educated population is more likely to practice healthy habits, seek quality medical care, and drive innovation in health technologies.
Conversely, a healthy population is better able to engage in education, work, and entrepreneurship.
Public spending serves as the bridge that influences how many of these benefits are achieved.
Proper allocation and use of resources ensure that education and health systems are not only accessible but also fair and effective.
When spending on education is disconnected from health priorities or vice versa, the outcomes become less effective.
For example, schools in underserved rural areas often lack proper sanitation facilities, which can reduce girls’ attendance despite increased investments in textbooks and teachers.
Similarly, health programs like nutrition initiatives lose their impact when education systems fail to inform students about their benefits.
Therefore, integrating education, health, and fiscal policies is essential to maximize socio-economic benefits.
Bangladesh’s health sector has achieved success in reducing child mortality, maternal deaths, and communicable diseases.
However, inequalities in access, poor infrastructure, and increasing burdens of non-communicable diseases remain significant challenges.
Poor health outcomes restrict labor force participation, productivity, and educational achievement, ultimately hindering economic growth.
Better coordination between education and public spending can help address these challenges.
For example, public investment in school-based health services, such as regular check-ups, nutrition supplementation, and mental health support, can both reduce health disparities and improve academic performance.
Public spending faces two main challenges: limited fiscal space and inefficient resource use.
Even with large increases in social sector budgets, results often don’t improve proportionally because of fragmentation, leakage, and poor coordination among agencies.
Integrating education and health through focused public spending requires shifting from sectoral divisions to coordinated planning.
For example, the Ministry of Education and the Ministry of Health could work together to develop school health programs funded through a dedicated budget line. Equally important is prioritizing equity in spending.
Marginalized groups, such as rural women and low-income households, often face compounded disadvantages in both education and health.
Pro-poor budget allocations, conditional cash transfers, and targeted subsidies can ensure resources reach those most in need, maximizing social returns on investment.
When education, health, and public spending are coordinated, the cumulative benefits extend far beyond individual sectors, as below.
1. Integrated investment leads to healthier, more skilled workers who contribute effectively to the economy. For instance, healthier children perform better in school, while educated adults engage in preventive health measures, reducing healthcare demands.
2. Synchronization ensures that the poorest communities are not left behind. Conditional cash transfers tied to school attendance and health check-ups can effectively increase enrollment, improve nutrition, and enhance income security.
3. Girls’ education, supported by school health programs that address menstrual hygiene and reproductive health, enhances women’s workforce participation and benefits development across generations.
4. A well-educated and healthy workforce drives innovation, entrepreneurship, and competitiveness, strengthening Bangladesh’s position in the global knowledge economy.
5. Investing in human capital reduces long-term costs by shifting the focus from fixing problems to preventing them, which ensures financial sustainability and resilience against shocks like pandemics.
However, several obstacles hinder effective synchronization: (a) Ministries often operate independently, causing duplication of efforts and wasting resources; (b) Limited tax revenues constrain the government’s ability to significantly increase spending in social sectors; (c) Unequal distribution of health and educational infrastructure worsens regional inequalities; (d) Corruption, inefficiency, and weak monitoring systems reduce the effectiveness of public investments; (e) External shocks such as climate change, pandemics, or global economic downturns strain already limited resources.
To tackle these challenges, Bangladesh must adopt a comprehensive strategy:
1. Create inter-ministerial platforms to develop and oversee joint programs in education and health, supported by unified budget frameworks.
2. Use evidence-based planning tools to prioritize spending on high-impact interventions, such as nutrition programs in schools or digital health and learning platforms.
3. Expand community clinics linked with schools to provide preventive health services and awareness programs.
4. Leverage private sector expertise and investment in both education, such as e-learning and vocational training, and health, like telemedicine and diagnostics.
5. Broaden the tax base, cut inefficiencies, and direct more funds to health and education to promote sustainability.
6. Create gender-sensitive and pro-poor interventions to enhance fairness in access and outcomes.
The coordination of education, health, and public spending is vital for sustainable development. While each sector contributes to human welfare and economic growth, together they create a positive cycle that improves socio-economic outcomes. By adopting integrated planning and prioritizing equity, Bangladesh can unlock the full potential of its human capital. This strategy will help the country progress toward its goal of becoming a prosperous, inclusive, and resilient nation dedicated to sustainable development.
(The author, PhD in Public Policy, Ulster, UK is an Associate Professor of Public Policy, Bangladesh Institute of Governance and Management
(Affiliated with the
University of Dhaka)