Investigator(s)
| WHO Technical Officer |
Nazis Arefin Saki WCO Bangladesh Nazis Arefin Saki 
|
| Principal Investigator |
Syed Abdul Hamid Institute of Health Economics, University of Dhaka Syed Abdul Hamid
|
Title(s) and abstract
| Scientific title | Tuberculosis Patient Cost Survey in Bangladesh |
| Public title | Tuberculosis Patient Cost Survey in Bangladesh |
| Background | To inform national efforts aimed at eliminating catastrophic costs for tuberculosis (TB) patients and to track progress towards achieving the End TB Strategy target, the World Health Organization (WHO) recommends conducting baseline and periodic assessments of the expenses incurred by TB patients through national surveys. In light of this context, WHO is embarking on a cost survey of TB patients in Bangladesh, with the objectives of estimating the proportion of TB patients facing catastrophic costs and analyzing the factors that drive expenses associated with seeking TB diagnosis and treatment. The findings from this survey will provide valuable insights for policy discussions regarding potential modifications to TB service delivery and financing mechanisms in order to reduce patient costs. Additionally, these findings will support policy dialogues involving a diverse set of stakeholders from various sectors to enhance social support for TB patients and their families. |
| Objectives | The overall objective of the proposal is to conduct the first national Tuberculosis catastrophic cost survey in Bangladesh. Hence the specific objectives are: 1. To document the magnitude and main drivers of different types of costs incurred by TB patients (and their households) in order to guide policies to reduce financial access barriers and minimize the adverse socioeconomic impact of TB. 2. To determine the baseline and periodically measure the percentage of TB patients (and their households) treated in the NTP network and incurring total catastrophic costs due to TB. |
| Study Methods | This study will follow the standard guideline of the World Health Organization published in the Tuberculosis Patient Cost Survey: A Handbook. A representative sample will be selected from all the reported TB cases in the recently available period, including drug-sensitive tuberculosis (DS-TB) and drug-resistant tuberculosis (DR-TB) groups, enrolled for treatment regardless of age, sex, and type of TB (are at least two weeks into the intensive or continuation phase). To draw a representative sample from TB patients across the country, a stratified cluster random sampling method will be applied to select the clusters. Samples will be collected from two different strata i.e. DS-TB and DR-TB strata. A total of 800 patients from the DS-TB strata and 200 from the DR-TB strata will be enrolled. A structured interview with a survey instrument will be conducted for each patient asking the total cost incurred during the full episode of TB diagnosis, treatment and care. A combination of descriptive and econometric analysis will be conducted. All data cleaning, analysis and visualization will be conducted in Stata (Stata Corp, 2022). |
| Expected outcomes and use of results | The outputs resulting from this study will include a detailed assessment of the economic costs incurred by TB patients in Bangladesh which will aid in the design of policies and interventions to minimize barriers for accessing and adhering to TB treatment, with the overall goal of improving access to TB care. Moreover, the research will allow the identification and prioritization of future research required to develop and/or scale-up policies and interventions to mitigate against these costs, and later to assess the effectiveness of these policies and interventions. |
| Keywords | TB, Tuberculosis, Socio-economic Barriers |
Research Details
| Student research | No |
| Start Date | 01-Jul-2023 |
| End Date | 31-Dec-2023 |
| Key Implementing Institution | Institute of Health Economics, University of Dhaka |
| Multi-country research | No |
| Nationwide research | Yes |
| Research Domain(s) | Communicable Disease Research |
| Research field(s) | Tuberculosis |
| Involves human subjects | Yes |
| Data Collection | Primary data |
| Proposal reviewed by other Committee | Final decision available |