Household Income And Expenditure Survey Research Articles

Spending privately for education despite having a free public education policy: evidence from Sri Lankan household surveys

PurposeCompared to other neighbouring South Asian countries, Sri Lanka performs well in terms of education outcomes. Education is provided by the government for free from primary school level to the first-degree University level, yet households’ private education expenses are steadily increasing over time. Thus, this paper analyses trends and determinants of household private education expenditures using the country-wide micro-data from 1990 to 2013.Design/methodology/approachUsing Household Income and Expenditure Survey (HIES) 1990/91, 2002 and 2012/13 data along with annual school census data, this paper examines the relationship between private education expenditure patterns and the observed changes of reported both demand-side and supply-side factors. In particular, the present paper analyses determinants of household private education expenditures within the two-part model econometric framework by taking into account location and time fixed-effects.FindingsThe results show that trend of spending privately for education is increasing over time with rising household income. Rural, Tamil and Islamic households and those headed by less-educated members are less likely to spend privately for education. The results also confirm that improved-supply-side factors can significantly lower the household burden arising from out-of-pocket education expenditure.Research limitations/implicationsUnavailability of panel data and missing data on several districts due to security concerns are limitations of the study.Social implicationsThe trend of increasing private education expenses has implications on equity concerns of education in Sri Lanka, and it can undermine the purpose of free public education policy.Originality/valueTo our knowledge, this is the first study for Sri Lanka that examines patterns and determinants of private education expenditures using nationwide data for last two decades. This paper applies novel econometric techniques to account for various issues in household survey data analysis.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-07-2019-0445

Preference for parboiled rice: empirical evidence from Sri Lanka

PurposeUnderstanding parboiled rice consumption trends by households is important because parboiled rice provides economic benefits as well as health benefits compared to non-parboiled ordinary milled rice. Thus, the objective of this study is to examine the patterns and determinants of parboiled rice consumption by Sri Lankan households.Design/methodology/approachThis study uses the Household Income and Expenditure Survey (HIES) data compiled by the Department of Census and Statistics (DCS) of Sri Lanka in 2002, 2006/2007 and 2012/2013. This paper analyses the parboiled rice consumption behaviour of households using information from 56,000 households. Specifically, present paper estimates the determinants of parboiled rice consumption within two-part model econometric framework controlling for demand side factors as well as location and time fixed-effects.FindingsDespite its nutritional and health benefits, results show that the likelihood of consuming parboiled rice has decreased over the years. There are significant ethnic and regional differences of consuming parboiled rice supporting the claim of heterogeneous distribution of rice consumption patterns even within the same country.Research limitations/implicationsUse of repeated cross-sectional data due to lack of panel data and missing data on several districts due to security concerns are limitations of the study.Originality/valueTo our knowledge, this is the first study for Sri Lanka that examines parboiled rice consumption behaviour using nationwide data for last 2 decade.

Hefty fee for a healthy life: finding predictors by econometric comparison

Bangladesh has made notable progress on many health indicators. However, out-of-pocket (OOP) healthcare costs continue to burden patients and their families as the need for public spending in the health sector grows. This article examines the effects of selected variables on OOP healthcare expenditure which have not previously been well researched. Data from the Bangladesh Household Income and Expenditure Survey (HIES) 2010/2011 (n = 4025) was analyzed. This study applied the double-hurdle model, the Tobit Model, and the truncated regression model to analyze the effects of selected independent variables on OOP healthcare expenditure. The presence of chronic illness, or any symptoms of illness, make people spend more on healthcare. People tend to expend more on those healthcare service providers who provide sufficient consultation time. If the healthcare service provider is chosen because of better treatment quality, people will pay more for the service. The study also showed that the time needed to reach the service provider and the waiting time to be treated by the service provider have a significant positive relationship with OOP healthcare expenditure. The desire for a healthy life motivates people to spend money on healthcare within or beyond their ability. People, in general, want to live healthy throughout their lifetime. Thus, the demand for seeking better healthcare service is inelastic in terms of income and price. These seemingly inevitable and high OOP payments are posing an economic burden for the patients and their families. An optimized payment policy can enhance the welfare of both the patients and the service providers.

