Impact Of Maternal And Child Health Private Expenditure On Poverty And Inequity In Bangladesh
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| Author | : Asian Development Bank |
| Publisher | : Asian Development Bank |
| Total Pages | : 59 |
| Release | : 2012-12-01 |
| Genre | : Business & Economics |
| ISBN | : 9290929774 |
The Government of Bangladesh has made it a priority to expand access to maternal, neonatal, and child health (MNCH) services. However, healthcare services in Bangladesh are predominantly financed through household out-of-pocket expenditures. This study used a number of different data sources and innovative methods to determine overall expenditures on MNCH treatment, and how they are financed. Total expenditure on MNCH patient services is estimated at Taka 17.3 billion in fiscal year 2007, which represents 12% of total recurrent expenditures on health. Of this expenditure, 60% was for treating children under the age of 5 years, and only 28% was for childbirth care. In terms of financing, the government financed only 28% of this expenditure. More than two- thirds of MNCH expenditures in 2006-2007 was financed through household out-of-pocket spending, most of which was spent on purchasing medicines and other commodities from private pharmacies. The findings suggest the need for substantial increases in public funding of MNCH services, with the prioritization of increased funding to childbirth care and improving the availability of medicines at MOHFW facilities
| Author | : Asian Development Bank |
| Publisher | : Asian Development Bank |
| Total Pages | : 67 |
| Release | : 2012-12-01 |
| Genre | : Business & Economics |
| ISBN | : 9290929758 |
The Government of Bangladesh has made it a priority to expand access by the poor to maternal, neonatal, and child health (MNCH) services. Central to its strategy is the provision of healthcare services at free or nearly free prices through Ministry of Health and Family Welfare (MOHFW) facilities. However, poor families make less use of MOHFW services than the non-poor, and many patients are reported to incur significant costs at MOHFW facilities. The Patient Exit Survey (PES) 2011 carried out exit interviews of over 5,000 inpatients and outpatients at a representative sample of MOHFW facilities in order to find out why patients incur out-of-pocket expenses at MOHFW facilities, to quantify their size, and to assess the impact of demand-side financing (DSF) pilot schemes on patient out-of-pocket costs and utilization of MNCH services. Almost all outpatients and inpatients report out-of-pocket expenses associated with their healthcare visits. These fall into four categories: (i) travel costs to reach the healthcare institution, (ii) official fees charged by MOHFW facilities, (iii) informal or unofficial fees paid to persons inside the facility to obtain services or other benefits, and (iv) the costs of purchasing medicines recommended by the medical staff that which are not available at the health facility. The major out-of-pocket expense reported is purchasing medicines and supplies that are recommended by medical staff but are not available at the facility. About 50% of outpatients and over 90% of inpatients report such costs, which average Tk301 per outpatient and Tk980 per inpatient. Travel costs to the facility average Tk27 for outpatients and Tk131 for inpatients, however, travel costs for expectant mothers are much higher and average Tk220. About 50% of outpatients and 75% of inpatients report having to pay official fees, with inpatient women who had delivered, reporting higher-than-average fees. The incidence of informal payments is much lower than anticipated, with most outpatients reporting no such expenses. There have been large increases since 2006 in facility childbirths at facilities enrolled in the DSF schemes, with the greatest impact seen in those enrolled in the universal DSF schemes. However, findings show that the DSF actual out-of-pocket costs incurred at the time of treatment are no lower at DSF enrolled facilities, and that equity of utilization does not seem to have been improved.
| Author | : Asian Development Bank |
| Publisher | : Asian Development Bank |
| Total Pages | : 198 |
| Release | : 2012-12-01 |
| Genre | : Business & Economics |
| ISBN | : 9290929715 |
Reducing the burden of poor maternal, neonatal, and child health ill-health requires improvements in both the supply and use of effective maternal, newborn and child health (MNCH) services. The financial costs of treatment are known globally to be a major barrier to accessing essential care, potentially imposing considerable burdens on households. To find out what was known about the scale and impact on families of out-of-pocket expenditures in accessing MNCH care in the Asia-Pacific region, this study undertook a systematic review of the global and regional evidence. The findings show that despite significant progress in improving coverage in the region, millions of families in the region continue to face financial barriers to accessing essential MNCH care, and experience significant financial hardships as a result of out-of-pocket payments. It points to areas where the research needs to be improved both methodologically and in terms of geographical coverage, and where better policies might make a difference.
| Author | : Sameh El-Saharty |
| Publisher | : World Bank Publications |
| Total Pages | : 127 |
| Release | : 2015-06-02 |
| Genre | : Business & Economics |
| ISBN | : 1464805377 |
Bangladesh is committed to achieving universal health coverage (UHC) by 2032; to this end, the government of Bangladesh is exploring policy options to increase fiscal space for health and expand coverage while improving service quality and availability. Despite Bangladesh’s impressive strides in improving its economic and social development outcomes, the government still confronts health financing and service delivery challenges. In its review of the health system, this study highlights the limited fiscal space for implementing UHC in Bangladesh, particularly given low public spending for health and high out-of-pocket expenditure. The crisis in the country’s human resources for health (HRH) compounds public health service delivery inefficiencies. As the government explores options to finance its UHC plan, it must recognize that reform of its service delivery system with particular focus on HRH has to be the centerpiece of any policy initiative.
| Author | : Asian Development Bank |
| Publisher | : Asian Development Bank |
| Total Pages | : 83 |
| Release | : 2012-12-01 |
| Genre | : Business & Economics |
| ISBN | : 929254229X |
The burden of poor maternal, neonatal and child health (MNCH) remains unacceptably high in many developing member countries (DMCs). To understand the barriers facing households in accessing MNCH care, the ADB technical assistance project RETA-6515 analyzed data from routine national household expenditure surveys in six DMCs: Bangladesh, Cambodia, the Lao People's Democratic Republic (Lao PDR),Pakistan, Papua New Guinea, and Timor-Leste. The findings reveal not only the rich evidence base available in these surveys, but also show how healthcare costs, quality, and physical barriers play differing roles in different countries in preventing access, and how families are often impoverished by accessing needed care.
