Out-of-pocket expenditure for seeking health care for sick children younger than 5 years of age in Bangladesh: findings from cross-sectional surveys, 2009 and 2012

Tahsina, Tazeen; Ali, Nazia Binte; Hoque, Dewan Md Emdadul; Huda, Tanvir; Salam, Shumona Sharmin; Hasan, Mohammad Mehedi; Hossain, Altaf; Matin, Ziaul; Kuppen, Lianne; Garnett, Sarah P.; Arifeen, Shams El

doi:10.1186/s41043-017-0110-4

Cited by 20 publications

(22 citation statements)

References 17 publications

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“…The type of illness also varied according to ethnicity which suggests a significant difference in OOPE. To our (Tahsina et al 2017). Medicine contributed the major portion of overall OOPE and higher overall OOPE for care seeking was associated with a priority illness which is consistent to findings in this study.…”

Section: Discussionmentioning

confidence: 86%

Out of Pocket Expenditure for Sick Newborn Care in Referral Hospitals of Nepal

Sunny

Gurung

et al. 2020

Matern Child Health J

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Background Almost all preventable neonatal deaths take place in low-and middle-income countries and affect the poorest who have the least access to high quality health services. Cost of health care is one of the factors preventing access to quality health services and universal health coverage. In Nepal, the majority of expenses related to newborn care are borne by the caregiver, regardless of socioeconomic status. We conducted a study to assess the out of pocket expenditure (OOPE) for sick newborn care in hospitals in Nepal. Methods This cross-sectional study of hospital care for newborns was conducted in 11 hospitals in Nepal and explored OOPE incurred by caregivers for sick newborn care. Data were collected from the caregivers of the sick newborn on the topics of cost of travel, accommodation, treatment (drugs, diagnosis) and documented on a sick newborn case record form. Results Data were collected from 814 caregivers. Cost of caregivers' stay accounted for more than 40% of the OOPE for sick newborn care, followed by cost of travel, and the baby's stay and treatment. The overall OOPE ranged from 13.6 to 226.1 US dollars (USD). The median OOPE was highest for preterm complications ($33.2 USD; CI 14.0-226.1), followed by hyperbilirubinemia ($31.9 USD; CI 14.0-60.7), respiratory distress syndrome ($26.9 USD; 15.3-121.5), neonatal sepsis ($ 25.8 USD; CI 13.6-139.8) and hypoxic ischemic encephalopathy ($23.4 USD;. Discussion for practice In Nepal, OOPE for sick newborn care in hospitals varied by neonatal morbidity and duration of stay. The largest proportion of OOPE were for accommodation and travel. Affordable and accessible health care will substantially reduce the OOPE for sick newborn care in hospitals.Keywords Catastrophic health expenditure · Neonatal care · Nepal · Out-of-pocket expenditure Abbreviations ANC

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Section: Discussionmentioning

confidence: 86%

Out of Pocket Expenditure for Sick Newborn Care in Referral Hospitals of Nepal

Sunny

Gurung

et al. 2020

Matern Child Health J

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“…While each country must decide its own path towards UHC based on the individual country contexts, all should draw on existing evidence and shared experience. Currently available evidences from Bangladesh on UHC mostly include quantitative household surveys on out of pocket expenditure [14,15], financial risk protection [6,[15][16][17], and equity analysis [6,[16][17][18]. The policy environment around UHC issues has been analyzed by very few studies, which includes an assessment of a set of proposed indicators related to UHC [19,20], and generic policy papers without description of methodology [21,22].…”

