Disparities of health service for the poor in the coastal area: does Universal health coverage reduce disparities?

Abstract

Background & Objective : Poor people, in general, get poor quality of health services. The situation is very much worsening for the poor who live in the remote areas in the coastal belt of Bangladesh as health care facilities and services are often less complete, farther away, and therefore most costly to reach than in urban hospitals and physician. Ensure of better health service for the poor, it is essential to examine the effectiveness of Universal Health Coverage (UHC). This study sets its objectives to evaluate the health service for the poor in the coastal area of Bangladesh and develop an approach of management strategy. Methods : This study followed a two-stage cluster sampling technique and carried out a household survey through the open-ended questionnaire. In addition, the study applied the logistic regression model to generate empirically supported assessments. Results : Result from the disparity rate ratio (DRR) revealed that there is a big health care disparity of different income groups like poor and rich. Furthermore, results from the model demonstrated that Medicaid, Medicare, Social Health Insurance, Telemedicine and Capitation under the provision Universal Health Coverage (UHC) are statistically significant compared to reduce the health care disparity. Conclusion : UHC becomes a critical issue for improved and quality health care system for all the groups especially, the poor in coastal Bangladesh. This study showed that Medicaid, Medicare and Social Health Insurance and Capitation perform well to provide better health care facilities for all.

Spatial accessibility to healthcare facilities in coastal region of Bangladesh

“…This result was found consistent with the results of previous studies. [14][15][16] Accessibility to healthcare facilities was found very poor in char area and the southern part (seashores) of Kalapara upazila. Number of CCs found in the char area was far less than the number found in the rest of the region.…”

“…Those who have limited or no accessibility to healthcare facilities mostly live in rural and remote areas, including slums, hilly areas, seashore areas, isolated and riverside islands (char), and khas land. [14][15][16][17] Generally, people living in the coastal region do not have proper accessibility to healthcare facilities because of poverty, poor transportation infrastructure, lack of healthcare facilities, excessive distance between population and healthcare facilities, presence of a large number of settlements in char areas, and/or the frequent occurrence of natural disasters, including cyclone, sea-level rise, storm surge, salinity, and waterlogging. 15,18,19 As a result, those living in the coastal region are particularly vulnerable to health risks, which also has a profound effect on their livelihood.…”

“…[14][15][16][17] Generally, people living in the coastal region do not have proper accessibility to healthcare facilities because of poverty, poor transportation infrastructure, lack of healthcare facilities, excessive distance between population and healthcare facilities, presence of a large number of settlements in char areas, and/or the frequent occurrence of natural disasters, including cyclone, sea-level rise, storm surge, salinity, and waterlogging. 15,18,19 As a result, those living in the coastal region are particularly vulnerable to health risks, which also has a profound effect on their livelihood. 15 Nevertheless, proper accessibility to healthcare is a fundamental right of the people living in the coastal region of Bangladesh.…”

“…15,18,19 As a result, those living in the coastal region are particularly vulnerable to health risks, which also has a profound effect on their livelihood. 15 Nevertheless, proper accessibility to healthcare is a fundamental right of the people living in the coastal region of Bangladesh. To ensure better healthcare service for those people, ensuring good spatial accessibility to healthcare facilities is essential.…”

Telemedicine: An Innovative Twist to Primary Health Care in Rural Bangladesh

“…Nobel laureate economists Joseph Stiglitz, Kenneth Arrow, Alvin Roth, Vernon Smith, and Christopher Pissarides argued that health care is an investment, not a cost. 36 The economic case for telemedicine includes the cost of health, driving economic growth, and building well-being and resilience. However, in Bangladesh, the degree of enrolment in the telemedicine services remains far from satisfactory level due to the existence of unstable and higher payment for telemedicine and not the consideration of households' ability to pay option.…”