| Author | : UNICEF. |
| Publisher | : UNICEF |
| Total Pages | : 168 |
| Release | : 2008 |
| Genre | : Business & Economics |
| ISBN | : 9280643185 |
Having a child remains one of the biggest health risks for women worldwide. Fifteen hundred women die every day while giving birth. That's a half a million mothers every year. UNICEF's flagship publication, The State of the World's Children 2009, addresses maternal mortality, one of the most intractable problems for development work.The difference in pregnancy risk between women in developing countries and their peers in the industrialised world is often termed the greatest health divide in the world. A woman in Niger has a one in seven chance of dying during the course of her lifetime from complications during pregnancy or delivery. That's in stark contrast to the risk for mothers in America, where it's one in 4,800 or in Ireland, where it's just one in 48,000. Addressing that gap is a multidisciplinary challenge, requiring an emphasis on education, human resources, community involvement and social equality. At a minimum, women must be guaranteed antenatal care, skilled birth attendants and emergency obstetrics, and postpartum care. These essential interventions will only be guaranteed within the context of improved education and the abolition of discrimination.
| Author | : Sameh El-Saharty |
| Publisher | : World Bank Publications |
| Total Pages | : 205 |
| Release | : 2016-11-29 |
| Genre | : Business & Economics |
| ISBN | : 146480964X |
South Asia Region (SAR) has decreased maternal mortality ratio (MMR) by 65 percent between 1990 and 2013, which was the greatest progress among all world regions. Such achievement implores the question, What made SAR stand out against what is predicted by standard socioeconomic outcomes? Improving Maternal and Reproductive Health in South Asia: Drivers and Enablers identifies the interventions and factors that contributed to reducing MMR and improving maternal and reproductive health (MRH) outcomes in SAR. In this study, the analytical framework assumes that improving MRH outcomes is influenced by a multitude of forces from within and outside the health system and considers factors at the household and community levels, as well as interventions in other sectors and factors in the enabling environment. The analysis is based on a structured literature review of the interventions in SAR countries, relevant international experience, and review of the best available evidence from systematic reviews. The focus of the analysis is mainly on assessing the effectiveness of interventions. The findings from this study indicate that the most effective interventions that prevent maternal mortality are those that address the intra-partum stage - the point where most maternal deaths occur - and include improving skilled birth attendance coverage, increasing institutional delivery rates, and scaling up access to emergency obstetric care. There is also adequate evidence that investing in family planning to increase contraceptive use also played a key role during the inter-partum phase by preventing unwanted pregnancies and thus averting the risk of maternal mortality in SAR countries. Outside the programmatic interventions, the levels of household income, women’s education, and completion of secondary education of girls were also strongly correlated with improved MRH outcomes. Also, there is strong evidence that health financing schemes - both demand and supply side - and conditional cash transfer programs were effective in increasing the uptake of MRH services. The study points out to many other interventions with different degrees of effectiveness. The study also identified four major reasons for why SAR achieved this progress in MMR reduction. The best practices and evidence of what works synthesized in this study provide an important way forward for low- and middle-income countries toward achieving the health-related Sustainable Development Goals.
| Author | : Adam Wagstaff |
| Publisher | : World Bank Publications |
| Total Pages | : 234 |
| Release | : 2007-11-02 |
| Genre | : Medical |
| ISBN | : 0821369342 |
Have gaps in health outcomes between the poor and better off grown? Are they larger in one country than another? Are health sector subsidies more equally distributed in some countries than others? Are health care payments more progressive in one health care financing system than another? What are catastrophic payments and how can they be measured? How far do health care payments impoverish households? Answering questions such as these requires quantitative analysis. This in turn depends on a clear understanding of how to measure key variables in the analysis, such as health outcomes, health expenditures, need, and living standards. It also requires set quantitative methods for measuring inequality and inequity, progressivity, catastrophic expenditures, poverty impact, and so on. This book provides an overview of the key issues that arise in the measurement of health variables and living standards, outlines and explains essential tools and methods for distributional analysis, and, using worked examples, shows how these tools and methods can be applied in the health sector. The book seeks to provide the reader with both a solid grasp of the principles underpinning distributional analysis, while at the same time offering hands-on guidance on how to move from principles to practice.
| Author | : Robert Black |
| Publisher | : World Bank Publications |
| Total Pages | : 419 |
| Release | : 2016-04-11 |
| Genre | : Medical |
| ISBN | : 1464803684 |
The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.
| Author | : Stephane Hallegatte |
| Publisher | : World Bank Publications |
| Total Pages | : 227 |
| Release | : 2015-11-23 |
| Genre | : Business & Economics |
| ISBN | : 1464806748 |
Ending poverty and stabilizing climate change will be two unprecedented global achievements and two major steps toward sustainable development. But the two objectives cannot be considered in isolation: they need to be jointly tackled through an integrated strategy. This report brings together those two objectives and explores how they can more easily be achieved if considered together. It examines the potential impact of climate change and climate policies on poverty reduction. It also provides guidance on how to create a “win-win†? situation so that climate change policies contribute to poverty reduction and poverty-reduction policies contribute to climate change mitigation and resilience building. The key finding of the report is that climate change represents a significant obstacle to the sustained eradication of poverty, but future impacts on poverty are determined by policy choices: rapid, inclusive, and climate-informed development can prevent most short-term impacts whereas immediate pro-poor, emissions-reduction policies can drastically limit long-term ones.
