Assessing health-related quality of life among cancer survivors during systemic and radiation therapy in Bangladesh: a cancer-specific exploration.

BACKGROUND: Evaluating the effects of cancer diagnosis and treatment on a patient's overall well-being is crucial and health-related quality of life (HRQoL) is a reliable metric for assessing this impact. Little is known about HRQoL among cancer survivors across various stages and treatments. The study examined individual and clinical factors influencing HRQoL among cancer survivors. METHODS: A cross-sectional study was conducted in two specialised cancer care hospitals in Dhaka, Bangladesh. Cancer-diagnosed adults receiving treatment at selected hospitals from January to May 2022 were enrolled. The 5-level EuroQol-5 Dimensions version (EQ-5D-5L) instrument was used to collect HRQoL data. HRQoL scores were derived using UK value sets. The investigation used a multivariable Tobit regression model to determine the association between independent variables and HRQoL scores. RESULTS: A total of 607 adult patients were enrolled, with 55% being females and 66% aged 36 to 64 years. Reported health problems in five EQ-5D domains include mobility (11%), self-care (11%), usual daily activities (19%), pain/discomfort (21%), and anxiety/depression (46%). Patients with throat, brain, lung, blood, and liver cancer had lower utility scores. Advanced-stage cancer survivors had lower utility scores (ß = -49 units, 95% codfidence interval [CI]: -0.75 to -0.22) compared to early-stage survivors. Physically inactive survivors had lower utility scores by 0.41 units (95% CI: -0.51 to -0.30) compared to their counterparts. Private hospital patients had higher utility scores, whereas patients belonged to poor socioeconomic groups scored worse than wealthier ones. CONCLUSIONS: This study highlights the impact of clinical and individual characteristics on HRQoL among cancer survivors. These findings advocate for an enhanced Bangladeshi cancer patient care model through timely interventions or programs, early detection or diagnosis, tailored treatments, and the promotion of physical activity to bolster HRQoL outcomes.

Cost-effectiveness of inhaled oxytocin for prevention of postpartum haemorrhage: a modelling study applied to two high burden settings.

BACKGROUND: Access to oxytocin for prevention of postpartum haemorrhage (PPH) in resource-poor settings is limited by the requirement for a consistent cold chain and for a skilled attendant to administer the injection. To overcome these barriers, heat-stable, non-injectable formulations of oxytocin are under development, including oxytocin for inhalation. This study modelled the cost-effectiveness of an inhaled oxytocin product (IHO) in Bangladesh and Ethiopia. METHODS: A decision analytic model was developed to assess the cost-effectiveness of IHO for the prevention of PPH compared to the standard of care in Bangladesh and Ethiopia. In Bangladesh, introduction of IHO was modelled in all public facilities and home deliveries with or without a skilled attendant. In Ethiopia, IHO was modelled in all public facilities and home deliveries with health extension workers. Costs (costs of introduction, PPH prevention and PPH treatment) and effects (PPH cases averted, deaths averted) were modelled over a 12-month program. Life years gained were modelled over a lifetime horizon (discounted at 3%). Cost of maintaining the cold chain or effects of compromised oxytocin quality (in the absence of a cold chain) were not modelled. RESULTS: In Bangladesh, IHO was estimated to avert 18,644 cases of PPH, 76 maternal deaths and 1954 maternal life years lost. This also yielded a cost-saving, with the majority of gains occurring among home deliveries where IHO would replace misoprostol. In Ethiopia, IHO averted 3111 PPH cases, 30 maternal deaths and 767 maternal life years lost. The full IHO introduction program bears an incremental cost-effectiveness ratio (ICER) of between 2 and 3 times the per-capita Gross Domestic Product (GDP) ($1880 USD per maternal life year lost) and thus is unlikely to be considered cost-effective in Ethiopia. However, the ICER of routine IHO administration considering recurring cost alone falls under 25% of per-capita GDP ($175 USD per maternal life-year saved). CONCLUSIONS: IHO has the potential to expand access to uterotonics and reduce PPH-associated morbidity and mortality in high burden settings. This can facilitate reduced spending on PPH management, making the product highly cost-effective in settings where coverage of institutional delivery is lagging.

Systematic review and meta-analysis of the prevalence of smokeless tobacco consumption among adults in Bangladesh, India and Myanmar.

