IDEAS home Printed from https://ideas.repec.org/a/plo/pntd00/0009894.html
   My bibliography  Save this article

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

Author

Listed:
  • Kimberly M Koporc
  • David R Hotchkiss
  • Charles F Stoecker
  • Deborah A McFarland
  • Thomas Carton

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.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.

Suggested Citation

  • Kimberly M Koporc & David R Hotchkiss & Charles F Stoecker & Deborah A McFarland & Thomas Carton, 2021. "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 healt," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 15(11), pages 1-21, November.
  • Handle: RePEc:plo:pntd00:0009894
    DOI: 10.1371/journal.pntd.0009894
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0009894
    Download Restriction: no

    File URL: https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0009894&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pntd.0009894?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications - Books, The World Bank Group, number 6896, December.
    2. Ernest O Mensah & Moses K Aikins & Margaret Gyapong & Francis Anto & Moses J Bockarie & John O Gyapong, 2016. "Extent of Integration of Priority Interventions into General Health Systems: A Case Study of Neglected Tropical Diseases Programme in the Western Region of Ghana," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 10(5), pages 1-16, May.
    3. World Bank, 2011. "World Bank for Results 2011," World Bank Publications - Books, The World Bank Group, number 15792, December.
    4. Ties Boerma & Carla AbouZahr & David Evans & Tim Evans, 2014. "Monitoring Intervention Coverage in the Context of Universal Health Coverage," PLOS Medicine, Public Library of Science, vol. 11(9), pages 1-13, September.
    5. Anna Cavalli & Sory I Bamba & Mamadou N Traore & Marleen Boelaert & Youssouf Coulibaly & Katja Polman & Marjan Pirard & Monique Van Dormael, 2010. "Interactions between Global Health Initiatives and Country Health Systems: The Case of a Neglected Tropical Diseases Control Program in Mali," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 4(8), pages 1-7, August.
    6. Aluísio J D Barros & Cesar G Victora, 2013. "Measuring Coverage in MNCH: Determining and Interpreting Inequalities in Coverage of Maternal, Newborn, and Child Health Interventions," PLOS Medicine, Public Library of Science, vol. 10(5), pages 1-9, May.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Nora Lustig & Florencia Amábile & Marisa Bucheli & George Gray Molina & Sean Higgins & Miguel Jaramillo & Wilson Jiménez Pozo & Veronica Paz Arauco & Claudiney Pereira & Carola Pessino & Máximo Rossi , 2014. "El impacto del sistema tributario y del gasto social sobre la desigualdad y la pobreza en Argentina, Bolivia, Brasil, México, Perú y Uruguay: Un panorama general," Commitment to Equity (CEQ) Working Paper Series 1313S, Tulane University, Department of Economics.
    2. Andrew J. Mirelman & Miqdad Asaria & Bryony Dawkins & Susan Griffin & Richard Cookson & Peter Berman, 2020. "Fairer Decisions, Better Health for All: Health Equity and Cost-Effectiveness Analysis," World Scientific Book Chapters, in: Paul Revill & Marc Suhrcke & Rodrigo Moreno-Serra & Mark Sculpher (ed.), Global Health Economics Shaping Health Policy in Low- and Middle-Income Countries, chapter 4, pages 99-132, World Scientific Publishing Co. Pte. Ltd..
    3. Mohammad Abu-Zaineh & Habiba Romdhane & Bruno Ventelou & Jean-Paul Moatti & Arfa Chokri, 2013. "Appraising financial protection in health: the case of Tunisia," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 73-93, March.
    4. Ahmed Shoukry Rashad, 2014. "The Catastrophic Economic Consequences of Illness and their Effect on Poverty Estimates in Egypt, Jordan, and Palestine," Working Papers 842, Economic Research Forum, revised Oct 2014.
    5. World Bank, 2012. "Health Equity and Financial Protection in Ghana," World Bank Publications - Reports 27067, The World Bank Group.
    6. Kinyondo, Abel Alfred & Ntegwa, Magashi Joseph & Masawe, Cresencia Apolinary, 2022. "Socioeconomic Inequality in Maternal Healthcare Services: The Case of Tanzania," African Journal of Economic Review, African Journal of Economic Review, vol. 10(1), January.
    7. Rahman, Md Mizanur & Jung, Jenny & Islam, Md Rashedul & Rahman, Md Mahfuzur & Nakamura, Ryota & Akter, Shamima & Sato, Motohiro, 2022. "Global, regional, and national progress in financial risk protection towards universal health coverage, 2000–2030," Social Science & Medicine, Elsevier, vol. 312(C).
    8. Tavares, Lara Patrício & Zantomio, Francesca, 2017. "Inequity in healthcare use among older people after 2008: The case of southern European countries," Health Policy, Elsevier, vol. 121(10), pages 1063-1071.
    9. Ben Jann, 2008. "A Stata implementation of the Blinder-Oaxaca decomposition," ETH Zurich Sociology Working Papers 5, ETH Zurich, Chair of Sociology, revised 14 May 2008.
    10. Primus Che Chi & Patience Bulage & Henrik Urdal & Johanne Sundby, 2015. "Barriers in the Delivery of Emergency Obstetric and Neonatal Care in Post-Conflict Africa: Qualitative Case Studies of Burundi and Northern Uganda," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-24, September.
    11. Balk, Bert M. & Rambaldi, Alicia N. & Rao, D. S. Prasada, 2022. "Macro-Economic Measures For A Globalized World: Global Growth And Inflation," Macroeconomic Dynamics, Cambridge University Press, vol. 26(2), pages 314-360, March.
    12. Axenciuc, Victor & Georgescu, George, 2017. "Gross Domestic Product – National Income of Romania 1862 – 2010. Secular statistical series and methodological foundations," MPRA Paper 84614, University Library of Munich, Germany.
    13. Sowmya Dhanaraj, 2014. "Health Shocks and Coping Strategies: State Health Insurance Scheme of Andhra Pradesh, India," WIDER Working Paper Series wp-2014-003, World Institute for Development Economic Research (UNU-WIDER).
    14. Chen, Yiu Por (Vincent) & Zhang, Yuan, 2018. "A decomposition method on employment and wage discrimination and its application in urban China (2002–2013)," World Development, Elsevier, vol. 110(C), pages 1-12.
    15. Hai Zhong, 2010. "The impact of missing data in the estimation of concentration index: a potential source of bias," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(3), pages 255-266, June.
    16. Arnab Acharya & Melisa Martínez-Álvarez, 2012. "Aid Effectiveness in the Health Sector," WIDER Working Paper Series wp-2012-069, World Institute for Development Economic Research (UNU-WIDER).
    17. Georgescu, George, 2016. "The Gross Domestic Product. History, relevance and limitations in its interpretation," MPRA Paper 73644, University Library of Munich, Germany.
    18. Yujuico, Emmanuel, 2015. "Considerations in the diffusion of a public traffic app for Metro Manila," Journal of Transport Geography, Elsevier, vol. 42(C), pages 48-56.
    19. Hirvonen, Kalle & Bossuyt, Anne & Pigois, Remy, 2017. "Complementarities between social protection and health sector policies: Evidence from the Productive Safety Net Program in Ethiopia," ESSP working papers 112, International Food Policy Research Institute (IFPRI).
    20. Rati Ram, 2016. "PPP GDP Per Capita for Countries of the World: A Comparison of the New ICP Results with World Bank Data," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 127(3), pages 1057-1066, July.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pntd00:0009894. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosntds (email available below). General contact details of provider: https://journals.plos.org/plosntds/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.