Socioeconomic inequality in dental care utilization in Iran: a decomposition approach

PurposeSocioeconomic inequalities in dental care utilization in Iran are rarely documented. This study aimed to provide insight into socioeconomic inequalities in dental care utilization and its main contributing factors among Iranian households.Design/methodology/approachA total of 37,860 households from the 2017 Household Income and Expenditure Survey (HIES) were included in the study. Data on dental care utilization, age, gender and education attainment of the head of household, socioeconomic status of households, health insurance coverage, living areas and provinces were obtained for the survey. The concentration curve and the normalized concentration index (Cn) was used to illustrate and quantify socioeconomic inequalities in dental care utilization among Iranian households. The Cn was decomposed to identify the main determinants of the observed socioeconomic inequality in dental care utilization in Iran.FindingsThe study indicated that the prevalence of dental care utilization among Iranian’s households was 4.67% (95% confidence interval [CI]: 4.46 to 4.88%). The results suggested a higher concentration of dental care utilization among socioeconomically advantaged households (Cn = 0.2522; 95% CI: 0.2258 to 0.2791) in Iran. Pro-rich inequality in dental care utilization also found in rural (Cn = 0.2659; 95%CI: 0.2221 to 0.3098) and urban (Cn = 0.0.2504; 95% CI: 0.0.2159 to 0.2841) areas. The results revealed socioeconomic status of households, age and education status of head of households and residing provinces as the main contributing factors to the concentration of dental care utilization among the wealthy households.Originality/valueThis study revealed pro-rich inequalities in dental care utilization among households in Iran and its provinces. Thus, health policymakers should focus on designing effective evidence-based interventions to improve healthcare utilization among household with the older head of households, lower education status, and living in relatively poor provinces to reduce socioeconomic inequality in dental care utilization in Iran.

Determinants of utilization and out-of-pocket payments for psychiatric healthcare in Iran

Purpose Mental health is an inevitable and vital dimension when it comes to providing a global definition for the appropriate health status. This highlights the importance of investigating factors influencing utilization and out-of-pocket payments (OOP) for mental health services. Thus, the purpose of this paper is to assess the determinants of the utilization and OOP for psychiatric healthcare in Iran. Design/methodology/approach A total of 39,864 households were included in this cross-sectional study. Data on the utilization and OOP for psychiatric healthcare as well as all their determinants (e.g. wealth index of households, geographical area, household size, etc.) were extracted from the Household Income and Expenditure Survey (HIES). The HIES was conducted by the Statistical Center of Iran in 2016. A zero-inflated Tobit model was used to identify the main factors affecting utilization and OOP for psychiatric healthcare utilization. Findings The average of utilization and OOP for psychiatric services was found to be 14.67 times per 1,000 households and $7.783 per month for service users, respectively. There were significant positive relationships between income and utilization (p=0.0002) and OOP (p<0.0001) for psychiatric services. Significant negative associations were found between the number of illiterate people in the household and OOP (coefficient=−1.56) and utilization (coefficient=−0.2002) for psychiatric services. Utilization and OOP for psychiatric services were statistically significantly higher among households with higher wealth status. Originality/value Despite the higher rate of mental disorders, the utilization of psychiatric services in Iran is very low. Due to financial barriers and insufficient insurance coverage, high socioeconomic status (SES) households utilize more psychiatric services than low-SES households. Thus, the integration of mental health services in public health programs is required to improve the utilization of psychiatric services in Iran.

The impact of health reform in Iran on catastrophic health expenditures: Equity and policy implications.

In 2014, the Islamic Republic of Iran launched the Health Transformation Plan (HTP), with the goal of achieving universal health coverage (UHC) through improved financial protection and access to high-quality health services among Iranian households. We aimed to investigate the impact of the HTP on the level and pattern of out-of-pocket (OOP) payments for health care. Using data from two rounds (2013 and 2016) of the Iranian Statistics Centre's Household Expenditure and Income Survey (HEIS), collected before and after implementation of the HTP, we estimate changes in the level and drivers of OOP payments, and the prevalence, intensity, and distribution of catastrophic health expenditures (CHEs) among Iranian households. Our results indicate that per capita OOP payments on health remained stable during the observed period, with the largest proportion of OOP payments spent on medicines. Using thresholds of 10% and 25% of total consumption, there was a slight increase in the prevalence of CHE. The prevalence of CHE increased from 3.76% to 3.82% at threshold of 25% of total consumption. Using 40% capacity to pay threshold, prevalence diminished modestly from 2.5% to 2.37% and the intensity decreased from 13.16% to 12.32%. At all thresholds, CHE were more concentrated among wealthier households. These results suggest that while financial protection of the poor in Iran has improved due to the HTP, more work is needed to achieve UHC in Iran. For the next phase of health reforms, more emphasis should be placed on shifting away from OOP co-payments for health financing to progressive prepayment mechanisms to facilitate better sharing of financial risks across population groups.

