Mohammad Enamul Hoque

Willingness-to-pay for community-based health insurance among informal workers in urban Bangladesh

Introduction Reliance on out-of-pocket payment for healthcare may lead poor households to undertake catastrophic health expenditure, and risk-pooling mechanisms have been recommended to mitigate such burdens for households in Bangladesh. About 88% of the population of Bangladesh depends on work in the informal sector. We aimed to estimate willingness-to-pay (WTP) for CBHI and identify its determinants among three categories of urban informal workers rickshaw-pullers, shopkeepers and restaurant workers. Methods The bidding game version of contingent valuation method was used to estimate weekly WTP. In three urban locations 557 workers were interviewed using a structured questionnaire during 2010 and 2011. Multiple-regression analysis was used to predict WTP by demographic and household characteristics, occupation, education level and past illness. Results WTP for a CBHI scheme was expressed by 86.7% of informal workers. Weekly average WTP was 22.8 BDT [Bangladeshi Taka; 95% confidence interval (CI) 20.9–24.8] or 0.32 USD and varied significantly across occupational groups (p = 0.000) and locations (p = 0.003). WTP was highest among rickshaw-pullers (28.2 BDT or 0.40 USD; 95% CI: 24.7–31.7), followed by restaurant workers (20.4 BDT 0.29 USD; 95% CI: 17.0–23.8) and shopkeepers (19.2 BDT or 0.27 USD; 95% CI: 16.1–22.4). Multiple regression analysis identified monthly income, occupation, geographical location and educational level as the key determinants of WTP. WTP increased 0.196% with each 1% increase in monthly income, and was 26.9% lower among workers with up to a primary level of education versus those with higher than primary, but less than one year of education. Conclusion Informal workers in urban areas thus are willing to pay for CBHI and socioeconomic differences explain the magnitude of WTP. The policy maker might think introducing community-based model including public-community partnership model for healthcare financing of informal workers. Decision making regarding the implementation of such schemes should consider worker location and occupation.

Rapid shift toward overweight from double burden of underweight and overweight among Bangladeshi women: a systematic review and pooled analysis.

CONTEXT Studies show there is a double burden of underweight and overweight in Bangladesh amidst a global background of increasing rates of overweight in low-income settings. OBJECTIVE The aim of this review was to determine the rates of change in the prevalence of underweight and of overweight among Bangladeshi women of reproductive age, to investigate whether there has been a shift from underweight to overweight in this population, and, if a shift was documented, to identify potential determinants. DATA SOURCES Data was obtained via electronic searches of the PubMed, CINAHL, and Embase databases. STUDY SELECTION Studies and survey reports were eligible for inclusion if they provided data on the prevalence of underweight and of overweight among women of reproductive age as well as sociodemographic information. DATA SYNTHESIS A meta-analysis was performed by reviewing data extracted from the included studies. Using data from 5 successive national demographic and health surveys, the average annual rates of change in underweight and in overweight were calculated, along with their associations with potential determinants. CONCLUSIONS In Bangladesh, the prevalence of overweight exceeded that of underweight in 2014. A higher average annual rate of reduction of underweight was found among wealthier, highly educated, urban-living women, while a higher average annual rate of increase of overweight was found among poorer, uneducated, rural-living women. The shift in body mass index from underweight to overweight was most positively associated with urban residence, age, higher socioeconomic status, and higher education attainment.

Household coping strategies for delivery and related healthcare cost: findings from rural Bangladesh

This study aims to measure the economic costs of maternal complication and to understand household coping strategies for financing maternal healthcare cost.

Economic burden of underweight and overweight among adults in the Asia-Pacific region: a systematic review.

To assess the economic burden of underweight and overweight among adults in the Asia–Pacific region.

Effect of Maternal Mortality on Survival of Under-Five Children: Evidence from Matlab, Bangladesh

With regards to children who are born shortly before their mothers death (index), the cumulative proportion of survival up to 60 months of age was significantly lower (0.39 vs. 0.81) than those born just before the last child (penultimate) of the same mother. Such a difference is mainly due to high mortality in the first six months of age. Over the period between 1974 and 2005, survival improved among the penultimate but not the index children. For index children, the cumulative proportion of survival up to 60 months of age was significantly higher (0.79 vs. 0.51) if adopted by other households by the age of 15 days compared to those who stayed in their own households. Again for index children, the cumulative proportion of survival up to 60 months of age was significantly higher (0.82 vs. 0.70) for those who stayed in their own households where a grandmother was present compared to the presence of other female household members.

Prevalence of overweight and obesity among children and adolescents of the Indian subcontinent: a meta-analysis.

