Sayan Chakrabarty

Assessing willingness to pay for health care quality improvements

BackgroundContingent valuation (CV) is used to estimate the willingness to pay (WTP) of consumers for specific attributes to improve the quality of health care they received in three hospitals in Bangladesh.MethodsRandom sample of 252 patients were interviewed to measure their willingness to pay for seven specified improvements in the quality of delivered medical care. Partial tobit regression and corresponding marginal effects analysis were used to analyze the data and obtain WTP estimates.ResultsPatients are willing to pay more if their satisfaction with three attributes of care are increased. These are: a closer doctor-patient relationship, increased drug availability and increased chances of recovery. The doctor patient relationship is considered most important by patients and exhibited the highest willingness to pay.ConclusionsThis study provides important information to policy makers about the monetary valuation of patients for improvements in certain attributes of health care in Bangladesh.

Waste management in the meat processing industry: conversion of paunch and DAF sludge into solid fuel

This article addresses the novel dewatering process of immersion-frying of paunch and dissolved air flotation (DAF) sludge to produce high energy pellets. Literature have been analysed to address the feasibility of replacing conventional boiler fuel at meat processing facilities with high energy paunch-DAF sludge pellets (capsules). The value proposition of pelleting and frying this mixture into energy pellets is based on a Cost-Benefit Analysis (CBA). The CBA is based on information derived from the literature and consultation with the Australian Meat Processing Industry. The calorific properties of a mixture of paunch cake solids and DAF sludge were predicted from literature and industry consultation to validate the product. This study shows that the concept of pelletizing and frying paunch is economically feasible. The complete frying and dewatering of the paunch and DAF sludge mixture produces pellets with energy content per kilogram equivalent to coal. The estimated cost of this new product is half the price of coal and the payback period is estimated to be between 1.8 and 3.2years. Further research is required for proof of concept, and to identify the technical challenges associated with integrating this technology into existing meat processing plants.

Gender-differentiated Social and Human Capital and the Use of Microcredit in Bangladeshi Female Entrepreneurship

In many developing countries, microfinance has become a critical component in implementing poverty reduction strategies, which are often addressed through social business and female entrepreneurship. Despite poor individuals being excluded from formal credit, microfinance organisations are delivering opportunities for them to obtain small amounts of credit. This chapter examines whether gender-differentiated social and human capital matters in social entrepreneurship, and how loans received by Bangladeshi men and women are being used in productive ways. It identifies barriers that might exclude the poorest women from these microfinance programs in Bangladesh. This analysis has important policy implications for donors, microfinance institutions and NGOs operating in developing countries as it focuses on employment generation and poverty alleviation, and also on impact on poor women in microcredit programs.

Interactions between low-socioeconomic status, adult influences on macronutrient intakes and childhood obesity

Australia as a developed country has 60% of adults and one in four (25%) children identified as overweight or obese. In 2014–15, 63.4% of Australians adults (aged 18 years and over) were classified as overweight or obese (11.2 million people), with 35.5% overweight (6.3 million people) and 27.9% obese (4.9 million people). The remainder of the population were identified mainly as normal weight (35.0%), with 1.6% of the population as underweight. The prevalence of overweight and obese children aged 5–17 years was 25.3% in 2011–12.1 Additionally, the Australian Health Survey (2011–12) revealed that in the four-year period starting from 2007–08 there was no statistically significant difference in the proportion of children (aged 5–14) overweight or obese (23% in 2007–08 and 26% in 2011–12). This study provides an empirical demonstration of the impact that adult influence has on a child’s chances of becoming obese through diet habit as well as the prevalence of overweight and obesity among Australian children of low socioeconomic status.

Cost of illness for outpatients attending public and private hospitals in Bangladesh

BackgroundA central aim of Universal Health Coverage (UHC) is protection for all against the cost of illness. In a low income country like Bangladesh the cost burden of health care in tertiary facilities is likely to be significant for most citizens. This cost of an episode of illness is a relatively unexplored policy issue in Bangladesh. The objective of this study was to estimate an outpatient’s total cost of illness as result of treatment in private and public hospitals in Sylhet, Bangladesh.MethodsThe study used face to face interviews at three hospitals (one public and two private) to elicit cost data from presenting outpatients. Other socio-economic and demographic data was also collected. A sample of 252 outpatients were randomly selected and interviewed. The total cost of outpatients comprises direct medical costs, non-medical costs and the indirect costs of patients and caregivers. Indirect costs comprise travel and waiting times and income losses associated with treatment.ResultsThe costs of illness are significant for many of Bangladesh citizens. The direct costs are relatively minor compared to the large indirect cost burden that illness places on households. These indirect costs are mainly the result of time off work and foregone wages. Private hospital patients have higher average direct costs than public hospital patients. However, average indirect costs are higher for public hospital patients than private hospital patients by a factor of almost two. Total costs of outpatients are higher in public hospitals compared to private hospitals regardless of patient’s income, gender, age or illness.ConclusionOverall, public hospital patients, who tend to be the poorest, bear a larger economic burden of illness and treatment than relatively wealthier private hospital patients. The large economic impacts of illness need a public policy response which at a minimum should include a national health insurance scheme as a matter of urgency.