Analyzing the Impact of Agricultural Landownership on Poverty and Food Security in Sri Lanka: A Household Level Econometric Analysis

Aims: This study examined the impact of agricultural landownership on poverty and food security in Sri Lanka. The current study enriches the literature by extending traditional two way poverty classification into four groups: Extremely Poor, Poor, Vulnerable Non-Poor and Non-Poor and quantifies the impact of agricultural landownership on each type of poverty. Similarly, the impact of agricultural landownership on food security is was also estimated considering the four types of food security such as, Extremely Food Insecure, Food Insecure, Vulnerable to Food Insecure and Food Secure, based on Minimum Dietary Energy Requirements.
 Methodology: The analysis is was based on the secondary data from the Household Income and Expenditure Survey (HIES) of Sri Lanka. Ordered Probit Models were estimated to examine the impacts of agricultural landownership on poverty and food security to accomplish the objectives of the study.
 Results: The results highlighted that the probability of being non-poor of the households with agriculture land is was higher by 6.42% compared to the households without agricultural lands. Similarly, having agriculture land also reduces the probability of being extremely poor, poor and vulnerable to poverty by 0.1%, 2.2% and 4.1% respectively. In addition, the empirical findings indicated that ownership of agricultural land lessens the probability of being extremely food insecure (0.8%), food insecure (1.4%) and vulnerable to food insecure (0.7%). Moreover, the probability of being food secured of thefor households with agricultural lands is was higher by 0.9% compared to the households without agricultural lands.
 Conclusion: Therefore, the study emphasized the significance of agricultural landownership to mitigate the poverty and food insecurity which ultimately enhances the household wellbeing. Hence, the current study strongly recommends implementing appropriate policies to address land-right related issues faced by developing countries ensuring long term wellbeing of the households.

An Analysis of Household Expenditure Pattern and Consumption Inequality

본 연구는 Aguiar and Blis(2015)의 방법론을 바탕으로 소비지출 특성을 파악하기 위해 소비지출 탄력성을 추정하고, 고소득층과 저소득층 간의 소비 불평등을 실증적으로 분석하였다. 분석을 위하여 가구의 소비지출과 가구원 정보를 제공하는 통계청의 가계동향조사 마이크로데이터를 이용하였다. 먼저, 가구특성별 변수와 총소비지출을 바탕으로 탄력성을 추정하였다. 분석결과, 오락문화, 교통, 교육, 기타상품 및 서비스 등과 같은 서비스품목에 대한 탄력성은 다른 재화에 비해 상대적으로 높게 나타났다. 그리고 측정오차를 고려하여 소득 5분위와 소득 1분위 간 소비지출 격차를 추정하였다. 1990년대 초 소비지출 불평등도는 높았으나 경제충격으로 인해 오히려 1998-2000년까지 소비지출 격차가 완화되는 것으로 나타났다. 그러나 구조조정 이후 한계 소비성향이 큰 저소득층의 소비침체가 이어지면서 2000년대 후반 소비지출 불평등은 크게 증가한 것으로 나타났다. 특히, 2000년대 들어 비내구재 소비 지출 격차가 크게 증가하였는데, 이는 가구 소비의 서비스화가 진전되고 있으며 소득수준별 후생 차이가 커질 것임을 의미한다. 따라서 저소득층에 대한 정책적 지원이 필요하며 저소득층 지출과 관련한 정책적 지원은 소비증대로 이어져 민간소비지출 회복에 기여할 것으로 보인다.This research examines the income (total expenditure) elasticities and the trends of consumption inequality between the high income and low-income households, using the microdata from Household Income and Expenditure Survey (HIES). We consider that each household with different income level have different income elasticity and estimates total expenditure elasticities for each goods using household demographic dummy variables (households’ age, sex, number of members, number of earners and education level). The result shows that the elasticity of service goods such as entertainment culture, transportation, education, and other goods and services is relatively higher than other goods. To correct for measurement error, we employ the invert demand system, which is concerned in elasticity estimation, and analyze the consumption inequality evolution between fifth income households and first income households. The early 1990s consumption inequality is higher than that of income, but because of the financial crisis in 1997, its evolution is decreased until the late of 1990s. After economic reconstructing, consumption expenditure has stagnated in low-income households with a higher marginal propensity to consume (MPC), and consumption inequality has increased significantly in the late 2000s. In particular, the gap in non-durable goods consumption expenditure has increased significantly in the 2000s, which means that households consumption of services is increasing and the welfare difference by income level will expand. These results highlight the needs of policy support for low-income households, which could contribute to the recovery of household consumption expenditure.

