ORCID Profile
0000-0002-2022-7590
Current Organisations
University Of Strathclyde
,
icddr,b
,
Bangladesh Institute of Development Studies (BIDS)
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Publications
Willingness to pay for oral cholera vaccines in urban Bangladesh
Publisher: Public Library of Science (PLoS)
Date: 30-04-2020
Cost comparison and determinants of out‐of‐pocket payments on child delivery care in Bangladesh
Publisher: Wiley
Date: 09-08-2018
DOI: 10.1002/HPM.2615
Abstract: The objective of this study is to capture the relevant out-of-pocket (OOP) costs, coping mechanisms, and associated factors that are related to child delivery in Bangladesh through the use of nationwide household level data. The study was conducted using a secondary data source of the latest Bangladesh Demographic and Health Survey 2014. A cross-sectional survey was performed for 6 months, from June to November 2014, where closed-ended questions regarding child delivery-related expenditure were included. Log linear regression and descriptive analysis methods were used to analyze these data. Analysis indicated that the average self-reported OOP payment per child delivery was US$ 79.23 (SD ±128.05). The highest OOP was observed for C-section (US$ 249.89, SD ±153.54), followed by institutional normal delivery (US$ 61.62, SD ±75.28). The average cost per normal home delivery was US$ 15.89 (SD ±25.84). The richest quintile spent significantly more than the poorest quintile regarding C-section (US$ 281 vs US$ 204), normal delivery at an institution (US$ 80 vs US$ 65), and even normal delivery at home (US$ 22 vs US$ 13). The study showed that there was a huge variation of OOP, which was dependent on the facility and socioeconomic demographic status of the households. As such, policy efforts need to focus on lowest wealth quintiles to avoid economic burdens during child delivery-related activities, and therefore, financial risk protection should be provided. Social health insurance might be an option for financing during child delivery, which is in line with the core objective of the Healthcare Financing Strategy of Bangladesh, which is to achieve universal health coverage.
Cost-effectiveness analysis of introducing universal childhood rotavirus vaccination in Bangladesh
Publisher: Informa UK Limited
Date: 12-12-2017
Inequality of childhood undernutrition in Bangladesh: A decomposition approach
Publisher: Wiley
Date: 08-11-2019
DOI: 10.1002/HPM.2918
Abstract: Undernutrition is one of the major public health concerns in Bangladesh. This study examined the trends and patterns of childhood undernutrition, inequality, and its socioeconomic contributors in Bangladesh. Data were extracted from the last four rounds of the Bangladesh Demographic Health Survey (BDHS). A regression-based decomposition method was applied to assess the socioeconomic contributors of inequality. Although the prevalence of childhood undernutrition has declined during the period 2004 to 2014, the rate of undernutrition is higher among the children of mothers who had lower education, live in rural areas, and are from the poorest wealth quintile. Socioeconomic status accounted for almost half of the total inequality in the prevalence of both stunting and underweight among children, whereas maternal education was ranked second among the contributors. Findings of the study indicate that undernutrition inequalities in terms of socioeconomic aspects appear to have widened over time. Improving economic activity and maternal education will improve the nutritional status of children and as a consequence reduce inequality. Therefore, investments in education, creation of working opportunities, and empowerment of vulnerable and disadvantaged people along with nutrition-specific interventions will be important measures to eliminate this inequality at the population level.
Determinants of adolescent maternal healthcare utilization in Bangladesh
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.PUHE.2018.01.010
Abstract: To identify the factors associated with adolescent maternal healthcare utilization in Bangladesh. A secondary analysis was undertaken using the latest data set from the Bangladesh Demographic and Health Survey (2014). Data were collected from the cross-sectional survey carried out from June to mid November 2014. In total, 17,863 ever-married women aged 15-49 years were interviewed. According to the definition of the World Health Organization, 2029 of these women were adolescents and therefore eligible for inclusion in this study. Both bivariate and multivariate logistic regression models were used to determine the factors influencing adolescent pregnancy, use of contraception, use of antenatal care services, facility-based delivery and presence of a skilled birth attendant at the last birth. The results are presented in terms of adjusted odds ratio (OR) with 95% confidence interval (CI), at a significance level of 5%. Maternal age, education, knowledge of menstrual regulations i.e. any procedure which disrupts the intra uterine environment, awareness of community clinic, household size, socio-economic status and administrative ision were found to have a significant effect on adolescent pregnancy in Bangladesh. Sexual knowledge has a significant positive role in the use of modern contraceptives. Adolescents of low socio-economic status are significantly more likely to deliver at home compared with adolescents in the richest quintile (OR 0.26, 95% CI 0.15-0.47 P < 0.001). The likelihood of delivering at a health facility was higher among adolescents who had knowledge about sexually transmitted infections (OR 1.84, 95% CI 1.28-2.65 P < 0.001) and menstrual regulations (OR 1.41, 95% CI 1.04-1.91 P < 0.05). Adolescent maternal healthcare utilization was associated with a number of factors including low socio-economic status, limited reproductive knowledge (e.g. menstrual regulations, sexually transmitted infections) and geographical region. The study findings will serve to inform policy and would be beneficial for introducing need-based adolescent maternal health programmes by targeting a range of maternal health services and opportunities that contribute to better health and development for adolescent mothers in Bangladesh.
Cost of Caregivers for Treating Hospitalized Diarrheal Patients in Bangladesh
Publisher: MDPI AG
Date: 26-12-2018
DOI: 10.3390/TROPICALMED4010005
Abstract: Introduction: Diarrheal diseases are a global public health problem and one of the leading causes of mortality, morbidity and economic loss. The objective of the study is to estimate the economic cost of caregivers and cost distribution per diarrheal episodes in Bangladesh. Methods: This was a cross-sectional hospital-based study conducted in public hospitals in Bangladesh. A total of 801 diarrheal patients were randomly selected and interviewed during January to December 2015. Simple descriptive statistics including frequencies, percentage, mean with 95% CI and median are presented. Results: The overall average cost of caregivers was BDT 2243 (US$ 28.58) while only BDT 259 (US$ 3.29) was spent as out of pocket payments. Caregivers mostly spent money (US$ 1.63) for food, lodging, utility bills, and other lump sum costs followed by the transportation costs (US$ 1.57). The caregivers spent more (US$ 44.45) when they accompanied the patients who were admitted in inpatients care and almost 3.6 times higher than for out-patients care (US$ 12.42). Conclusions: The study delivers an empirical evidence to the health-care programmers and policy makers about the economic cost of caregivers during diarrheal treatment care, which should be accounted for in designing future diarrheal prevention programme.
Predictors of Optimal Antenatal Care Service Utilization Among Adolescents and Adult Women in Bangladesh
Publisher: SAGE Publications
Date: 2018
Abstract: Utilization of recommended antenatal care (ANC) throughout the pregnancy period is a proven healthy behavior in reducing maternal mortalities and morbidities. The objective of this study is to identify the demand side factors that are associated with the recommended utilization of ANC services among adolescents and adult women in Bangladesh. This study utilized cross-sectional data from latest Bangladesh Demographic and Health Survey 2014. Data of a total of 4626 adolescents and adult women were analyzed. Bivariate and multivariate analyses were performed for identifying the significant determining factors associated with the ANC services utilization. Approximately, 32% adult and 30% adolescent women utilized the recommended ANC care. The higher educated adolescents and adult women were 8.08 times ( P .001) and 2.98 times ( P .001) more likely to receive 4 or more ANC, respectively, compared to uneducated women. The richest quintile showed higher tendency to utilize optimum ANC services and had 2.70 times ( P .05) and 6.51 times ( P .001) more likelihood to receive optimal ANC services for adolescent and adult groups, respectively, compared to poorest quintile. Other than education and income, several other factors including mass -media, place of residence, working status, and geographical variations were significantly associated with recommended ANC. These findings might help health-care programmers and policy makers for initiating appropriate policy and programs for ensuring optimal ANC coverage for all. Ensuring adequate ANC regardless of economic status and residence of pregnant women could guarantee universal maternal health-care coverage as devoted to a national strategic guideline.
