The impact of community-based health insurance on the utilization of medically trained healthcare providers among informal workers in Bangladesh

We aimed to estimate the impact of a Community-Based Health Insurance (CBHI) scheme on utilization of healthcare from medically trained providers (MTP) by informal workers. A quasi-experimental study was conducted where insured households were included in the intervention group and uninsured househo...

Full description

Bibliographic Details
Main Authors: Ahmed, S, Sarker, AR, Sultana, M, Chakrovorty, S, Ahmed, MW, Dorin, F, Mirelman, AJ, Islam, Z, Rahman, MH, Niessen, LW, Rehnberg, C, Khan, JAM
Format: Journal article
Language:English
Published: Public Library of Science 2018
_version_ 1826263156934049792
author Ahmed, S
Sarker, AR
Sultana, M
Chakrovorty, S
Ahmed, MW
Dorin, F
Mirelman, AJ
Islam, Z
Rahman, MH
Niessen, LW
Rehnberg, C
Khan, JAM
author_facet Ahmed, S
Sarker, AR
Sultana, M
Chakrovorty, S
Ahmed, MW
Dorin, F
Mirelman, AJ
Islam, Z
Rahman, MH
Niessen, LW
Rehnberg, C
Khan, JAM
author_sort Ahmed, S
collection OXFORD
description We aimed to estimate the impact of a Community-Based Health Insurance (CBHI) scheme on utilization of healthcare from medically trained providers (MTP) by informal workers. A quasi-experimental study was conducted where insured households were included in the intervention group and uninsured households in comparison group. In total 1,292 (646 insured and 646 uninsured) households were surveyed from Chandpur district comprising urban and rural areas after 1 year period of CBHI introduction. Matching of the characteristics of insured and uninsured groups was performed using a propensity score matching approach to minimize the observed baseline differences among the groups. Multilevel logistic regression model, with adjustment for individual and household characteristics was used for estimating association between healthcare utilization from the MTP and insurance enrolment. The utilization of healthcare from MTP was significantly higher in the insured group (50.7%) compared to the uninsured group (39.4%). The regression analysis demonstrated that the CBHI beneficiaries were 2.111 (95% CI: 1.458–3.079) times more likely to utilize healthcare from MTP.CBHI scheme increases the utilization of MTP among informal workers. Ensuring such healthcare for these workers and their dependents is a challenge in many low and middle income countries. The implementation and scale-up of CBHI schemes have the potential to address this challenge of universal health coverage.
first_indexed 2024-03-06T19:47:14Z
format Journal article
id oxford-uuid:22b8ce23-d01c-4098-ac14-5d1ad6896cd6
institution University of Oxford
language English
last_indexed 2024-03-06T19:47:14Z
publishDate 2018
publisher Public Library of Science
record_format dspace
spelling oxford-uuid:22b8ce23-d01c-4098-ac14-5d1ad6896cd62022-03-26T11:40:23ZThe impact of community-based health insurance on the utilization of medically trained healthcare providers among informal workers in BangladeshJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:22b8ce23-d01c-4098-ac14-5d1ad6896cd6EnglishSymplectic ElementsPublic Library of Science2018Ahmed, SSarker, ARSultana, MChakrovorty, SAhmed, MWDorin, FMirelman, AJIslam, ZRahman, MHNiessen, LWRehnberg, CKhan, JAMWe aimed to estimate the impact of a Community-Based Health Insurance (CBHI) scheme on utilization of healthcare from medically trained providers (MTP) by informal workers. A quasi-experimental study was conducted where insured households were included in the intervention group and uninsured households in comparison group. In total 1,292 (646 insured and 646 uninsured) households were surveyed from Chandpur district comprising urban and rural areas after 1 year period of CBHI introduction. Matching of the characteristics of insured and uninsured groups was performed using a propensity score matching approach to minimize the observed baseline differences among the groups. Multilevel logistic regression model, with adjustment for individual and household characteristics was used for estimating association between healthcare utilization from the MTP and insurance enrolment. The utilization of healthcare from MTP was significantly higher in the insured group (50.7%) compared to the uninsured group (39.4%). The regression analysis demonstrated that the CBHI beneficiaries were 2.111 (95% CI: 1.458–3.079) times more likely to utilize healthcare from MTP.CBHI scheme increases the utilization of MTP among informal workers. Ensuring such healthcare for these workers and their dependents is a challenge in many low and middle income countries. The implementation and scale-up of CBHI schemes have the potential to address this challenge of universal health coverage.
spellingShingle Ahmed, S
Sarker, AR
Sultana, M
Chakrovorty, S
Ahmed, MW
Dorin, F
Mirelman, AJ
Islam, Z
Rahman, MH
Niessen, LW
Rehnberg, C
Khan, JAM
The impact of community-based health insurance on the utilization of medically trained healthcare providers among informal workers in Bangladesh
title The impact of community-based health insurance on the utilization of medically trained healthcare providers among informal workers in Bangladesh
title_full The impact of community-based health insurance on the utilization of medically trained healthcare providers among informal workers in Bangladesh
title_fullStr The impact of community-based health insurance on the utilization of medically trained healthcare providers among informal workers in Bangladesh
title_full_unstemmed The impact of community-based health insurance on the utilization of medically trained healthcare providers among informal workers in Bangladesh
title_short The impact of community-based health insurance on the utilization of medically trained healthcare providers among informal workers in Bangladesh
title_sort impact of community based health insurance on the utilization of medically trained healthcare providers among informal workers in bangladesh
work_keys_str_mv AT ahmeds theimpactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT sarkerar theimpactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT sultanam theimpactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT chakrovortys theimpactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT ahmedmw theimpactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT dorinf theimpactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT mirelmanaj theimpactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT islamz theimpactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT rahmanmh theimpactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT niessenlw theimpactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT rehnbergc theimpactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT khanjam theimpactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT ahmeds impactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT sarkerar impactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT sultanam impactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT chakrovortys impactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT ahmedmw impactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT dorinf impactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT mirelmanaj impactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT islamz impactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT rahmanmh impactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT niessenlw impactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT rehnbergc impactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh
AT khanjam impactofcommunitybasedhealthinsuranceontheutilizationofmedicallytrainedhealthcareprovidersamonginformalworkersinbangladesh