Section: Introductionmentioning

confidence: 99%

Universal Health Coverage in Bangladesh: Activities, Challenges, and Suggestions

Joarder¹,

Chaudhury

Mannan

2019

Advances in Public Health

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Catastrophic health expenditure forces 5.7 million Bangladeshis into poverty. Inequity is present in most of health indicators across social, economic, and demographic parameters. This study explores the existing health policy environment and current activities to further the progress towards Universal Health Coverage (UHC) and the challenges faced in these endeavors. This qualitative study involved document reviews (n=22) and key informant interviews (KII, n=15). Thematic analysis of texts (themes: activities around UHC, implementation barriers, suggestions) was done using the manual coding technique. We found that Bangladesh has a comprehensive set of policies for UHC, e.g., a health-financing strategy and staged recommendations for pooling of funds to create a national health insurance scheme and expand financial protection for health. Progress has been made in a number of areas including the roll out of the essential package of health services for all, expansion of access to primary health care services (support by donors), and the piloting of health insurance which has been piloted in three subdistricts. Political commitment for these areas is strong. However, there are barriers pertaining to the larger policy level which includes a rigid public financing structure dating from the colonial era. While others pertain to the health sector’s implementation shortfalls including issues of human resources, political interference, monitoring, and supervision, most key informants discussed demand-side barriers too, such as sociocultural disinclination, historical mistrust, and lack of empowerment. To overcome these, several policies have been recommended, e.g., redesigning the public finance structure, improving governance and regulatory mechanism, specifying code of conduct for service providers, introducing health-financing reform, and collaborating with different sectors. To address the implementation barriers, recommendations include improving service quality, strengthening overall health systems, improving health service management, and improving monitoring and supervision. Addressing demand-side barriers, such as patient education and community empowerment, is also needed. Research and advocacy are required to address crosscutting barriers such as the lack of common understanding of UHC.

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“…Among studies included in the review, a majority was from India (n=30, 48 %) . There were 11 studies from Nepal (42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52) , 10 from Bangladesh (53)(54)(55)(56)(57)(58)(59)(60)(61)(62) , six from Indonesia (63)(64)(65)(66)(67)(68) and two from Timor-Leste 69,70 . From Bhutan 71 , Thailand 72 , and Myanmar 73 one from each was identi ed.…”

Section: Resultsmentioning

confidence: 99%

“…Cultural norms and practices also play a role in quality care as identi ed by few studies in the region 26,36,73 . Few studies have identi ed that high out of pocket expenditure is a challenge for quality maternal and child care 12,62 .…”

Section: E Leadership and Governancementioning

confidence: 99%

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Successes, Challenges and Opportunities Towards Universal Health Coverage for Maternal and Child Health in South East Asian Countries: A Systematic Review

Perera

Gilks

Alemu

2020

Preprint

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Background: Sustainable Development Goal 3 (SDG-3) aims to ensure healthy lives and promote wellbeing for all. Universal Health Coverage (UHC) assures delivering health services to all who need without suffering from financial hardships. This paper aims to identify the successes, challenges and opportunities towards achieving UHC for maternal and childcare in countries in the World Health Organization, South East Asian Region (SEAR). Methods: We conducted a systematic review of the literature. We searched PubMed, Embase, Scopus, CINAHL, PsycINFO, WHO research portal and Google scholar for studies published in English from 2010 to 2020. We included studies conducted in maternal and childcare focusing on challenges, opportunities or successes towards UHC in countries in SEAR. Data was synthesized and presented as a narrative description, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Results: We identified 62 studies with different study designs from eight SEAR countries , majority were from India. We observed successes or opportunities in access and quality in MCH with government cash transfer schemes and private sector contribution in India, Bangladesh and Indonesia. Politically prioritized MCH care was identified as an opportunity in a state of India. Inadequate healthcare infrastructure including trained human resources, medical products and other supplies were identified as the main challenges in the region. Facilities are overcrowded in Bangladesh and Indonesia. From provider perspective, health care workers’ knowledge and skills as well as attitudes and behaviors were also identified as issues in the region. Lack of health literacy, misconceptions and cultural barriers are identified as challenges from clients’ side. Difficulties in geographical distribution and transport were contributing to poor healthcare access in four countries. Deficiencies in government policies and administration were identified in some fields. Poverty was detected as an overarching barrier.Conclusions: SEAR countries have demonstrated improvements in access, quality and equity on MCH towards UHC. There are, however, challenges related to human and other resources, health care facilities and socio-economic determinants of health. Regional bodies as well as authorities in individual countries should work on these issues to address challenges to achieve UHC.Registration: PROSPERO: CRD42020166404

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Out-of-pocket expenditure for seeking health care for sick children younger than 5 years of age in Bangladesh: findings from cross-sectional surveys, 2009 and 2012

Cited by 20 publications

References 17 publications

Out of Pocket Expenditure for Sick Newborn Care in Referral Hospitals of Nepal

Out of Pocket Expenditure for Sick Newborn Care in Referral Hospitals of Nepal

Universal Health Coverage in Bangladesh: Activities, Challenges, and Suggestions

Successes, Challenges and Opportunities Towards Universal Health Coverage for Maternal and Child Health in South East Asian Countries: A Systematic Review

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