Healthcare services access challenges and determinants among persons with disabilities in Bangladesh.


Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
19 08 2024
Historique:
received: 17 02 2024
accepted: 16 08 2024
medline: 20 8 2024
pubmed: 20 8 2024
entrez: 19 8 2024
Statut: epublish

Résumé

Persons with disabilities in LMICs facing numerous challenges in accessing essential healthcare services. However, this understanding is lacking so far in LMICs and Bangladesh. This study aimed to explore the pattern and determinants of healthcare services access among persons with disabilities in Bangladesh. We analysed data from 4293 persons with disabilities extracted from the 2021 National Survey on Persons with Disabilities. The outcome variable was healthcare services access within three months of the survey, categorized as either "yes" or "no" based on perceived needs. Several individual, household, and community-level factors were considered as explanatory variables. We utilized a multilevel mixed-effect logistic regression model to explore the association of the outcome variable with explanatory variables. The analysis included stratification by age groups: 0-17 years and 18-95 years. One out of every four persons with disabilities in Bangladesh reported that they could not access healthcare services based on their needs within three months of the survey. The main reasons for not accessing services were healthcare costs (52.10%), followed by lack of family support (27.0%), and absence of healthcare facilities in their areas of residence (10.10%). Among those who did receive healthcare services, the majority reported accessing them from governmental hospitals (26.49%), followed by village practitioner (20.52%), and private healthcare centres (19.87%). There was a higher likelihood of accessing healthcare services among persons with disabilities residing in households with higher wealth quintiles and living in the Chattogram and Sylhet divisions. Unmarried or divorced/widowed/separated persons with disabilities reported lower likelihoods of accessing healthcare services. The findings of this study emphasize the need for policies and programs to ensure healthcare services for persons with disabilities in Bangladesh. This entails raising awareness about the importance of providing healthcare services for this demographic, as well as considering healthcare services as part of social safety net programs.

Identifiants

pubmed: 39160270
doi: 10.1038/s41598-024-70418-2
pii: 10.1038/s41598-024-70418-2
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

19187

Informations de copyright

© 2024. The Author(s).