Sex-specific prevalence, inequality and associated predictors of hypertension, diabetes, and comorbidity among Bangladeshi adults: results from a nationwide cross-sectional demographic and health surv
Publisher: BMJ
Date: 09-2019
DOI: 10.1136/BMJOPEN-2019-029364
Abstract: To determine the sex-specific prevalence, inequality and factors associated with healthcare utilisation for diabetes mellitus (DM), hypertension and comorbidity among the adult population of Bangladesh. This study analysed cross-sectional nationwide Bangladesh Demographic and Health Survey data from 2011. Comorbidity was defined as the coexistence of both DM and hypertension. Several socioeconomic and demographic factors such as age, sex, education, geographic location, administrative ision, employment status, education and wealth index were considered as major explanatory variables. Inequality in prevalence and healthcare utilisation was measured using the ‘Lorenz curve’. Adjusted multiple logistic regression models were performed to observe the effects of different factors and reported as adjusted ORs (AORs) with 95% CIs. A p value of .05 was adopted as the level of statistical significance. The study was conducted in Bangladesh. A total of 7521 adult participants with availability of biomarkers information were included. The mean age of the study participants was 51.4 years (SD ±13.0). The prevalence of hypertension, diabetes and comorbidity were 29.7%, 11.0% and 4.5% respectively. Socioeconomic inequality was observed in the utilisation of healthcare services. A higher prevalence of hypertension and comorbidity was significantly associated with in iduals aged years (AOR 7.0, 95% CI 5.0 to 9.9 AOR 6.7, 95% CI 3.0 to 14.9). The risk of having hypertension, diabetes and comorbidity were significantly higher among more educated, unemployed as well as among in iduals from Khulna ision. The study revealed a rising prevalence of hypertension, diabetes and comorbidity with inequality in service utilisation. A joint effort involving public, private and non-governmental organisations is necessary to ensure improved accessibility in service utilisation and to reduce the disease burden.
Out-of-pocket payment for healthcare among urban citizens in Dhaka, Bangladesh
Publisher: Public Library of Science (PLoS)
Date: 24-01-2022
DOI: 10.1371/JOURNAL.PONE.0262900
Abstract: Out-of-pocket (OOP) payment is the major payment strategy for healthcare in Bangladesh, and the share of OOP expenditure has increased alarmingly. Dhaka is recognised as one of the fastest-growing megacities in the world. The objective of this study is to capture the self-reported illnesses among urban citizens and to identify whether and to what extent socioeconomic, demographic and behavioural factors of the population influence OOP healthcare expenditures. This study utilises cross-sectional survey data collected from May to August 2019 in urban Dhaka, Bangladesh. A total of 3,100 households were randomly selected. Simple descriptive statistics including frequencies, percentage, mean (95% CI), median and inter-quartile range were presented. Bivariate analysis and multivariate regression models were employed. We observed that acute illnesses (e.g., fever, flu/cough) were dominant among participants. Among the chronic illnesses, approximately 9.6% of people had diabetes, while 5.3% had high/low blood pressure. The richest quintile only spent 5.2% of their household income on healthcare, while the poorest households spent approximately six times more than the richest households. We noted that various factors such as marital status, religion, source of care, access to safe water, income quintile and even the location of households had a significant relationship with OOP expenditure. Our findings can serve as important source of data in terms of disease- specific symptoms and out-of-pocket cost among urban citizens in Dhaka. The people belonging to wealthier households tended to choose better healthcare facilities and spend more. A pro-poor policy initiative and even an urban health protection scheme may be necessary to ensure that healthcare services are accessible and affordable, in line with the Bangladesh National Urban Health Strategy.
