Background

Despite substantial improvements in health indicators, Bangladesh's health system is
constrained by chronic underfunding. The country’s public health spending remains below 1%
of GDP, leading to high out-of-pocket expenditures (74%). Systemic inefficiencies often result
in the underutilization of these limited resources. This research aims to analyse health budget
allocation, expenditure, and utilization at the primary and secondary levels of healthcare
facilities (District Hospital, Upazila Health Complex, Union Health and Family Planning Centre
and Community Clinic).