Assessing Food Insecurity Trends and Determinants by using Mix Methods in Pakistan: Evidence from Household Pooled Data (2005-2014)

In this study, we try to indirectly quantify the welfare of people in Pakistan through measuring the food insecurity, malnutrition during last decade (2005-14). This study takes lead from earlier studies, in a sense; it covers two food price hike periods (2007 and 2011). So, it is important to understand, how food insecurity status and nutrition are affected by these shocks during this period. Thus, we use nationally representative data called as Household Income and Expenditure Survey (HIES) from 2005-2014. Pakistan Bureau of Statistics collects this data in five rounds; 2005-06, 2007-08, 2010-11, 2011-12, and 2013-14 comprised 81102 households. Results from the headcount ratios suggest that over the period food insecurity trends of the households raised from (58%) to (77%). we find urban households are more food insecure over the time as compared to rural households. Whereas, in qualitative terms of food insecurity, we use two food diversification measures; one is dietary diversity score and second one is share of staple food in total calories consumed by household, suggest that households dietary diversity score is good on average that is 9 out of 10 food groups and on the whole it is slightly improved from (8.8 %) to (9%) in previous 10 years. Interestingly, when we analyze the share of staple food in total calories, results suggest that major portion of a household's diet is consisting of staple food (wheat), (53%) and increased to (57%) from 2005 to 2014. We use the Heckman Approach to find out determinants of food insecurity. Results suggest that female headship plays a significant positive role in caloric intake, among the other variable head education, households' member with basic education and higher education, live stock ownership, consumption of livestock produced at home, farming, consumption of food crop produced at home and foreign and domestic remittances plays a significant positive role in caloric intake of food insecure households.

Adequacy of Retirement Wealth in Malaysia: Spending Behaviour Analysis

This paper aims to measure the retirement wealth adequacy among population in Malaysia based on 7743 samples from Household Expenditure and Income Survey (HEIS) 2014. The determinants of retirement wealth adequacy are also examined using the OLS regression. The HEIS2014 contains information on household income and expenditure data, together with socio-economic and demographic characteristics of each household head such as age, education level and occupational group. The retirement wealth adequacy is projected using a wealth-need ratio, which is equal to the projected wealth (or income) accumulated in working years divided by the projected total needs (or consumptions) in retirement years. A wealth-need ratio of equal or larger than one indicates that an individual’s retirement wealth is adequate. Based on life cycle hypothesis which states that retirees should retire with a maintained lifestyle, a 70% replacement ratio is used in this study to project the total consumptions throughout retirement years. We also project the total consumptions by implementing different replacement ratios for different salary classes in Malaysia to take into account heterogeneity of consumptions among households. The results show that all households (or 100%) have wealth-need ratio of one or more if we use 70% replacement ratio. However, the percentage of households who have wealth-need ratio of equal or larger than one reduces to 88% when we use different replacement ratios for different income classes. The results from the wealth-need ratio indicates that the following demographic and socio-economic groups have higher percentage of adequate retirement wealth; age 30-35, single (not married), work in management field, degree education, live in region 4 (Pulau Pinang, Selangor, Kuala Lumpur, Putrajaya), and work in private sectors.

Consumption displacement in households with noncommunicable diseases in Bangladesh.

