Browsing by Author "Islam, Muhammed Nazmul"

Now showing 1 - 4 of 4

Determinants of health seeking behavior for chronic non-communicable diseases and related out-of-pocket expenditure: results from a cross-sectional survey in northern Bangladesh
(BMC, 12/23/2019) Binte Rasul, Fatema; Kalmus, Olivier; Sarker, Malabika; Adib, Hossain Ishrath; Hossain, Md Shahadath; Hasan, Md Zabir; Brenner, Stephan; Nazneen, Shaila; Islam, Muhammed Nazmul; De Allegri, Manuela
Background: In spite of high prevalence rates, little is known about health seeking and related expenditure for chronic non-communicable diseases in low-income countries. We assessed relevant patterns of health seeking and related out-of-pocket expenditure in Bangladesh. Methods: We used data from a household survey of 2500 households conducted in 2013 in Rangpur district. We employed multinomial logistic regression to assess factors associated with health seeking choices (no care or selfcare, semi-qualified professional care, and qualified professional care). We used descriptive statistics (5% trimmed mean and range, median) to assess related patterns of out-of-pocket expenditure (including only direct costs). Results: Eight hundred sixty-six (12.5%) out of 6958 individuals reported at least one chronic non-communicable disease. Of these 866 individuals, 139 (16%) sought no care or self-care, 364 (42%) sought semi-qualified care, and 363 (42%) sought qualified care. Multivariate analysis confirmed that the following factors increased the likelihood of seeking qualified care: a higher education, a major chronic non-communicable disease, a higher socio-economic status, a lower proportion of chronic household patients, and a shorter distance between a household and a subdistrict public referral health facility. Seven hundred fifty-four (87 %) individuals reported out-of-pocket expenditure, with drugs absorbing the largest portion (85%) of total expenditure. On average, qualified care seekers encountered the highest out-of-pocket expenditure, followed by those who sought semi-qualified care and no care, or self-care. Conclusion: Our study reveals insufficiencies in health provision for chronic conditions, with more than half of all affected people still not seeking qualified care, and the majority still encountering considerable out-of-pocket expenditure. This calls for urgent measures to secure better access to care and financial protection.
Harmful practices prevail despite legal knowledge: A mixed-method study on the paradox of child marriage in Bangladesh
(Taylor & Francis, 2/24/2021) Akter, Sayema; Williams, Chloe; Talukder, Animesh; Islam, Muhammed Nazmul; Escallon, Juanita Vasquez; Sultana, Tania; Kapil, Neha; Sarker, Malabika
Child marriage is a globally recognised human rights violation that disproportionately affects girls, especially in developing countries. It has serious negative consequences on girls’ physical, mental, sexual, and reproductive health and rights. Although well-pronounced laws against child marriage were enacted in Bangladesh, the practice remains a significant challenge. Lack of law enforcement and persistent social norms ultimately allow child marriage to persist around the country. Social norms have an impact on the prevalent attitudes toward child marriage. Therefore, this mixed-method study aimed to explore the legal knowledge, perception, and practice of child marriage in Bangladesh. This study was part of a broader evaluation of a UNICEF media programme. Adolescent boys and girls aged between 10 and 19 years and their parents were interviewed in three Bangladeshi districts. All the respondents were aware of the legal age of marriage and knew that child marriage is punishable by law. This study illuminated the reasons, including early marriage among boys, poverty, dowry, and sexual harassment. Communities and policymakers need to be engaged to trigger larger structural and cultural changes to remedy the harmful social norm and its practice
Health shock and preference instability: Assessing health-state dependency of willingness-to-pay for corrective eyeglasses
(BMC, 11/7/2019) Islam, Muhammed Nazmul; Rabbani, Atonu; Sarker, Malabika
Background: Differences in contingent valuation (CV) estimates for identical healthcare goods can cast considerable doubt on the true economic measures of consumer preferences. Hypothetical nature of CV methods can potentially depend on the salience, context and perceived relevance of the good or service under consideration. Thus, the high demand elasticity for healthcare goods warrants careful selection of study population as the contexts of valuation significantly changes after experiencing health shock. Methods: In this study, using triple-bounded dichotomous choice (TBDC) experiments, we test how negative health shock (namely, being diagnosed with refractive errors), can alter preference over a common health good (namely, corrective eyeglasses). We compared elicited WTP of diagnosed patients with a synthetically constructed comparable cohort without the same health shock, controlling for the possible self-selection using a number of matching techniques based on the observable socio-demographic characteristics. Results: The consumers diagnosed with vision problems exhibit a rightward shift in their demand curve compared to observationally identical consumers without such problems resulting in about 17% higher consumer surplus. The consumers without the health shock are willing to pay about BDT 762.4 [95% CI: BDT 709.9 - BDT 814.9] for corrective eyeglasses, which gets 15–30% higher for the matched with-health-shock consumers. Multivariable analyses suggest more educated and wealthier individuals are willing to pay respectively BDT 208 and BDT 119 more for corrective eyeglasses. We have tested the models for different matching protocols. Our results are fairly robust to alternate specifications and various matching techniques. Conclusion: The preferences for healthcare goods, such as eyeglasses, can significantly depend upon the respondent being diagnosed with refractive errors. Our findings have implications for general cost-benefit analyses often relying on WTP, which can vary depending on the contexts. There are also increasing interests in cost recovery models, which require understanding the demand for healthcare goods and services. We find eliciting the demand needs to consider the health status of the population from which the respondents are sampled.
Willingness to pay for cataract surgeries among patients visiting eye care facilities in Dhaka, Bangladesh
(Springer Link, 5/7/2019) Islam, Muhammed Nazmul; Engels, Thomas; Hossain, Shafayet; Sarker, Malabika; Rabbani, Atonu
Background Cataract is the leading cause of avoidable blindness globally. It is estimated that 89% of people with visual impairment live in low- and middle-income countries where the cost of cataract surgery represents a major barrier for accessing these services. Developing self-sustaining healthcare programs to cater the unmet demands warrants a better understanding of patients’ willingness to pay (WTP) for their services. Objectives Using a sample of patients visiting eye care facilities in Dhaka, Bangladesh, we estimate WTP for two diferent cataract extraction techniques, namely small incision cataract surgery (SICS) and phacoemulsifcation. Methods We used contingent valuation (CV) approach and elicited WTP through double-bounded dichotomous choice experiments. We interviewed 556 randomly selected patients (283 for SICS and 273 for phacoemulsifcation) from fve diferent eye care hospitals of Dhaka. In this paper, we estimated the mean and marginal WTP using interval regression models. We also compared the estimated WTP and stated demand for cataract surgeries against the prevailing market prices of SICS and phacoemulsifcation. Results We found the mean WTP of BDT 7579 (US$93) for SICS and BDT 10,208 (US$126) for phacoemulsifcation are equivalent to 12 and 16 days of household income, respectively. Household income and assets appeared as the major determinants of WTP for cataract surgeries. However, we did not fnd any signifcant association with gender, occupation, and household size among other socioeconomic characteristics. Comparisons between market prices and average WTP suggest it is possible to have a viable market for SICS, but a subsidy-based model for phacoemulsifcation will be fnancially challenging because of low WTP and high costs. Conclusion Our fndings suggest lower-cost SICS can potentially provide patients access to surgeries to treat cataract conditions. Moreover, price discrimination and cross-subsidization could be a viable strategy to increase the service-uptake as well as ensure fnancial sustainability