Sheikh, N. , Twumwaa Tagoe, E., Akram, R., Ali, N., Howick, S. and Morton, A. (2022) Implementation barriers and remedial strategies for community-based health insurance in Bangladesh: insights from national stakeholders. BMC Health Services Research, 22(1), 1200. (doi: 10.1186/s12913-022-08561-7) (PMID:36153512) (PMCID:PMC9508716)
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Abstract
Background: Community-based health insurance (CBHI) is a part of the health system in Bangladesh, and overcoming the obstacles of CBHI is a significant policy concern that has received little attention. The purpose of this study is to analyze the implementation barriers of voluntary CBHI schemes in Bangladesh and the strategies to overcome these barriers from the perspective of national stakeholders. Methods: This study is exploratory qualitative research, specifically case study design, using key informant interviews to investigate the barriers of CBHI that are faced during the implementation. Using a topic guide, we conducted thirteen semi-structured in-depth interviews with key stakeholders directly involved in the CBHI implementation process. The data were analyzed using the Framework analysis method. Results: The implementation of CBHI schemes in Bangladesh is being constrained by several issues, including inadequate population coverage, adverse selection and moral hazard, lack of knowledge about health insurance principles, a lack of external assistance, and insufficient medical supplies. Door-to-door visits by local community-health workers, as well as regular promotional and educational campaigns involving community influencers, were suggested by stakeholders as ways to educate and encourage people to join the schemes. Stakeholders emphasized the necessity of external assistance and the design of a comprehensive benefits package to attract more people. They also recommended adopting a public–private partnership with a belief that collaboration among the government, microfinance institutions, and cooperative societies will enhance trust and population coverage in Bangladesh. Conclusions: Our research concludes that systematically addressing implementation barriers by including key stakeholders would be a significant reform to the CBHI model, and could serve as a foundation for the planned national health protection scheme for Bangladesh leading to universal health coverage.
Item Type: | Articles |
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Additional Information: | This study was funded by the University of Strathclyde’s Student Excellence Award as part of NS’s PhD studentship. |
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Sheikh, Mr Md Nurnabi |
Authors: | Sheikh, N., Twumwaa Tagoe, E., Akram, R., Ali, N., Howick, S., and Morton, A. |
College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment |
Journal Name: | BMC Health Services Research |
Publisher: | BioMed Central |
ISSN: | 1472-6963 |
ISSN (Online): | 1472-6963 |
Copyright Holders: | Copyright © 2022 The Authors |
First Published: | First published in BMC Health Services Research 22(1):1200 |
Publisher Policy: | Reproduced under a Creative Commons License |
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