Trends in, and projections of, indicators of universal health coverage in Bangladesh, 1995–2030: a Bayesian analysis of population-based household data

Rahman, Shafiur; Rahman, Mizanur; Gilmour, Stuart; Swe, Khin Thet; Abe, Sarah Krull; Shibuya, Kenji

doi:10.1016/s2214-109x(17)30413-8

Cited by 49 publications

(52 citation statements)

References 36 publications

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“…Mohanty (2017) [ 30 ] suggested increasing government spending on health and increasing households' access to health insurance could reduce catastrophic health spending and multidimensional poverty based on 9247 households sample size in Myanmar, Nepal and India. Rahman(2018) [ 31 ] suggested to reform health financing systems of Bangladesh to avoid high dependency on out-of-pocket spending, otherwise the incidence of CHE would increase from 17% to 20% in 5 years by estimation of Bayesian regression model. Rad(2017) [ 32 ], Rezapour(2018)[ 33 ] considered there was a high degree of CHE in Iran especially caused by chronic non-communicable diseases or in retirees based on sample survey.…”

Section: Conclusion and Discussionmentioning

confidence: 99%

Improvement of the reduction in catastrophic health expenditure in China’s public health insurance

Fang

Nie

2018

PLoS ONE

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This study aimed to locate the contributing factors of Catastrophic Health Expenditure (CHE), evaluate their impacts, and try to propose strategies for reducing the possibilities of CHE in the context of China’s current public health insurance system. The financial data of all hospitalization cases from a sample hospital in 2013 were gathered and used to determine the pattern of household medical costs. A simulation model was constructed based on China’s current public health insurance system to evaluate the financial burden for medical service on Chinese patients, as well as to calculate the possibilities of CHE. Then, by adjusting several parameters, suggestions were made for China’s health insurance system in order to reduce CHE. It’s found with China’s current public health insurance system, the financial aid that a patient may receive depends on whether he is from an urban or rural area and whether he is employed. Due to the different insurance policies and the wide income gap between urban and rural areas, rural residents are much more financially vulnerable during health crisis. The possibility of CHE can be more than 50% for low-income rural families. The CHE ratio can be dramatically lowered by applying different policies for different household income groups. It’s concluded the financial burden for medical services of Chinese patients is quite large currently, especially for those from rural areas. By referencing different healthcare policies in the world, applying different health insurance policies for different income groups can dramatically reduce the possibility of CHE in China.

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Section: Conclusion and Discussionmentioning

confidence: 99%

Improvement of the reduction in catastrophic health expenditure in China’s public health insurance

Fang

Nie

2018

PLoS ONE

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“… 22 23 ECOH has been able to address these barriers by providing consistent care to the residents of Ekhlaspur and at free or low cost. As Bangladesh moves towards implementing universal healthcare, 24 efforts should be focused on establishing clinics particularly in rural areas to make healthcare accessible and to support the continuity of care.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in prevalence and determinants of hypertension among adults: a cross-sectional survey of one rural village in Bangladesh

Islam¹,

Zaman²,

Ahmed³

et al. 2020

BMJ Open

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ObjectivePrevention of mortality due to cardiovascular disease (CVD) through control of hypertension is a public health priority in Bangladesh. Our objective was to assess sex differences in prevalence and determinants of hypertension among adults in one rural area of Bangladesh.Study designCross-sectional.Setting and participantsFrom January 2014 to December 2015, we conducted a cross-sectional study of 2600 men and women aged ≥18 years located in one rural district of Bangladesh. We collected data on demographics, behavioural factors, physical measurements and health history.Primary outcome measuresOur primary outcome was hypertension (systolic blood pressure ≥140 or diastolic blood pressure ≥90 mm Hg).ResultsThe average age of participants was 41.6 years and 53.7% were women. Hypertension prevalence was 6.9% (95% CI 5.9 to 7.9), and was significantly higher among women (8.9%) than men (4.5%). The highest prevalence of hypertension was observed among women aged ≥60 years at 21.3% (95% CI 16.6 to 26.7). A higher proportion of men with hypertension were aware of their condition (72.2%) compared with women (52.4%). Determinants of hypertension included older age, higher education, current tobacco use, increasing body mass index, and hyperglycaemia.ConclusionOur research suggests that hypertension prevalence is higher among women than men in rural Bangladesh. Sex-specific interventions should be developed to inform adults of the necessary lifestyle changes that may reduce the risk of hypertension and subsequent CVDs.

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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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Trends in, and projections of, indicators of universal health coverage in Bangladesh, 1995–2030: a Bayesian analysis of population-based household data

Abstract: Japan Ministry of Health, Labour, and Welfare.

Cited by 49 publications

References 36 publications

Improvement of the reduction in catastrophic health expenditure in China’s public health insurance

Improvement of the reduction in catastrophic health expenditure in China’s public health insurance

Sex differences in prevalence and determinants of hypertension among adults: a cross-sectional survey of one rural village in Bangladesh

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

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