General service and child immunization-specific readiness assessment of healthcare facilities in two selected divisions in Bangladesh

Shawon, Shajedur Rahman; Adhikary, Gourab; Ali, Md. Wazed; Shamsuzzaman, Md.; Ahmed, Syed Imran; Alam, Nurul; Shackelford, Katya Anne; Woldeab, Alexander; Lim, Stephen S; Levine, Aubrey J.; Gakidou, Emmanuela; Uddin, Md. Jasim

doi:10.1186/s12913-018-2858-7

Cited by 27 publications

(29 citation statements)

References 11 publications

(6 reference statements)

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“…These results concur with Shawon et al (2018) who reported that in Bangladesh, facilities at all levels had lowest scores for diagnostic capacity. Another study conducted in India reported absence of diagnostics for routine blood, urine and stool examination especially in Empowered Action Group states such as Assam where only 20% primary health centers had basic laboratory facilities (Ninama et.…”

Section: Creating Vulnerability Indexsupporting

confidence: 92%

Supply Side Readiness for Universal Health Coverage: Assessing Service Availability and Barriers in Remote and Fragile Setting.

Verma

Dash

2019

Preprint

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Background: The study hinged upon unravelling supply side readiness and barriers in attaining universal health coverage in a difficult setting. This district representative study is conducted in a fragile, remote, rural district of Jammu and Kashmir in India with unprecedented geographical barriers and heavy military deployment. Hilly geographical terrain, military skirmishes and sporadic militant attacks, rudimentary/absence of road network and absolute poverty are quintessential to this area. Methods: Mixed method approach was employed to triangulate quantitative and qualitative findings. Facility survey at various levels of facilities was conducted to gauge general service availability and service specific availability (depth of coverage). Compendium of checklist was designed using national standards in form of standard core questionnaire and parsimonious indices were computed by coalescing an array of tracer indicators across various domains as proposed in WHO’s Service Availability and Readiness Assesment (SARA) module. Polychoric principal component analysis was used to identify significant variables causing variation in health service delivery and generalized ordinal logistic model was employed to determine factors impacting facility readiness score. Multifarious techniques like observations, key informant interviews and focus group discussions using semi structured questionnaires on both leaders and laggards were administered for critical stakeholder’s analysis to discern qualitative information. Results: Results indicated poorest readiness for peripheral rural facilities with a composite score of 41% and 24% for subcenters and new type primary health centers respectively. Availability of basic amenities, diagnostic capacity and preparedness for emergencies and Non Communicable diseases was particularly subjacent having lowest scores. For primary care facilities; principal component was mainly characterized by basic newborn care as well as preparedness for delivery. Degree of environmental vulnerability of facilities, facility type and frequency of monitoring/supervision significantly impacted facility’s readiness. Lack of incentives for health workers in remote and shelling prone areas, unavailability of residential accommodation, absence of motorable roads, political interferences aiding internal adjustments in form of transfer/attachment of health workers, leakages in supply chain of drugs and consumables, reticence of skilled staff in serving militancy impacted areas, nonchalant attitude of policymakers were identified as major barriers for service provisioning.

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Section: Creating Vulnerability Indexsupporting

confidence: 92%

Supply Side Readiness for Universal Health Coverage: Assessing Service Availability and Barriers in Remote and Fragile Setting.

Verma

Dash

2019

Preprint

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“…The study was focused on two divisions with different levels of vaccination coverage: Sylhet (low coverage at 61.1%) and Rajshahi (high coverage at 83.6%) [13]. In each division, we selected a district and a city corporation, representative of rural and urban settings.…”

Section: Study Population and Sitesmentioning

confidence: 99%

The Economic Burden of Measles in Children Under Five in Bangladesh

Broucker¹,

Ahmed

Hasan

et al. 2020

Preprint

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Background: This study estimated the economic cost of treating measles in children under-5 in Bangladesh from the caregiver, government, and societal perspectives.Method: We conducted an incidence-based study using an ingredient-based approach. We surveyed the administrative staff and the healthcare professionals at the facilities, recording their estimates supported by administrative data from the healthcare perspective. We conducted 100 face-to-face caregiver interviews at discharge and phone interviews 7 to 14 days post-discharge to capture all expenses, including time costs related to measles. All costs are in 2018 USD ($).Results: From a societal perspective, a hospitalized and ambulatory measles cost $159 and $18, respectively. On average, the government spent $22 per hospitalized measles. At the same time, caregivers incurred $131 and $182 in economic costs, including $48 and $83 in out-of-pocket expenses in public and private not-for-profit facilities, respectively. Seventy-eight percent of the poorest caregivers faced catastrophic health expenditures compared to 21% of the richest. In 2018, 2263 cases of measles were confirmed, totaling $348,073 in economic costs to Bangladeshi society, with $121,842 in out-of-pocket payments for households.Conclusion: Households face substantial out-of-pocket expenses and productivity loss related to measles. Improving vaccination coverage in Sylhet division would likely alleviate most of this burden.

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“…The study was focused on two divisions with different levels of vaccination coverage: Sylhet (low coverage at 61.1%) and Rajshahi (high coverage at 83.6%) [14]. In each division, we selected a district (Maulvibazar and Natore districts) and a city corporation (Sylhet and Rajshahi city corporations), representative of rural and urban settings.…”

Section: Study Population and Sitesmentioning

confidence: 99%

The economic burden of measles in children under five in Bangladesh

Broucker¹,

Ahmed

Hasan

et al. 2020

Preprint

Self Cite

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Background: This study estimated the economic cost of treating measles in children under-5 in Bangladesh from the caregiver, government, and societal perspectives.Method: We conducted an incidence-based study using an ingredient-based approach. We surveyed the administrative staff and the healthcare professionals at the facilities, recording their estimates supported by administrative data from the healthcare perspective. We conducted 100 face-to-face caregiver interviews at discharge and phone interviews 7 to 14 days post-discharge to capture all expenses, including time costs related to measles. All costs are in 2018 USD ($).Results: From a societal perspective, a hospitalized and ambulatory measles cost $159 and $18, respectively. On average, the government spent $23 per hospitalized measles. At the same time, caregivers incurred $131 and $182 in economic costs, including $48 and $83 in out-of-pocket expenses in public and private not-for-profit facilities, respectively. Seventy-eight percent of the poorest caregivers faced catastrophic health expenditures compared to 21% of the richest. In 2018, 2263 cases of measles were confirmed, totaling $348,073 in economic costs to Bangladeshi society, with $121,842 in out-of-pocket payments for households.Conclusion: The resurgence of measles outbreaks is a substantial cost for society, requiring important short-term public expenditures putting households into a precarious financial situation. Improving vaccination coverage in areas where it is deficient (Sylhet division in our study) would likely alleviate most of this burden.

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General service and child immunization-specific readiness assessment of healthcare facilities in two selected divisions in Bangladesh

Cited by 27 publications

References 11 publications

Supply Side Readiness for Universal Health Coverage: Assessing Service Availability and Barriers in Remote and Fragile Setting.

Supply Side Readiness for Universal Health Coverage: Assessing Service Availability and Barriers in Remote and Fragile Setting.

The Economic Burden of Measles in Children Under Five in Bangladesh

The economic burden of measles in children under five in Bangladesh

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