Do employer-sponsored health insurance schemes affect the utilisation of medically trained providers and out-of-pocket payments among ready-made garment workers? A case–control study in Bangladesh
Publisher: BMJ
Date: 03-2020
DOI: 10.1136/BMJOPEN-2019-030298
Abstract: We estimated the effect of an employer-sponsored health insurance (ESHI) scheme on healthcare utilisation of medically trained providers and reduction of out-of-pocket (OOP) expenditure among ready-made garment (RMG) workers. We used a case–control study design with cross-sectional preintervention and postintervention surveys. The study was conducted among workers of seven purposively selected RMG factories in Shafipur, Gazipur in Bangladesh. In total, 1924 RMG workers (480 from the insured and 482 from the uninsured, in each period) were surveyed from insured and uninsured RMG factories, respectively, in the preintervention (October 2013) and postintervention (April 2015) period. We tested the effect of a pilot ESHI scheme which was implemented for 1 year. The outcome measures were utilisation of medically trained providers and reduction of OOP expenditure among RMG workers. We estimated difference-in-difference (DiD) and applied two-part regression model to measure the association between healthcare utilisation, OOP payments and ESHI scheme membership while controlling for the socioeconomic characteristics of workers. The ESHI scheme increased healthcare utilisation of medically trained providers by 26.1% (DiD=26.1 p .01) among insured workers compared with uninsured workers. While accounting for covariates, the effect on utilisation significantly reduced to 18.4% (p .05). The DiD estimate showed that OOP expenditure among insured workers decreased by −3700 Bangladeshi taka and -1100 Bangladeshi taka compared with uninsured workers when using healthcare services from medically trained providers or all provider respectively, although not significant. The multiple two-part models also reported similar results. The ESHI scheme significantly increased utilisation of medically trained providers among RMG workers. However, it has no significant effect on OOP expenditure. It can be recommended that an educational intervention be provided to RMG workers to improve their healthcare-seeking behaviours and increase their utilisation of ESHI-designated healthcare providers while keeping OOP payments low.
Coverage and Determinants of Full Immunization: Vaccination Coverage among Senegalese Children
Publisher: MDPI AG
Date: 14-08-2019
Abstract: Background and Objectives: In line with the global success of immunization, Senegal achieved impressive progress in childhood immunization program. However, immunization coverage is often below the national and international targets and even not equally distributed across the country. The objective of this study is to estimate the full immunization coverage across the geographic regions and identify the potential factors of full immunization coverage among the Senegalese children. Materials and Methods: Nationally representative dataset extracted from the latest Continuous Senegal Demographic and Health Survey 2017 was used for this analysis. Descriptive statistics such as the frequency with percentage and multivariable logistic regression models were constructed and results were presented in terms of adjusted odds ratio (AOR) with a 95% confidence interval (CI). Results: Overall, 70.96% of Senegalese children aged between 12 to 36 months were fully immunized and the coverage was higher in urban areas (76.51%), west ecological zone (80.0%), and among serer ethnic groups (77.24%). Full immunization coverage rate was almost the same between male and female children, and slightly higher among the children who were born at any health care facility (74.01%). Children who lived in the western zone of Senegal were 1.66 times (CI: 1.25–2.21 p = 0.001) and the children of Serer ethnic groups were 1.43 times (CI: 1.09–1.88 p = 0.011) more likely to be fully immunized than the children living in the southern zone and from the Poular ethnic group. In addition, children who were born at health facilities were more likely to be fully immunized than those who were born at home (AOR = 1.47 CI: 1.20–1.80 p 0.001), and mothers with recommended antenatal care (ANC) (4 and more) visits during pregnancy were more likely to have their children fully immunized than those mother with no ANC visits (AOR: 2.06 CI: 1.19–3.57 p = 0.010). Conclusions: Immunization coverage was found suboptimal by type of vaccines and across ethnic groups and regions of Senegal. Immunization program should be designed targeting low performing areas and emphasize on promoting equal access to education, decision-making, encouraging institutional deliveries, and scaling up the use of antenatal and postnatal care which may significantly improve the rate full immunization coverage in Senegal.
Related Organisations
University Of Strathclyde
Location: United Kingdom of Great Britain and Northern Ireland
Bangladesh Institute Of Development Studies (BIDS)
Location: Bangladesh
Related Funding Activities
No related grants have been discovered for Abdur Razzaque Sarker.