Health Economics and Financing Research Group, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh.
Health Econ Rev. 2013 Apr 29;3(1):12. doi: 10.1186/2191-1991-3-12.
The reliance on out-of-pocket payments for health services leads to a catastrophic burden for many households in Bangladesh. The World Health Organization suggests that risk-pooling mechanisms should be used for financing healthcare. Like many low-income countries (LIC), a large share of employment in Bangladesh is in the informal sector (88%). Inclusion of these workers in health insurance is a big challenge. Among other barriers, the "literacy gap" for health insurance" is a reason for the low insurance uptake in Bangladesh. The aim of this study is, therefore, to assess the impact of an educational intervention on willingness-to-pay (WTP) for health insurance among informal sector workers in urban Bangladesh.
An educational intervention on occupational solidarity and health insurance is offered to groups of informal workers. Educational sessions take place once a week (3-4 hours) during three subsequent weeks for each occupational group. For assessing the impact of the educational intervention, WTP for joining health insurance using occupational solidarity between workers in "pre- and post-treatment" periods as well as between "control and treatment" groups were compared. Multiple-regression analysis is applied for predicting WTP by educational intervention, while controlling for demographic and socioeconomic characteristics.
The coefficient of variation (CoV) of the WTP is estimated in control and treatment groups and expected to be lower in the latter. The WTP for health insurance is higher (33.8%) among workers who joined the educational intervention in comparison with those who did not (control group). CoV of WTP is found to be generally lower in post-treatment period and in treatment group compared to pre-treatment period and control group respectively.
Educational interventions can be used for increasing demand for health insurance scheme using occupational solidarity among informal sector workers.
在孟加拉国，许多家庭因依赖自费支付医疗服务而面临灾难性的负担。世界卫生组织建议使用风险共担机制为医疗保健提供资金。与许多低收入国家（LIC）一样，孟加拉国的大量就业机会在非正规部门（88%）。将这些工人纳入医疗保险是一个巨大的挑战。除其他障碍外，“医疗保险的文化素养差距”是孟加拉国保险参保率低的一个原因。因此，本研究旨在评估教育干预对城市孟加拉国非正规部门工人参加医疗保险的意愿支付（WTP）的影响。
向非正规工人群体提供职业团结和医疗保险教育干预。对于每个职业群体，教育课程每周进行一次（3-4 小时），持续三周。为了评估教育干预的影响，在“治疗前和治疗后”期间以及“对照组和治疗组”之间比较了加入健康保险的 WTP 意愿。应用多元回归分析来预测教育干预对 WTP 的影响，同时控制人口统计学和社会经济特征。
控制组和治疗组的 WTP 变异系数（CoV）估计，预计后者较低。与未参加教育干预的工人（对照组）相比，参加教育干预的工人的健康保险 WTP 更高（33.8%）。与治疗前时期和对照组相比，治疗后时期和治疗组的 WTP CoV 普遍较低。
教育干预可以用于利用非正规部门工人之间的职业团结来增加对健康保险计划的需求。