Références

World Health Organization. Global Oral Health Status Report: Towards Universal Health Coverage for Oral Health by 2030 (World Health Organization, 2022).
James, S. L. et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet 392, 1789–1858 (2018).
doi: 10.1016/S0140-6736(18)32279-7
World Health Organization. (Geneva, Switzarland, 2023).
Lee, J., Lau, S., Meijer, E. & Hu, P. Living longer, with or without disability? A global and longitudinal perspective. J. Gerontol. Series A 75, 162–167 (2020).
doi: 10.1093/gerona/glz007
Rana, M. S. et al. Prevalence and patterns of comorbidities in people with disabilities and their associated socio-demographic factors. Sci. Rep. 14, 1425 (2024).
doi: 10.1038/s41598-024-51678-4 pubmed: 38228776 pmcid: 10791601
Rahman, M., Rana, M. S., Khandaker, G., Rahman, M. M. & Khan, M. N. National burden of disability in Bangladesh and its socio-demographic correlates. medRxiv, 2023.2009. 2013.23295500 (2023).
Rahman, M., Rana, M. S., Rahman, M. M. & Khan, M. N. Exploring access to social protection for people with disabilities in Bangladesh. medRxiv, 2023.2011. 2006.23298193 (2023).
Banks, L. M. et al. Access to social protection among people with disabilities: Mixed methods research from Tanahun, Nepal. Eur. J. Dev. Res. 31, 929–956 (2019).
doi: 10.1057/s41287-019-0194-3
Moniruzzaman, M., Zaman, M. M., Mashreky, S. R. & Rahman, A. F. Prevalence of disability in Manikganj district of Bangladesh: results from a large-scale cross-sectional survey. BMJ open 6, e010207 (2016).
doi: 10.1136/bmjopen-2015-010207 pubmed: 27431897 pmcid: 4964198
Marella, M. et al. Prevalence and correlates of disability in Bogra district of Bangladesh using the rapid assessment of disability survey. BMC Public Health 15, 1–9 (2015).
doi: 10.1186/s12889-015-2202-7
Hosseinpoor, A. R. et al. Socio-demographic patterns of disability among older adult populations of low-income and middle-income countries: Results from World Health Survey. Int. J. Public Health 61, 337–345 (2016).
doi: 10.1007/s00038-015-0742-3 pubmed: 26537634
Buz, J. & Cortés-Rodríguez, M. Measurement of the severity of disability in community-dwelling adults and older adults: Interval-level measures for accurate comparisons in large survey data sets. BMJ Open 6, e011842. https://doi.org/10.1136/bmjopen-2016-011842 (2016).
doi: 10.1136/bmjopen-2016-011842 pubmed: 27612539 pmcid: 5020766
Hunt, X. et al. Community support for persons with disabilities in low- and middle-income countries: A scoping review. Int. J. Environ. Res. Public Health 19, 8269. https://doi.org/10.3390/ijerph19148269 (2022).
doi: 10.3390/ijerph19148269 pubmed: 35886121 pmcid: 9319493
Torsha, N. et al. Disability-friendly healthcare at public health facilities in Bangladesh: A mixed-method study to explore the existing situation. BMC Health Serv. Res. 22, 1178 (2022).
doi: 10.1186/s12913-022-08538-6 pubmed: 36127659 pmcid: 9490997
Khan, M. N., Harris, M. L. & Loxton, D. Assessing the effect of pregnancy intention at conception on the continuum of care in maternal healthcare services use in Bangladesh: Evidence from a nationally representative cross-sectional survey. PloS one 15, e0242729 (2020).
doi: 10.1371/journal.pone.0242729 pubmed: 33216799 pmcid: 7678970
World Health Organization. Global Report on Health Equity for Persons with Disabilities (World Health Organization, 2022).
Kibria, G., Islam, T., Miah, S., Ahmed, S. & Hossain, A. Barriers to healthcare services for persons with disabilities in Bangladesh amid the COVID-19 pandemic. Public Health Pract. 1, 100027 (2020).
doi: 10.1016/j.puhip.2020.100027
Bangladesh Bureau of Statistics. National Survey on Persons with Disabilities (NSPD). (Bangladesh Bureau of Statistics; Ministry of Planning; Government of the People’s Republic of Bangladesh, 2022).
Altman, B. M. International Views on Disability Measures: Moving Toward Comparative Measurement 9–16 (Emerald Group Publishing Limited, 2006).
doi: 10.1016/S1479-3547(2006)4
Nuri, R. P., Aldersey, H. M., Ghahari, S., Huque, A. S. & Shabnam, J. The Bangladeshi rights and protection of persons with disability act of 2013: A policy analysis. J. Disab. Policy Stud. 33, 178–187 (2022).
doi: 10.1177/10442073211066789
Rotarou, E. S. & Sakellariou, D. Inequalities in access to health care for people with disabilities in Chile: The limits of universal health coverage. Crit. Public Health 27, 604–616 (2017).
doi: 10.1080/09581596.2016.1275524
Tesfaye, T., Woldesemayat, E. M., Chea, N., Wachamo, D. J. R. M. & Policy, H. Accessing healthcare services for people with physical disabilities in Hawassa City Administration, Ethiopia: A cross-sectional study. RMHP 14, 3993–4002 (2021).
doi: 10.2147/RMHP.S317849
