Sarker Abdur Razzaque, Sultana Marufa, Mahumud Rashidul Alam, Ahmed Sayem, Islam Ziaul, Morton Alec, Khan Jahangir A M
Health Economics and Financing Research, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh.
University of Strathclyde, Glasgow, Scotland.
PLoS One. 2017 Jul 27;12(7):e0181706. doi: 10.1371/journal.pone.0181706. eCollection 2017.
Providing access to affordable health care for the informal sector remains a considerable challenge for low income countries striving to make progress towards universal health coverage. The objective of the study is to identify the factors shaping the decision to enroll in a cooperative based health scheme for informal workers in Bangladesh and also help to identify the features of informal workers without health schemes and their likelihood of being insured.
Data were derived from a cross-sectional in-house survey within the catchment area of a cooperative based health scheme in Bangladesh during April-June 2014, covering a total of 784 households (458 members and 326 non-members). Multivariate logistic regression model was used to identify factors associated with cooperative based health scheme and explanatory variables.
This study found that a number of factors were significant determinants of health scheme participation including sex of household head, household composition, occupational category as well as involvement social financial safety net programs.
Findings from this study can be suggestive for policy-makers interested in scaling up health insurance for informal workers in Bangladesh. Shared funding from this large informal sector can generate new resources for healthcare, which is in line with the healthcare financing strategy of Bangladesh as well as the recommendation of the World Health Organization for developing social health insurance as part of the path to Universal Health Coverage.
对于努力朝着全民健康覆盖迈进的低收入国家而言，为非正规部门提供负担得起的医疗保健服务仍然是一项巨大挑战。本研究的目的是确定影响孟加拉国非正规部门工人加入合作医疗计划的决定因素，并帮助识别未参加医疗计划的非正规部门工人的特征及其参保可能性。
数据来自2014年4月至6月在孟加拉国一个基于合作医疗计划的集水区内进行的一项横断面内部调查，共涵盖784户家庭（458名成员和326名非成员）。采用多变量逻辑回归模型来确定与合作医疗计划相关的因素和解释变量。
本研究发现，包括户主性别、家庭构成、职业类别以及参与社会金融安全网计划在内的一些因素是医疗计划参与情况的重要决定因素。
本研究结果可为有意扩大孟加拉国非正规部门工人医疗保险覆盖范围的政策制定者提供参考。来自这个庞大非正规部门的共同资金可为医疗保健创造新资源，这符合孟加拉国的医疗保健筹资战略以及世界卫生组织关于发展社会医疗保险作为全民健康覆盖途径一部分的建议。
