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
Abstract Background Bangladesh has committed to universal health coverage, and options to decrease household out-of-pocket expenditure (OPE) are being explored. Understanding the determinants of OPE is an essential step. This study aimed to estimate and identify determinants of OPE in seeking health...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-09-01
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| Series: | Journal of Health, Population and Nutrition |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s41043-017-0110-4 |
| _version_ | 1818991128033099776 |
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| author | Tazeen Tahsina Nazia Binte Ali D.M. Emdadul Hoque Tanvir M. Huda Shumona Sharmin Salam Mohammad Mehedi Hasan Md Altaf Hossain Ziaul Matin Lianne Kuppen Sarah P. Garnett Shams El Arifeen |
| author_facet | Tazeen Tahsina Nazia Binte Ali D.M. Emdadul Hoque Tanvir M. Huda Shumona Sharmin Salam Mohammad Mehedi Hasan Md Altaf Hossain Ziaul Matin Lianne Kuppen Sarah P. Garnett Shams El Arifeen |
| author_sort | Tazeen Tahsina |
| collection | DOAJ |
| description | Abstract Background Bangladesh has committed to universal health coverage, and options to decrease household out-of-pocket expenditure (OPE) are being explored. Understanding the determinants of OPE is an essential step. This study aimed to estimate and identify determinants of OPE in seeking health care for sick under-five children. Methods Cross-sectional data was collected by structured questionnaire in 2009 (n = 7362) and 2012 (n = 6896) from mothers of the under-five children. OPE included consultation fees and costs of medicine, diagnostic tests, hospital admission, transport, accommodation, and food. Expenditure is expressed in US dollars and adjusted for inflation. Linear regression was used for ascertaining the determinants of OPE. Results Between 2009 and 2012, the median OPE for seeking care for a sick under-five child increased by ~ 50%, from USD 0.82 (interquartile range 0.39–1.49) to USD 1.22 (0.63–2.36) per child/visit. Increases were observed in every component OPE measured, except for consultation fees which decreased by 12%. Medicine contributed the major portion of overall OPE. Higher overall OPE for care seeking was associated with a priority illness (20% increase), care from trained providers (90% public/~ 2-fold private), residing in hilly/wet lands areas (20%), and for mothers with a secondary education (19%). Conclusion OPE is a major barrier to quality health care services and access to appropriate medicine is increasing in rural Bangladesh. To support the goal of universal health care coverage, geographic imbalances as well as expanded health financing options need to be explored. |
| first_indexed | 2024-12-20T20:05:20Z |
| format | Article |
| id | doaj.art-3af3054494184e659d2f3cccf0bbca64 |
| institution | Directory Open Access Journal |
| issn | 2072-1315 |
| language | English |
| last_indexed | 2024-12-20T20:05:20Z |
| publishDate | 2017-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Health, Population and Nutrition |
| spelling | doaj.art-3af3054494184e659d2f3cccf0bbca642022-12-21T19:27:58ZengBMCJournal of Health, Population and Nutrition2072-13152017-09-013611910.1186/s41043-017-0110-4Out-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 2012Tazeen Tahsina0Nazia Binte Ali1D.M. Emdadul Hoque2Tanvir M. Huda3Shumona Sharmin Salam4Mohammad Mehedi Hasan5Md Altaf Hossain6Ziaul Matin7Lianne Kuppen8Sarah P. Garnett9Shams El Arifeen10Maternal and Child Health Division (MCHD), icddr,bMaternal and Child Health Division (MCHD), icddr,bMaternal and Child Health Division (MCHD), icddr,bMaternal and Child Health Division (MCHD), icddr,bMaternal and Child Health Division (MCHD), icddr,bMaternal and Child Health Division (MCHD), icddr,bIMCI, Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare (MOHFW)Health Section, UNICEF BangladeshHealth Section, UNICEF BangladeshThe Children’s Hospital at Westmead Clinical School, University of SydneyMaternal and Child Health Division (MCHD), icddr,bAbstract Background Bangladesh has committed to universal health coverage, and options to decrease household out-of-pocket expenditure (OPE) are being explored. Understanding the determinants of OPE is an essential step. This study aimed to estimate and identify determinants of OPE in seeking health care for sick under-five children. Methods Cross-sectional data was collected by structured questionnaire in 2009 (n = 7362) and 2012 (n = 6896) from mothers of the under-five children. OPE included consultation fees and costs of medicine, diagnostic tests, hospital admission, transport, accommodation, and food. Expenditure is expressed in US dollars and adjusted for inflation. Linear regression was used for ascertaining the determinants of OPE. Results Between 2009 and 2012, the median OPE for seeking care for a sick under-five child increased by ~ 50%, from USD 0.82 (interquartile range 0.39–1.49) to USD 1.22 (0.63–2.36) per child/visit. Increases were observed in every component OPE measured, except for consultation fees which decreased by 12%. Medicine contributed the major portion of overall OPE. Higher overall OPE for care seeking was associated with a priority illness (20% increase), care from trained providers (90% public/~ 2-fold private), residing in hilly/wet lands areas (20%), and for mothers with a secondary education (19%). Conclusion OPE is a major barrier to quality health care services and access to appropriate medicine is increasing in rural Bangladesh. To support the goal of universal health care coverage, geographic imbalances as well as expanded health financing options need to be explored.http://link.springer.com/article/10.1186/s41043-017-0110-4Out-of-pocket expenditureChildhood illnessesUnder-five childrenHealth care-seekingBangladesh |
| spellingShingle | Tazeen Tahsina Nazia Binte Ali D.M. Emdadul Hoque Tanvir M. Huda Shumona Sharmin Salam Mohammad Mehedi Hasan Md Altaf Hossain Ziaul Matin Lianne Kuppen Sarah P. Garnett Shams El Arifeen 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 Journal of Health, Population and Nutrition Out-of-pocket expenditure Childhood illnesses Under-five children Health care-seeking Bangladesh |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Out-of-pocket expenditure Childhood illnesses Under-five children Health care-seeking Bangladesh |
| url | http://link.springer.com/article/10.1186/s41043-017-0110-4 |
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