The economic burden of noncommunicable diseases (NCDs), including treatment costs and income and productivity losses, is a growing concern in developing countries, where NCD medical expenditure may offset consumption of other essential commodities. This study examines the role of NCDs in household resource allocation in Bangladesh. We use the Bangladesh Household Income and Expenditure Survey (HIES) 2010 to obtain expenditure data on 11 household expenditure categories and 12 food expenditure sub-categories for 12,240 households. Household NCD status was determined through self-report of at least one of the six major NCDs within the household–heart disease, hypertension, diabetes, kidney diseases, asthma, and cancer. We estimated unadjusted and regression-adjusted differences in household expenditure shares between NCD and non-NCD households. We further investigated how consumption of different food sub-categories is related to NCD status, distinguishing between household economic levels. The medical expenditure share was estimated to be 59% higher for NCD households than non-NCD households, and NCD households had lower expenditure shares on food, clothing, hygiene, and energy. Regression results indicated that presence of NCDs was associated with lower relative expenditure on clothing and housing in all economic subgroups, and with lower expenditure on food among marginally poor households. Having an NCD was significantly associated with higher household spending on tobacco and higher-calorie foods such as sugar, beverages, meat, dairy, and fruit, and with lower spending on fish, vegetables, and legumes. The findings indicate a link between NCDs and the possibility of adverse economic effects on the household by highlighting the potential displacement effect on household consumption that might occur through higher medical expenditure and lower spending on essentials. The findings might also point to a need for raising awareness about the link between NCDs and diet in Bangladesh.

Impacts of Improved Infrastructure on Labor Allocation and Livelihoods: The Case of the Jamuna Multipurpose Bridge, Bangladesh

The present study econometrically examines the impacts of an improved road transportation system on labor allocation, input use, and livelihood diversification in an economically lagging part of Bangladesh. Before 1998, the northwest part of Bangladesh, home to 22% of nearly 160 million people, was de-linked from the economically advanced eastern part of Bangladesh. On June 23, 1998, the Jamuna Multipurpose Bridge (JMB) on the river Jamuna was opened for use. The bridge has established direct road and rail transportation systems between the northwestern part and the eastern part of Bangladesh. Using these phenomena, and linking the Household Income and Expenditure Survey (HIES) data, HIES2000 and HIES2010, this study elucidates the impacts of improved infrastructure on labor allocation and the input application behavior of the sampled households. Applying the difference-in-difference estimation approach, this study demonstrates that the JMB that has linked the northwest and eastern regions has encouraged labor out-migration, resulting in the most vulnerable day-laborers in both farm and non-farm sectors moving to other jobs with relatively high marginal returns. The improved transportation infrastructure had also increased the daily wage rates, which were lower than the comparison group, and the cropping intensity in the Rajshahi and Rangpur divisions. The study, therefore, concludes that investment in infrastructure can be instrumental in unleashing economic growth and alleviating poverty in the economically struggling parts of developing countries.

Health and Socio-economic Implications of Poverty in Bangladesh

The objective of this study was to explore the influences of the health and socio-economic factors associated with the poverty level of households in Bangladesh, through an analysis of data from the Household Income and Expenditure Survey (HIES) 2010 conducted by Bangladesh Bureau of Statistics (BBS). A total of all 12,240 households was considered in this study. CBN method was applied for estimating poverty of the household. A logistic regression analysis was used to identify the main factors that influence the household’s poverty. The results showed that the probability of the household being poor was higher when the household’s head suffered from various chronic diseases like chronic fever, injuries/disability, eczema, leprosy, and asthma/breathing trouble as compared to the household whose head didn’t suffer from any chronic diseases. From the analysis, it was also found that when a large number within household suffered from any chronic disease, the probability of the household being poor was increased. The household that had no access to health care was poorer than the household that had access to health care. The results also showed that with increased investment in health, the probability of the household being poor was decreased. The results showed that rural households were poorer than urban households. Monthly income, land ownership, construction materials of walls and roofs, types of the latrine, source of drinking water, household size; age, sex, and employment status of the household’s head all had a significant impact on the poverty level of the household.

Cereal consumption and marketing responses by rural smallholders under rising cereal prices

PurposeInternational commodity prices have escalated to an unprecedented level since 2008. Although commodity prices have declined recently, prices are still high compared to the pre-2008 levels. Combining this market phenomenon with Bangladesh Government’s Household Income and Expenditure Survey (HIES) data sets HIES 2005 and HIES 2010, and applying the seemingly unrelated regression (SUR) estimation process, the purpose of this paper is to examine paddy rice marketing, and the cereal and non-cereal food expenditure behavior of rural smallholders in Bangladesh under rising commodity prices.Design/methodology/approachThis study uses information collected by the Government of Bangladesh and applies two-step Heckman-type selection model estimation procedure, first to estimate total rice production by the rice production self-sufficiency status of the household. Second, the study estimates the paddy marketing behavior by the households by their rice self-sufficiency status under rising commodity price regime applying SUR estimation process combing with Heckman’s selection model estimation procedure.FindingsEmpirical findings demonstrate that there was no positive assertion between higher paddy rice prices and paddy rice marketing by the rural smallholders. Rather, under the rising commodity price regime, smallholders significantly reduced consumption expenditure on high food value-enriched non-cereal food items to adjust to the market shocks.Research limitations/implicationsThis is a Bangladesh-based case study. Individual country-level case studies should be conducted in order to generalize the findings of the present study.Originality/valueThe present study warns that the market volatility may discourage farm households to market their cereals more due to uncertain future. To the authors’ knowledge, this is the first attempt to explore the cereal marketing behavior of the farm households in Bangladesh under commodity price hikes by the rice production self-sufficiency status of the farm households.

Access to Microcredit and Women's Entrepreneurship: Evidence from Bangladesh

This paper intends to assess the impact of access to microcredit on women’s entrepreneurship in Bangladesh. The descriptive statistics and multivariate techniques have been used to achieve the objective of the paper. The study uses Household Income and Expenditure survey (HIES) 2010 dataset. The HIES 2010 survey covers 12,240 households from all districts in the country. Considering the endogeneity in the microcredit program participation of women, the study uses an instrumental variables technique (IV method) to assess the impact of access to microcredit on the entrepreneurial status of women. After adjustment for the endogeneity, the results from the multivariate analysis indicate that access to microcredit has a significant and positive impact on women’s entrepreneurship. It also has a significant and positive impact on men’s entrepreneurship and the marginal effects of access to microcredit are stronger on men’s entrepreneurship than on women’s entrepreneurship.

Factors affecting poverty in rural Bangladesh: An analysis using multilevel modelling

Poverty is a multi-faced problem in the developing world and it is much more complex in rural settings. Hence, policy formulation based on national level studies sometimes fails to find remedies of rural poverty. Thus, the present study aims to identify the determinants of poverty in rural Bangladesh using the nationally representative Household Income and Expenditure Survey (HIES) 2010 data. The HIES follows a hierarchical structure hence, two-level random intercept binary logistic regression models were used to capture the unobserved heterogeneity between communities along with revealing important factors associated with poverty. The analyses found that 32% of the households were absolute poor and 19% were extremely poor in rural Bangladesh. The potential factors having significant association with poverty were found to be age and education of household head, division, household size, household types, number of dependents, per capita income, household own land, access to electricity, amount of cultivable land, engagement in livestock and farm forestry, household non-agricultural assets, number of male earner and number of female earner in the family. Significant community-level variations were observed in the analyses which emphasis the need for special attention on the poor performing communities. Specific policy recommendations have been suggested for the poverty alleviation of rural households in Bangladesh.J. Bangladesh Agril. Univ. 16(1): 123-130, April 2018

Bayesian Inference for Spatial Beta Generalized Linear Mixed Models

In some applications, the response variable assumes values in the unit interval. The standard linear regression model is not appropriate for modelling this type of data because the normality assumption is not met. Alternatively, the beta regression model has been introduced to analyze such observations. A beta distribution represents a flexible density family on (0, 1) interval that covers symmetric and skewed families. In this paper, a beta generalized linear mixed model with spatial random effect is proposed emphasizing on small values of the spatial range parameter and small sample sizes. Then some models with both fixed and varying precision parameter and different combinations of priors and sample sizes are discussed. Next, the Bayesian estimation of the model parameters is evaluated in an intensive simulation study. Selected priors improved the Bayesian estimation of the parameters, especially for small sample sizes and small values of range parameter. Finally, an application of the proposed model on data provided by Household Income and Expenditure Survey (HIES) of Tehran city is presented.

