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Assessing the effects of disease-specific programs on health systems: An analysis of the Bangladesh Lymphatic Filariasis Elimination Program's impacts on health service coverage and catastrophic health expenditure
- Source :
- PLoS Neglected Tropical Diseases, PLoS Neglected Tropical Diseases, Vol 15, Iss 11, p e0009894 (2021)
- Publication Year :
- 2021
-
Abstract
- This study presents a methodology for using tracer indicators to measure the effects of disease-specific programs on national health systems. The methodology is then used to analyze the effects of Bangladesh’s Lymphatic Filariasis Elimination Program, a disease-specific program, on the health system. Using difference-in-differences models and secondary data from population-based household surveys, this study compares changes over time in the utilization rates of eight essential health services and incidences of catastrophic health expenditures between individuals and households, respectively, of lymphatic filariasis hyper-endemic districts (treatment districts) and of hypo- and non-endemic districts (control districts). Utilization of all health services increased from year 2000 to year 2014 for the entire population but more so for the population living in treatment districts. However, when the services were analyzed individually, the difference-in-differences between the two populations was insignificant. Disadvantaged populations (i.e., populations that lived in rural areas, belonged to lower wealth quintiles, or did not attend school) were less likely to access essential health services. After five years of program interventions, households in control districts had a lower incidence of catastrophic health expenditures at several thresholds measured using total household expenditures and total non-food expenditures as denominators. Using essential health service coverage rates as outcome measures, the Lymphatic Filariasis Elimination Program cannot be said to have strengthened or weakened the health system. We can also say that there is a positive association between the Lymphatic Filariasis Elimination Program’s interventions and lowered incidence of catastrophic health expenditures.<br />Author summary Evidence to understand the interactions between disease specific programs and the health system is insufficient and largely based on opinion. This study presents a methodology for using tracer indicators to measure the effect of a disease-specific program, the Bangladesh Lymphatic Filariasis Elimination Program, on its health system. The Composite Coverage Index and incidence of catastrophic health expenditures are well-established tracer indicators for measuring the strength of a health system. In this study, they were calculated, before the program started in 2000 and after it ended in 2015, using data from Demographic and Health Surveys and Household Income and Expenditure Surveys, respectively. Using the Composite Coverage Index to measure the effects of the Lymphatic Filariasis Elimination Program revealed that it did not negatively or positively affect health service coverage rates. We can also say that there is a positive association between the program interventions and lowered incidence of catastrophic health expenditures.
- Subjects :
- Epidemiology
Economics
RC955-962
Psychological intervention
Social Sciences
Insurance Coverage
Geographical Locations
Medical Conditions
Arctic medicine. Tropical medicine
Medicine and Health Sciences
Public and Occupational Health
Health Systems Strengthening
Lymphatic filariasis
Geographic Areas
education.field_of_study
Bangladesh
Family Characteristics
Geography
Incidence (epidemiology)
Health Services
Socioeconomic Aspects of Health
Filariasis
Infectious Diseases
Helminth Infections
Public aspects of medicine
RA1-1270
Research Article
Neglected Tropical Diseases
medicine.medical_specialty
Asia
Population
Elephantiasis, Filarial
Health Economics
Environmental health
medicine
Parasitic Diseases
Humans
Disease Eradication
education
Poverty
Health economics
Health Care Policy
Lymphatic Filariasis
Public Health, Environmental and Occupational Health
medicine.disease
Tropical Diseases
Educational attainment
Rural Areas
Health Care
People and Places
Earth Sciences
Rural area
Health Expenditures
Finance
Program Evaluation
Subjects
Details
- ISSN :
- 19352735
- Volume :
- 15
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- PLoS neglected tropical diseases
- Accession number :
- edsair.doi.dedup.....dac30f925593946f6b81b356a2bc21cd