In order to examine the prevalence of overweight and obesity in childhood within the Indian subcontinent, a meta-analysis of studies was conducted. Within the data sets analyzed, six homogeneous statistical subgroups were observed and three levels of prevalence were discernible (low, intermediate, and high). The pooled estimates of the prevalence of overweight and obesity in children were 2% (95% confidence interval [CI], 2-3%) to 6% (95% CI, 6-7%) for the low-prevalence group, 11% (95% CI, 11-12%) to 18% (95% CI, 17-18%) for the intermediate-prevalence group, and 23% (95% CI, 22-24%) to 36% (95% CI, 34-37%) for the high-prevalence group. Data on subjects in the low-prevalence group were obtained from national-level data and from data sets in which urban and rural subjects were combined. Neither the intermediate- nor the high-prevalence category contained any data from the rural or national level. The intermediate group largely included urban children, whereas the high-prevalence group generally included affluent children within major urban centers. Most of the data sets reported the prevalence of overweight and obesity among children in the 10-18-year age range. The prevalence of overweight and obesity was higher among boys than girls, and had increased among urban dwellers during the last decade.

Double burden of underweight and overweight among Bangladeshi adults differs between men and women: evidence from a nationally representative survey

OBJECTIVE To estimate the prevalence of underweight and overweight among Bangladeshi adults and to determine if the double burden of underweight and overweight differs by gender and other socio-economic characteristics of individuals. DESIGN We used data from the Bangladesh Demographic and Health Survey 2011. Multinominal logistic regression was used to examine associations between the different nutritional statuses of individuals and related determinants. Interaction effect was checked between gender and various socio-economic factors. SETTING Nationwide, covering the whole of Bangladesh. SUBJECTS Individuals aged >18 years (women, n 16 052; men, n 5090). RESULTS Underweight was observed among 28·3 % of men and 24·4 % of women, whereas overweight was observed among 8·4 % of men and 16·9 % of women. The odds of being overweight were significantly lower among urban men (OR=0·46; 95 % CI 0·37, 0·57) compared with urban women, whereas the odds of being underweight were significantly higher among urban men (OR=1·33; 95 % CI 1·07, 1·64) compared with urban women. The odds of being overweight were lower among higher educated men (OR=0·48; 95 % CI 0·39, 0·58) and men of rich households (OR=0·45; 95 % CI 0·37, 0·54) compared with higher educated women and women of rich households, respectively. CONCLUSIONS There are important gender differences in the prevalence of underweight and overweight among the adult population in Bangladesh. Women with higher education, in rich and urban households have higher chances of being overweight and lower chances of being underweight compared with their male counterparts.

Effects of mothers’ deaths on children’s schooling in Matlab subdistrict, Bangladesh

ABSTRACT This quantitative analysis examines evidence for the impacts of mothers’ death on the schooling of their left-behind children (ages 6–17 years) in the Matlab Health and Demographic Surveillance System (HDSS) area of the International Centre for Diarrhoeal Disease Research, Bangladesh. The analysis compared the completed levels of primary and junior secondary schooling in 2005 (respectively Class 1 among ages 6–17, Class 5 among ages 12–17 and Class 7 among ages 15–17) of children whose mothers had died during 1982–2005 (from maternal and/or nonmaternal causes, and any cause) with the completed schooling of children of surviving mothers in 2005. The results, after controlling for selected socioeconomic variables, indicate that children whose mothers had died had lower completion of schooling levels, and that those children from poorer households fared worst.

Effects of occupational illness on labor productivity: A socioeconomic aspect of informal sector workers in urban Bangladesh

The informal sector is the dominant area of employment and the economy for any developing country including Bangladesh. The cost of productivity loss due to absence from work or presenteeism with illness has rarely been examined in the Bangladesh context. This current study, therefore, attempted to examine the impact of ill health of informal sector workers on labor productivity, future earning, and healthcare‐related expenditure.

Visceral Leishmaniasis Elimination Program in Bangladesh and Achieving Millennium Development Goal

Aims: The aim of this review is to present the status of Visceral Leishmaniasis (VL) in Bangladesh and various steps taken to achieve the Millennium Development Goal (MDG). Additionally, the review covers the related challenges and opportunities to achieve this goal. Main Body: Currently, 45 out of 64 districts of the country are endemic for VL and 20 million people, around 18% of the total population, are considered to be at risk for VL. However, there is a concern about the total number of VL reported cases. It has been mentioned that the number of cases reported in surveillance data is likely to be at least five times underestimated. The current burden of VL disease is 23.4 times higher compare to the MDG of 1 case per 10,000 populations by 2015. In order to achieve the MDG various national strategies have been taken so far to eliminate VL from Bangladesh. Government of Bangladesh constituted a national steering committee and formed a technical working group to provide support to VL elimination program. Lack of trained and efficient labour force, along with lack of knowledge among the people are big