Healthcare-Seeking Behavior and Out-of-Pocket Payments in Rural Bangladesh: A Cross-Sectional Analysis

This study investigates the determinants of patient’s choice of treatment (i.e., modern vs. alternative healthcare) using Bangladesh’s Household Income and Expenditure Survey (HIES) dataset for exploring their healthcare-seeking behavior and the extent of out-of-pocket (OOP) payment due to illnesses. It explores this issues using the descriptive statistics, bivariate analysis like analysis of variance (ANOVA) and Chi-square test as well as econometric modeling (probit regression model on modern healthcare utilization for the full sample as well as for each quintile). All these help to identify the determinants of healthcare-seeking behavior in rural Bangladesh and how these vary across the quintiles of expenditure on food consumption. This study finds that higher percentage of healthcare-seeking patients receives alternative healthcare because of the lower cost and easier access compared to modern healthcare. The marginal effects of the predisposing factors like patient’s age, parent’s literacy, mother’s age, house with separate dining room, access to electricity and mobile are significantly positive, which means these are more likely to influence modern healthcare utilization. In contrast, the marginal effects of the enabling factors like income, landholdings, access to social benefit are positive, but insignificant. Therefore, predisposing factors rather than enabling factors play crucial role in determining choice of modern treatment in rural Bangladesh. In addition, variations in the marginal effects exist across different groups based on regression by quintile. Finally, sickness prevalence as well as modern healthcare utilization also varies across geographic regions. The average OOP payment is higher for modern healthcare compared to alternative one and it remains true after disaggregation of OOP expenditure. Disease-specific OOP using first-difference method is also positive for all diseases (i.e., OOP expenditure for modern healthcare> OOP expenditure for alternative healthcare) and most of the first-difference estimates are statistically significant. Similar tendencies are also observed in case of applying distributional analysis using quintiles. All these are important for formulating a national health policy for the rural people in Bangladesh. At last, a special attention to expanding utilization of modern healthcare is required for young mothers, elderly household head and the patients belong to minority group in rural Bangladesh.

The Household Response to Persistent Natural Disasters: Evidence from Bangladesh

We examine the short-run economic impacts of recurrent flooding on Bangladeshi households surveyed in 2000, 2005 and 2010. In 2010 Household Income and Expenditure Survey (HIES), households answered a set of questions’ on whether they were affected by flood and its likely impacts. We identify two treatment (affected) groups by using the self-reported data and historical rainfall data based flood risk index. We estimate a difference-indifference (DID) model to quantify the impacts on income, expenditure, asset and labour market outcomes and further extend our analysis to different income and expenditure brackets. Overall, we find robust evidence of negative impacts on agricultural income and expenditure. Intriguingly, the extreme poor (i.e. the bottom 15th quintile) experience significant positive impacts on agricultural income in the self-reported treatment case.

Investigating the significance of the data collection period of household consumption and expenditures surveys for food and nutrition policymaking: Analysis of the 2010 Bangladesh household income and expenditure survey

Efforts to improve the use of Household Income and Expenditure Surveys (HIES) for nutrition policy decisions face numerous methodological issues. Our objective was to explore how nutrition indicators vary by data collection period (number of days of household consumption data available) using the 2010 Bangladesh HIES. Household availability and individual apparent consumption of nutrients, foods, and food groups were estimated for each of 7 consecutive 2-day recall periods, both separately and in combinations representing 2, 4, 6, 8, 10, 12, or 14days of data. Differences among cumulative data collection periods in mean apparent nutrient consumption and proportion with low values were statistically significant but small (<4 percentage points), suggesting that a data collection period of one week or less would yield the same conclusions asa longer (and more costly) data collection period of 14days for these outcomes if the recall period were held constant. For all food groups except staple foods, the proportion of households consuming food groups and selected potentially fortified foods increased, and the mean amount consumed among consumers (the ‘conditional mean’) decreased with longer data collection periods; this observation is likely related to frequency of consumption and suggests that the choice of data collection period for these items will be determined by the intended application. Additional research is necessary to confirm the external validity of these findings.