Job Satisfaction of Health Assistants in Selected Upazila Health Complexes of Bangladesh

Health assistants play an important role in providing primary health care among the rural population in Bangladesh. Their improper working performance can hamper the entire nations’ health care. Proper productivity is related to the job satisfaction and job satisfaction is the result of attitude and behavior. The purpose of this study was to assess the job satisfaction level among health assistants working in selected Upazila Health Complex (UHC). 203 health assistants were interviewed through purposive sampling technique from four UHCs in the Dhaka district. Out of 203 respondents, 114 were female and 89 were male where Mean± SD was 38.80 ±7.62. The highest 109 (53.7%) participants had 1-10 years of working experience and 104 (51.2%) respondents had monthly income between 18000 -23000 BDTK. The percentage of neutral, satisfied and unsatisfied participants’ was 65%, 28% and 7%, respectively. There was significant (P < 0.05) relationship between job satisfaction and getting medical allowance, training opportunity and salary. Job nature such as security, meaningless, pride and enjoying, support colleagues such as supervisor and coworkers, acceptance by both the community and oneself were identified as the satisfied items where low and fair opportunities for promotion, low increment, and low pay, no praise, high work pressure, and null administrative capacity were found as dissatisfied factors of job. On the basis of these findings, policy makers and concerned authorities could take necessary steps for increasing the level of job satisfaction of health assistants

Catastrophic Health Expenditure, Distress Financing and Impoverishment due to Out-of-Pocket Expenses for Healthcare among Patients with Chronic Liver Disease: A Cross-sectional Study among Hospitalized Patients in Bangladesh

Out-of-pocket (OOP) expenses for hospitalized patients with chronic liver disease (CLD) poses an economic challenge on affected household in the form of catastrophic health expenditure (CHE), distress financing and impoverishment. OOP Expenses data for hospitalized CLD patients from Bangladesh is scarce. This study aimed to estimate the OOP expenses and resulting CHE, distress financing and impoverishment among hospitalized patients with CLD. This cross-sectional study was conducted among conveniently selected 107 diagnosed CLD patients admitted at Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH) aged 18 years and above. Data were collected from the respondents using a semi-structured questionnaire through face to face interview during discharge from hospital. Out of pocket expenditure for chronic liver disease in selected hospitals was Bangladeshi Taka (BDT) 19,262. Direct medical, direct non-medical and indirect cost was BDT 16,240; 2,165 and 1,510, respectively. Investigation cost and medicine cost contributed to 48.48% and 31.81% of the total OOP expenses, respectively. At 10% threshold level, 29% of the respondents were affected by CHE. 64.5% of the respondents were facing distress financing due to OOP expenses. Among the respondents, 1.9% slipped below the international poverty line of $1.90 (BDT 161.10, in 2019).There was statistically significant (p < 0.05) difference among the mean OOP expenses for different etiological types of chronic liver disease. The study concluded that it requires establishing a more accessible and affordable decentralized health care system for CLD treatment along with the implementation of financial risk protection