Benefit incidence analysis of healthcare in Bangladesh - equity matters for universal health coverage
This article was published in the Health Policy and Planning [© The Author 2016.] and the definitive version is available at: http://doi.org/10.1093/heapol/czw131 The Journal's website is at: https://academic.oup.com/heapol/article/32/3/359/2907862
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© 2017 Oxford University Press
2018
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| Acceso en línea: | http://hdl.handle.net/10361/9686 http://doi.org/10.1093/heapol/czw131 |
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10361-96862018-03-19T04:30:02Z Benefit incidence analysis of healthcare in Bangladesh - equity matters for universal health coverage Khan, Jahangir Am Ahmed, Sayem MacLennan, Mary E. Sarker, Abdur Razzaque Sultana, Marufa Rahman, Hafizur E.M.R. James P Grant School of Public Health, BRAC University Concentration indices Decomposition Universal health coverage Health insurance This article was published in the Health Policy and Planning [© The Author 2016.] and the definitive version is available at: http://doi.org/10.1093/heapol/czw131 The Journal's website is at: https://academic.oup.com/heapol/article/32/3/359/2907862 Background: Equity in access to and utilization of healthcare is an important goal for any health system and an essential prerequisite for achieving Universal Health Coverage for any country. Objectives: This study investigated the extent to which health benefits are distributed across socioeconomic groups; and how different types of providers contribute to inequity in health benefits of Bangladesh. Methodology: The distribution of health benefits across socioeconomic groups was estimated using concentration indices. Health benefits from three types of formal providers were analysed (public, private and NGO providers), separated into rural and urban populations. Decomposition of concentration indices into types of providers quantified the relative contribution of providers to the overall distribution of benefits across socioeconomic groups. Eventually, the distribution of benefits was compared to the distribution of healthcare need (proxied by 'self-reported illness and symptoms') across socioeconomic groups. Data from the latest Household Income and Expenditure Survey, 2010 and WHO-CHOICE were used. Results: An overall pro-rich distribution of healthcare benefits was observed (CI = 0.229, t-value = 9.50). Healthcare benefits from private providers (CI = 0.237, t-value = 9.44) largely favoured the richer socioeconomic groups. Little evidence of inequity in benefits was found in public (CI = 0.044, t-value = 2.98) and NGO (CI = 0.095, t-value = 0.54) providers. Private providers contributed by 95.9% to overall inequity. The poorest socioeconomic group with 21.8% of the need for healthcare received only 12.7% of the benefits, while the richest group with 18.0% of the need accounted for 32.8% of the health benefits. Conclusion: Overall healthcare benefits in Bangladesh were pro-rich, particularly because of health benefits from private providers. Public providers were observed to contribute relatively slightly to inequity. The poorest (richest) people with largest (least) need for healthcare actually received lower (higher) benefits. When working to achieve Universal Health Coverage in Bangladesh, particular consideration should be given to ensuring that private sector care is more equitable. Published 2018-03-19T04:25:56Z 2018-03-19T04:25:56Z 2017 Article Khan, J. A. M., Ahmed, S., MacLennan, M., Sarker, A. R., Sultana, M., & Rahman, H. (2017). Benefit incidence analysis of healthcare in bangladesh - equity matters for universal health coverage. Health Policy and Planning, 32(3), 359-365. 10.1093/heapol/czw131 02681080 http://hdl.handle.net/10361/9686 http://doi.org/10.1093/heapol/czw131 en https://academic.oup.com/heapol/article/32/3/359/2907862 © 2017 Oxford University Press |
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Brac University |
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Institutional Repository |
| language |
English |
| topic |
Concentration indices Decomposition Universal health coverage Health insurance |
| spellingShingle |
Concentration indices Decomposition Universal health coverage Health insurance Khan, Jahangir Am Ahmed, Sayem MacLennan, Mary E. Sarker, Abdur Razzaque Sultana, Marufa Rahman, Hafizur E.M.R. Benefit incidence analysis of healthcare in Bangladesh - equity matters for universal health coverage |
| description |
This article was published in the Health Policy and Planning [© The Author 2016.] and the definitive version is available at: http://doi.org/10.1093/heapol/czw131 The Journal's website is at: https://academic.oup.com/heapol/article/32/3/359/2907862 |
| author2 |
James P Grant School of Public Health, BRAC University |
| author_facet |
James P Grant School of Public Health, BRAC University Khan, Jahangir Am Ahmed, Sayem MacLennan, Mary E. Sarker, Abdur Razzaque Sultana, Marufa Rahman, Hafizur E.M.R. |
| format |
Article |
| author |
Khan, Jahangir Am Ahmed, Sayem MacLennan, Mary E. Sarker, Abdur Razzaque Sultana, Marufa Rahman, Hafizur E.M.R. |
| author_sort |
Khan, Jahangir Am |
| title |
Benefit incidence analysis of healthcare in Bangladesh - equity matters for universal health coverage |
| title_short |
Benefit incidence analysis of healthcare in Bangladesh - equity matters for universal health coverage |
| title_full |
Benefit incidence analysis of healthcare in Bangladesh - equity matters for universal health coverage |
| title_fullStr |
Benefit incidence analysis of healthcare in Bangladesh - equity matters for universal health coverage |
| title_full_unstemmed |
Benefit incidence analysis of healthcare in Bangladesh - equity matters for universal health coverage |
| title_sort |
benefit incidence analysis of healthcare in bangladesh - equity matters for universal health coverage |
| publisher |
© 2017 Oxford University Press |
| publishDate |
2018 |
| url |
http://hdl.handle.net/10361/9686 http://doi.org/10.1093/heapol/czw131 |
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