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Journal article
Financial risk protection against noncommunicable diseases: trends and patterns in Bangladesh
BMC Public Health, Vol.22(1), Art. 1835
2022
Abstract
Background
Demographic and epidemiological transitions are changing the disease burden from infectious to noncommunicable diseases (NCDs) in low- and middle-income countries, including Bangladesh. Given the rising NCD-related health burdens and growing share of household out-of-pocket (OOP) spending in total health expenditure in Bangladesh, we compared the country’s trends and socioeconomic disparities in financial risk protection (FRP) among households with and without NCDs.
Methods
We used data from three recent waves of the Bangladesh Household Income and Expenditure Survey (2005, 2010, and 2016) and employed the normative food, housing (rent), and utilities method to measure the levels and distributions of catastrophic health expenditure (CHE) and impoverishing effects of OOP health expenditure among households without NCDs (i.e. non-NCDs only) and with NCDs (i.e. NCDs only, and both NCDs and non-NCDs). Additionally, we examined the incidence of forgone care for financial reasons at the household and individual levels.
Results
Between 2005 and 2016, OOP expenses increased by more than 50% across all households (NCD-only: USD 95.6 to 149.3; NCD-and-non-NCD: USD 89.5 to 167.7; non-NCD-only: USD 45.3 to 73.0), with NCD-affected families consistently spending over double that of non-affected households. Concurrently, CHE incidence grew among NCD-only families (13.5% to 14.4%) while declining (with fluctuations) among non-NCD-only (14.4% to 11.6%) and NCD-and-non-NCD households (12.9% to 12.2%). Additionally, OOP-induced impoverishment increased among NCD-only and non-NCD-only households from 1.4 to 2.0% and 1.1 to 1.5%, respectively, affecting the former more. Also, despite falling over time, NCD-affected individuals more frequently mentioned prohibiting treatment costs as the reason for forgoing care than the non-affected (37.9% vs. 13.0% in 2016). The lowest quintile households, particularly those with NCDs, consistently experienced many-fold higher CHE and impoverishment than the highest quintile. Notably, CHE and impoverishment effects were more pronounced among NCD-affected families if NCD-afflicted household members were female rather than male, older people, or children instead of working-age adults.
Conclusions
The lack of FRP is more pronounced among households with NCDs than those without NCDs. Concerted efforts are required to ensure FRP for all families, particularly those with NCDs.
Details
- Title
- Financial risk protection against noncommunicable diseases: trends and patterns in Bangladesh
- Authors/Creators
- T. Rahman (Author/Creator) - Murdoch University, Murdoch Business SchoolD. Gasbarro (Author/Creator) - Murdoch UniversityK. Alam (Author/Creator) - Murdoch University
- Publication Details
- BMC Public Health, Vol.22(1), Art. 1835
- Publisher
- BioMed Central Ltd.
- Identifiers
- 991005540048907891
- Copyright
- © 2022 The Authors.
- Murdoch Affiliation
- Murdoch Business School; Centre for Healthy Ageing; Do not use- Former Murdoch Business School
- Language
- English
- Resource Type
- Journal article
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