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CC BY V4.0, Open Access
Journal article
Financial risk protection in health care in Bangladesh in the era of Universal Health Coverage
PLoS ONE, Vol.17(6), Art. e0269113
2022
Abstract
Background
Ensuring financial risk protection in health care and achieving universal health coverage (UHC) by 2030 is one of the crucial Sustainable Development Goals (SDGs) targets for many low- and middle-income countries (LMICs), including Bangladesh. We examined the critical trajectory of financial risk protection against out-of-pocket (OOP) health expenditure in Bangladesh.
Methods
Using Bangladesh Household Income and Expenditure Survey data from 2005, 2010, and 2016, we examined the levels and distributions of catastrophic health expenditure (CHE) and impoverishment incidences. We used the normative food, housing, and utilities method, refining it by categorizing households with zero OOP expenses by reasons.
Results
OOP expenditure doubled between 2005 and 2016 (USD 115.6 in 2005, USD 162.1 in 2010, USD 242.9 in 2016), accompanied by rising CHE (11.5% in 2005, 11.9% in 2010, 16.6% in 2016) and impoverishment incidence (1.5% in 2005, 1.6% in 2010, 2.3% in 2016). While further impoverishment of the poor households due to OOP expenditure (3.6% in 2005, 4.1% in 2010, 3.9% in 2016) was a more severe problem than impoverishment of the non-poor, around 5.5% of non-poor households were always at risk of impoverishment. The poorest households were the least financially protected throughout the study period (lowest vs. highest quintile CHE: 29.5% vs. 7.6%, 33.2% vs. 7.2%, and 37.6% vs. 13.0% in 2005, 2010, and 2016, respectively). The disparity in CHE among households with and without chronic illness was also remarkable in 2016 (25.0% vs. 9.1%).
Conclusion
Financial risk protection in Bangladesh exhibits a deteriorated trajectory from 2005 to 2016, posing a significant challenge to achieving UHC and, thus, the SDGs by 2030. The poorest and chronically ill households disproportionately lacked financial protection. Reversing the worsening trends of CHE and impoverishment and addressing the inequities in their distributions calls for implementing UHC and thus providing financial protection against illness.
Details
- Title
- Financial risk protection in health care in Bangladesh in the era of Universal Health Coverage
- Authors/Creators
- S. Raza (Author/Creator)T. Rahman (Author/Creator) - Murdoch UniversityD. Gasbarro (Author/Creator)K. Alam (Author/Creator)
- Publication Details
- PLoS ONE, Vol.17(6), Art. e0269113
- Publisher
- Public Library of Science
- Identifiers
- 991005540774107891
- Copyright
- © 2022 Rahman et al.
- Murdoch Affiliation
- Do not use- Former Murdoch Business School; Centre for Healthy Ageing
- Language
- English
- Resource Type
- Journal article
UN Sustainable Development Goals (SDGs)
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