Grills, N. et al. Access to services and barriers faced by people with disabilities: A quantitative survey. CBR Incl. Dev.. 28, 23–23 (2017).
Nuri, R. P., Aldersey, H. M., Ghahari, S. & Huque, A. S. Experience of families in accessing government-led support for children with disabilities in Bangladesh. Disab. Rehabil. 44, 1354–1366 (2022).
doi: 10.1080/09638288.2020.1804000
Talukdar, J. R., Mahmud, I. & Rashid, S. F. Primary health care seeking behaviour of people with physical disabilities in Bangladesh: A cross-sectional study. Arch. Public Health 76, 1–9 (2018).
doi: 10.1186/s13690-018-0293-1
David Garson, G. Fundamentals of Hierarchical Linear and Multilevel Modeling. In Hierarchical Linear Modeling: Guide and Applications (ed. Garson, G.) 3–26 (SAGE Publications, Inc., 2013).
doi: 10.4135/9781483384450.n1
Scarneo, S. E. et al. The socioecological framework: A multifaceted approach to preventing sport-related deaths in high school sports. J. Athlet. Train. 54, 356–360 (2019).
doi: 10.4085/1062-6050-173-18
Hashemi, G., Wickenden, M., Bright, T. & Kuper, H. Barriers to accessing primary healthcare services for people with disabilities in low and middle-income countries, a meta-synthesis of qualitative studies. Disab. Rehabil. 44, 1207–1220 (2022).
doi: 10.1080/09638288.2020.1817984
Soltani, S., Takian, A., Sari, A. A., Majdzadeh, R. & Kamali, M. Financial barriers to access to health services for adult people with disability in Iran: The challenges for universal health coverage. Iran. J. Public Health 48, 508 (2019).
pubmed: 31223579 pmcid: 6570792
Clemente, K. A. P. et al. Barriers to the access of people with disabilities to health services: A scoping review. Revis. Saúde Públ. 56, 64 (2022).
doi: 10.11606/s1518-8787.2022056003893
Dassah, E., Aldersey, H., McColl, M. A. & Davison, C. Factors affecting access to primary health care services for persons with disabilities in rural areas: A “best-fit” framework synthesis. Global Health Res. Policy 3, 1–13 (2018).
doi: 10.1186/s41256-018-0091-x
Jahan, N. & Holloway, C. Barriers to access and retain formal employment for persons with disabilities in Bangladesh and Kenya. (GDI Hub Working Paper Series, 2020).
Thompson, S. Disability inclusive development situational analysis for Bangladesh (2020).
Mannan, M. Access to public health facilities in Bangladesh: a study on facility utilisation and burden of treatment. Bangladesh Dev. Stud., 25–80 (2013).
Kabir, A., Karim, M. N. & Billah, B. The capacity of primary healthcare facilities in Bangladesh to prevent and control non-communicable diseases. BMC Prim. Care 24, 1–15 (2023).
doi: 10.1186/s12875-023-02016-6
Alam, M. B. et al. Exploring the effects of disability on adverse health and nutritional outcomes among under-five children in south Asian countries: Evidence from multiple indicator cluster surveys. Lancet Reg. Health Southeast Asia 25, 100401 (2024).
doi: 10.1016/j.lansea.2024.100401 pubmed: 38616818 pmcid: 11015120
Rotenberg, S., Davey, C. & McFadden, E. Association between disability status and health care utilisation for common childhood illnesses in 10 countries in sub-Saharan Africa: A cross-sectional study in the Multiple Indicator Cluster Survey. Eclinicalmedicine 57, 101870 (2023).
doi: 10.1016/j.eclinm.2023.101870 pubmed: 36895804 pmcid: 9989629
Gage-Bouchard, E. A. Social support, flexible resources, and health care navigation. Soc. Sci. Med. 190, 111–118 (2017).
doi: 10.1016/j.socscimed.2017.08.015 pubmed: 28858696 pmcid: 5607112
Pumkam, C., Probst, J. C., Bennett, K. J., Hardin, J. & Xirasagar, S. Health care expenditures among working-age adults with physical disabilities: Variations by disability spans. Disab. Health J. 6, 287–296 (2013).
doi: 10.1016/j.dhjo.2013.03.002
Prizeman, K., Weinstein, N. & McCabe, C. Effects of mental health stigma on loneliness, social isolation, and relationships in young people with depression symptoms. BMC Psychiatry 23, 527 (2023).
doi: 10.1186/s12888-023-04991-7 pubmed: 37479975 pmcid: 10362624
Rivenbark, J. G. & Ichou, M. Discrimination in healthcare as a barrier to care: experiences of socially disadvantaged populations in France from a nationally representative survey. BMC Public Health 20, 1–10 (2020).
doi: 10.1186/s12889-019-8124-z

Auteurs

Mizanur Rahman (M)

Bangamata Sheikh Fojilatunnesa Mujib Science & Technology University, Jamalpur, Bangladesh.

Md Shohel Rana (MS)

Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh.

Md Mostafizur Rahman (MM)

University of Rajshahi, Rajshahi, Bangladesh.

Md Nuruzzaman Khan (MN)

Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh. sumonrupop@gmail.com.
Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia. sumonrupop@gmail.com.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH