Catastrophic health expenditure among industrial workers in a large-scale industry in Nepal, 2017: a cross-sectional study

Pyakurel, Prajjwal; Tripathy, Jaya Prasad; Oo, Myo Minn; Acharya, Bijay; Pyakurel, Ujjwal; Singh, Surendra; Subedi, Laxmi; Yadav, Kamlesh Prasad; Poudel, Mohan; Pandey, Dipesh Raj; Budhathoki, Shyam Sundar; Lohani, Guna Raj; Jha, Nilambar

doi:10.1136/bmjopen-2018-022002

Cited by 9 publications

(14 citation statements)

References 30 publications

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“…About 16% of household members were admitted to health institutions [10] which is similar to our findings. It may be due to the working power and healthy life of the respondents.…”

Section: Discussionsupporting

confidence: 90%

“…According to this study, the annual expenditure on medical health care was less than fifty thousand rupees which are similar to the findings of the study among industrial workers of Nepal in which annual expenditure was about thirty thousand rupees. [10] The main reason may be because Nepal is a developing country and most people cannot invest enough budget for health care. But in the study conducted in low-income societies of Iran, the annual expenditure of healthcare was about eight thousand rupees as compared to the present study.…”

Section: Discussionmentioning

confidence: 99%

“…[10] Thismay have occurred because the outpatient services are used commonly. According to the present study, the percentage of household traveling abroad for medical treatment remains very low (2.6%) and among them, most of the household spent about one lakh fifty thousand rupees to two lakh rupees ($1228$ ~$1638) for the treatment which is low in comparison to the study conducted on low-and middle-income people of the Maldives.…”

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confidence: 99%

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Utilization of Healthcare Services & Healthcare Expenditure Patterns in the Rural Households of Nepal

Pokharel

Acharya

Pahari

et al. 2021

APJHM

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Background: Healthcare financing as a lever to move closer to universal health coverage. Financing health care has been identified as a barrier to access to health care and increases the likelihood of impoverishment of households. There is still limited study and information on healthcare service utilization in the rural community of Nepal. Our study aims to assess utilization of healthcare services & patterns of healthcare expenditure in the rural households of Nepal. Methods: A community-based research study was conducted among 341 rural households of Tanahun District, Nepal. A Chi-square test was used for assessing the associated factors with healthcare utilization. Results: The utilization of in-patient and out-patient health services was 89.9 % and 10.1 % respectively. The majority of households (88%) had in USD less than $410 annual household healthcare expenditure. The mean annual healthcare expenditure was found to be $279. Nearly three-fourths (71.4%) of households had annual expenditure on medicine more than $40 with mostly on allopathic medicine (93.4%). The majority of participants (70%) mentioned that the healthcare expenditure was a burden to their household. Conclusion: Despite the higher knowledge of health insurance, the involvement was found to be very low & poor. Educational status, knowledge about insurance, privileged ethnicity, religion, income source were the major factors associated with the utilization of healthcare services. Awareness & promotion programs focusing on rural communities should be implemented with affordable health services.

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“…About 16% of household members were admitted to health institutions [10] which is similar to our findings. It may be due to the working power and healthy life of the respondents.…”

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Utilization of Healthcare Services & Healthcare Expenditure Patterns in the Rural Households of Nepal

Pokharel

Acharya

Pahari

et al. 2021

APJHM

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“…The questions remained unanswered how healthy they are. It may be noteworthy to cite a report published online by Pyakurel et al from Nepal on "Catastrophic health expenditure among industrial workers" [14]. We emphasize that the industrial workers' health need comprehensive care (promotive, preventive, curative and rehabilitative), keeping in mind that they are indeed low paid marginalized section of the society.…”

Section: Discussionmentioning

confidence: 87%

Respiratory and other illnesses among the jute-mill workers in an industrial unit of Bangladesh

Rhaman¹,

Morshed²,

Sayeed³

2019

IMC J Med Sci

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Background and aims: Bangladesh produces 33% of the world’s jute and about 40 million people in Bangladesh are directly or indirectly involved in the jute sector. The jute (organic) dust inhalation causes byssinosis and other respiratory illnesses. However, no study has yet addressed the health status of the jute handlers/workers in Bangladesh. This study aimed to determine the prevalence of respiratory illnesses among the Jute Mill Workers (JMWs). Additionally, this study tried to find out the overall health status of the JMWs which included presence of non-communicable diseases (NCD) and its related risk, which are usually ignored. Study design: A cross-sectional study conducted in a purposively selected jute mill - 40km off from Dhaka City. Of the 5500 workers, a list of 600 workers was provided by the mill authority for enrollment in the study. The investigations included – a) interviewing on socio-demography and clinical history; b) anthropometry (height, weight, waist- and hip-circumference); c) blood pressure measurement; d) estimation of fasting blood glucose and lipids; e) peak flow meter test; f) spirometry; g) high resolution computerized tomography (HRCT) and electrocardiography. Results: Of the enlisted 600 jute mill workers, 514 (men / women = 478 / 36) took part in the study. The response rate was 85%. For overall estimate of bio-physical characteristics (n = 514), the means (95% confidence interval) of age, body mass index (BMI), waist-hip ratio (WHR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 44.19 (43.34 – 45.04) years, 24.44 (24.16 – 24.73), 0.90 (0.90 – 0.91), 118.9 (117.4 – 120.4), 79.69 (78.81 – 8/0.54), respectively. Regarding social class and education, 84.4% were from non-affluent (poor) class and 50% were illiterate. About 88% of the JMWs had been working for ≥42 hours a week and 91.6% were exposed to moderate or heavy work (equivalent to ≥60 min walk). The prevalence of breathlessness, tightness of chest and chronic cough were 16.5%, 25.7% and 16.3%, respectively. The restrictive and obstructive pulmonary functions were detected in 7.0% and 0.8% of study population respectively. The prevalence of systolic hypertension was 16.5%, diastolic hypertension was 7.2% and diabetes (IFG+DM) was 13.3%. They had increased cardiovascular risks – hypertriglyceridemia (23.9%) and hypercholesterolemia (24.3%). Conclusions: JMWs have been suffering mostly from respiratory illnesses and a substantial number of them suffer from undiagnosed hypertension, diabetes and other non-communicable diseases. Dyslipidemia was also prevalent as a potential risk factor. The study could not assess ocular, auditory, musculoskeletal and mental health and it suggests that a well designed study should address these health related problems of JMWs. IMC J Med Sci 2019; 13(1): 007

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“…Third, occupations directly affect the earning potential and financial status that facilitates the use of healthcare when needed (20,21). These factors together bring a pattern of financial hardship among the occupations not covered by the existing risk-pooling arrangements (9,22,23), more seriously to those in the lower-income spectrum.…”

Section: Introductionmentioning

confidence: 99%

Occupational and geographical differentials in financial protection against healthcare out-of-pocket payments in Nepal: evidence for universal health coverage

Sapkota

Bhusal²,

Adhikari

2022

Preprint

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Background . The low-and middle-income countries including Nepal aim to address financial hardship against healthcare out-of-pocket (OOP) payments through risk-pooling arrangements. World Health Organization (WHO) has recommended member states to establish pooling arrangements so that the financial risks owing to health uncertainty can be spread across population. This study aims to analyse the situation of financial protection across occupations and geography using nationally representative annual household survey (AHS) in Nepal. Methods. We measured catastrophic health expenditure (CHE) due to OOP using two approaches: budget share approach at 10% and 25% threshold, and capacity-to-pay approach at 40% threshold. Impoverishment impact due to OOP was measured at absolute and relative poverty lines. These estimates were disaggregated across occupations and geography. The inequality in financial risk protection was measured using concentration index. The analysis was based on the cross-sectional AHS 2014-15, the most recent round that provided information on occupations and consumption. AHS employed standard consumption measurement tool (COICOP). International Standard Classification of Occupations (ISCO) was used to categorize occupations. Results. Among the agricultural workers, we found a CHE of 10.7% at 10% threshold and 5.2% at 40% threshold. Among ‘plant operators and craft workers’, the corresponding figures were 10% and 4.8%. Impoverishment impact was higher in these households at all poverty lines. CHE was higher among unemployed households. A negative concentration index for CHE and impoverishment impact was found for agricultural workers and ‘plant operators and craft workers’. In rural areas, we found a CHE of 11.5% at 40% threshold and a high impoverishment impact. Across province, CHE was 12% in Madhesh and 14.3% in Lumbini at 10% threshold, and impoverishment impact was 1.9% in Madhesh, Karnali and Sudurpachim at US $1.90 a day poverty line. Conclusion. Households belonging to informal occupations such as agricultural workers, plant operators and craft workers, elementary occupations and unemployed were more prone to CHE and impoverishment impact due to healthcare OOP payments. There was wide urban/rural and provincial differential in financial protection status. The results can be useful to policymakers engaged in designing risk-pooling arrangements to make progress towards UHC.

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Catastrophic health expenditure among industrial workers in a large-scale industry in Nepal, 2017: a cross-sectional study

Cited by 9 publications

References 30 publications

Utilization of Healthcare Services & Healthcare Expenditure Patterns in the Rural Households of Nepal

Utilization of Healthcare Services & Healthcare Expenditure Patterns in the Rural Households of Nepal

Respiratory and other illnesses among the jute-mill workers in an industrial unit of Bangladesh

Occupational and geographical differentials in financial protection against healthcare out-of-pocket payments in Nepal: evidence for universal health coverage

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