Effect of payments for health care on poverty estimates in 11 countries in Asia: an analysis of household survey data

Doorslaer, Eddy van; O’Donnell, Owen; Rannan-Eliya, Ravindra P; Somanathan, Aparnaa; Adhikari, Shiva Raj; Garg, Chanchal; Harbianto, Deni; Herrin, Alejandro N.; Huq, Mohammed Nazmul; Ibragimova, Shamsia; Karan, Anup; Ng, Chiu Wan; Pande, Badri Raj; Racelis, Rachel H.; Shi, Tao; Tin, Keith; Tisayaticom, Kanjana; Trisnantoro, Laksono; Vasavid, Chitpranee; Zhao, Yang

doi:10.1016/s0140-6736(06)69560-3

Cited by 580 publications

(509 citation statements)

References 9 publications

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“…Number of Asians living below $1/day can be reduced by reducing such out of pocket health payments. 9 Education is one of the predictor in utilization of health care facility at individual level whereas socioeconomic status is a significant predictor at house hold level. 10 Cost can be a major issue in seeking alternate maternity health care.…”

Section: Discussionmentioning

confidence: 99%

Maternal Health Care Expenditure among Women in Rural Areas of Pakistan

Rehman

Adnan²,

Mahmood³

et al. 2017

Annals KEMU

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Background: With Pakistan failing to achieve Millennium Development Goals we have now entered into a new era of Sustainable Development Goals. Decreasing child mortality, improving maternal health and increasing the proportion of births by trained birth attendants, are the areas with unmet goals. As 29.5% of population of Pakistan is below the poverty line, expenditure on maternal health care services is of great importance as it determines the utilization of health care services to a large extent. Objective: To assess maternal health care expenditure and its sociodemographic predictors in rural Khanewal, Punjab, Pakistan. Methodology: In this cross sectional study average cost on delivery (both SVD and Cesarean section) was assessed in both public and private sector of rural

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Section: Discussionmentioning

confidence: 99%

Maternal Health Care Expenditure among Women in Rural Areas of Pakistan

Rehman

Adnan²,

Mahmood³

et al. 2017

Annals KEMU

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“…Apart from these, the healthcare services of nearly 500 village doctors (allopathic and homoeopathic) dominate the health service delivery in this area. Like the rest of the country, the major share of healthcare expenses is borne out-of-pocket by the community members [18]. Public health services, although provided free of charge, are hampered by shortage of supplies (medicine etc.…”

Section: Study Areamentioning

confidence: 99%

Who enrols in voluntary micro health insurance schemes in low-resource settings? Experience from a rural area in Bangladesh

Mahmood

Hanifi

Mia

et al. 2018

Global Health Action

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Background: Micro health insurance (MHI) has proved to be a potential health-financing tool for many developing countries. Bangladesh also included MHI in its current health-financing strategy which aims to achieve universal health coverage. However, low uptake, low renewal and high dropouts have historically challenged financial sustainability of these schemes. Objective: This study aims to identify factors influencing people from low-resource settings, particularly those from Bangladesh, to enrol in MHI schemes. Methods: The study analyses the ‘Amader Shasthya’ MHI scheme operating in Chakaria, a sub-district under Cox’s Bazar district, Bangladesh. A household survey was carried out during May–June 2016 among 2,000 households from the scheme coverage area. The Outreville’s insurance-demand framework was used to identify enrolment influencing factors. Multivariate logistic regression analysis was carried out to identify significant influencing factors of enrolment. Results: Enrolment influencing factors were identified in four dimensions: economic, socio-cultural, demographic and structural. Households with the main income earner having 10+ years of schooling (odds 1.9 [CI 1.2–2.9] compared to illiterate), having financial literacy (odds 1.5 [CI 1.2–1.8] compared to financially illiterate) and being a public/private service holder (odds 1.6 [CI 1.1–2.4] compared to menial labour) were more likely to enrol. Membership in development programmes of NGOs also influenced enrolment decision significantly (odds 1.3 [CI 1.0–1.5]). The presence of chronic illness in household encouraged enrolment (odds 1.5 [CI 1.2–1.8]). Households living closer to health centres were more likely to enrol (odds 2.1 [CI 1.6–2.7]) compared to those living further away. Conclusion: The findings are expected to have significant implications in terms of designing similar health insurance schemes, particularly in terms of designing demand-driven and context adapted schemes that have greater potential to attract a larger client pool, ensure effective risk pooling and eventually expedite the achievement of universal health coverage in low-resource settings.

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“…If a household chooses to spend sufficiently excessive amount on health care, the relative ranking of the households will go up. Further, if any household borrows to cover healthcare expenses, its total consumption expenditure will be greater than its available resources (van Doorslaer et al 2006). In both cases, inclusion of out-of-pocket payments, may change the relative ranking of the households.…”

Section: Benefit Incidence Analysismentioning

confidence: 99%