2. Public Social Expenditures Education (2.3 percent of GDP) Health (1 percent of GDP) Social protection (1 percent of GDP) -- equal to $12 per capita and low by international standards on account of low revenue mobilization (India -$21; Sri – Lanka $37; Pakistan-$13)

3. Data Requirements for BIA Data on utilization rates, income level and other background characteristics: 2000 Household Income and Expenditure Survey; Data on public expenditure, to infer unit cost: RIBEC and HEU data accuracy of analysis depends on the level of disaggregation of these two types of data

4. Five Steps for Calculating Benefit Incidence: 1. Rank all individuals from poorest to richest by the chosen measure of current welfare—form “Expenditure Quintiles”; 2. Identify which individuals used each type of the publicly provided services; 3. Calculate the average unit cost of providing each type of publicly provided service (net of fees, where applicable); 4. Multiply the utilization figures by the government's unit cost of provision. This then gives the amount of public spending on the good or service going to each group; 5. Summarize results by expressing the subsidy received by a groups as a percentage share in the total subsidy.

5. Yardsticks to Assess the Distribution of Benefits Compare benefits: 1. Across population groups (e.g., bottom income quintile, next quintile group, etc.). Do the poor receive a greater share of benefits compared to their population share? 2. With share of income across population groups. Do the poor receive a greater share of benefits compared to their share of total national income? 3. With the comparable distribution in other countries. Do the poor in Bangladesh receive a greater share of benefits compared to their counterparts in other countries?

12. Similar rates of self-reported morbidity across poor and non-poor, except for the young and the oldSimilar rates of self-reported morbidity across poor and non-poor, except for the young and the old Propensity to seek any curative medical services is higher for the non- poor, especially for 6 to 10 year old childrenPropensity to seek any curative medical services is higher for the non- poor, especially for 6 to 10 year old children Government is not the main provider of curative health services,Government is not the main provider of curative health services,

13. …but is a main provider of pre-natal, post-natal and immunization services, especially for the poor

17. Public expenditures in social sectors play important redistributive role, although not pro-poor overall; Their pro-poor bias could be greatly improved; The major constraints to more pro-poor incidence are: High private cost involved and the poor are less able to pay; Under-the-table payments are comparable with actual fees; Fees are charged for services that should be provided free; Leakages in program resources; …in addition it is not clear who ultimately benefits from private practices of government doctors. In Summary,

18. How can equity and efficiency of social expenditures be improved? Use area-based poverty indicators for allocating public funds to the social sectors: distribution of free teaching and learning materials in primary education; allocations to Female Stipends Program in secondary education; budgetary allocations in the health sector (i.e. de-link them from beds and staff, and anchor them on caseloads and poverty) Increase public access to information through Client Satisfaction Surveys, Participatory Monitoring and Evaluation, Public Expenditure Tracking Surveys Continue emphasis on primary education, especially on improving its quality and sustaining efforts to boost demand Increase public expenditures for the expansion of pre- and post-natal care Intensify efforts to deliver basic health services to hard-to-reach populations, especially urban slum dwellers

19. How can equity and efficiency of social expenditures be improved? continued Rebalance expenditures on labor and non-labor teaching inputs Expand the program of contracting out to NGOs and the private sector for the management of non-performing government schools and non-formal education Increase community involvement, but with a critical evaluation of existing SMCs Use examination results as well as other performance-based criteria to direct subvention payments to performing schools, particularly at the secondary and degree college levels

20. How can equity and efficiency of social expenditures be improved? Shift university funding from financing private services (Undergraduate and Masters degree-level education) to those functions of higher education that are more nearly public goods Introduce fees for university undergraduates and masters courses, accompanied by a means-tested scholarship program and, possibly, by a government supported loan program Develop an adequate regulatory framework for different health providers --Government, NGO and private Set up health consumer councils at national and regional levels to promote self-regulation and strengthening consumer voice