OBJECTIVE: To estimate the pooled prevalence of smokeless tobacco consumption (STC) by gender and location in Bangladesh, India and Myanmar and to identify periodic changes in STC prevalence using data extracted from published studies. METHODS: We searched for a combination of keywords in electronic databases and used a standard form to extract data from each article. We undertook a meta-analysis to estimate pooled prevalence and confidence intervals within these countries. To compare periodic changes in STC prevalence, we grouped studies into five-year periods (2000-2004, 2005-2009, 2010-2014 and 2015-2019). RESULTS: The pooled estimates of STC prevalence were 25% (95% CI: 22-28%), 22% (95% CI: 15-28%) and 21% (95% CI: 14-28%) for Bangladesh, India and Myanmar, respectively. In pooled estimates across these countries, we found higher STC prevalence for men (30%; 95% CI: 24-35%) than women (16%; 95% CI: 10-23%) and for rural dwellings (24%; 95% CI: 18-31%) than urban dwellings (17%; 95% CI: 10-24%). We found significant decrease in STC in Bangladesh and India in the period 2010-2014 and 2015-2019, respectively. In Myanmar, STC prevalence increased significantly and substantially in 2010-2014, to levels higher than in Bangladesh and India. CONCLUSIONS: The prevalence of STC in Bangladesh, India and Myanmar is highest in rural areas and among men. Public health prevention strategies are needed to maintain decrease in STC in Bangladesh and India, and to reverse the increased use in Myanmar.

OBJECTIF: Estimer la prévalence poolée de la consommation de tabac sans fumée (CTSF) par sexe et lieu au Bangladesh, en Inde et au Myanmar et identifier les changements périodiques de la prévalence des CTSF à l'aide de données extraites d'études publiées. MÉTHODES: Nous avons recherché une combinaison de mots-clés dans les bases de données électroniques et utilisé un formulaire standard pour extraire les données de chaque article. Nous avons entrepris une méta-analyse pour estimer la prévalence poolée et les intervalles de confiance dans ces pays. Pour comparer les changements périodiques de la prévalence des CTSF, nous avons regroupé les études en périodes de cinq ans (2000-2004, 2005-2009, 2010-2014, 2015-2019). RÉSULTATS: Les estimations poolées de la prévalence des CTSF étaient de 25% (IC95%: 22-28%), 22% (IC95%: 15-28%) et 21% (IC95%: 14-28%) pour le Bangladesh, l'Inde et le Myanmar, respectivement. Dans les estimations poolées de ces pays, nous avons constaté une prévalence des CTSF plus élevée pour les hommes (30%; IC95%: 24-35%) que pour les femmes (16%; IC95%: 10-23%) et pour les habitations rurales (24%; IC95%: 18-31%) que les habitations urbaines (17%; IC95%: 10-24%). Nous avons constaté une diminution significative des CTSF au Bangladesh et en Inde au cours de la période 2010-2014 et 2015-2019 respectivement. Au Myanmar, la prévalence des CTSF a augmenté de manière significative et substantielle en 2010-2014, à des niveaux plus élevés qu'au Bangladesh et en Inde. CONCLUSIONS: La prévalence des CTSF au Bangladesh, en Inde et au Myanmar est la plus élevée dans les zones rurales et chez les hommes. Des stratégies de prévention de la santé publique sont nécessaires pour maintenir la diminution des CTSF au Bangladesh et en Inde et pour inverser l'augmentation de la consommation au Myanmar.

Economic burden of underweight and overweight among adults in the Asia-Pacific region: a systematic review.

OBJECTIVE: To assess the economic burden of underweight and overweight among adults in the Asia-Pacific region. METHOD: Systematic review of articles published until March 2015. RESULTS: Seventeen suitable articles were found, of which 13 assess the economic burden of overweight/obesity and estimate that it accounts for 1.5-9.9% of a country's total healthcare expenditure. Four articles on the economic burden of underweight estimate it at 2.5-3.8% of the country's total GDP. Using hospital data, and compared to normal weight individuals, four articles estimated extra healthcare costs for overweight individuals of 7-9.8% and more, and extra healthcare costs for obese individuals of 17-22.3% and higher. CONCLUSION: Despite methodological diversity across the studies, there is a consensus that both underweight and overweight impose a substantial financial burden on healthcare systems in the Asia-Pacific region.

Household coping strategies for delivery and related healthcare cost: findings from rural Bangladesh.

OBJECTIVES: This study aims to measure the economic costs of maternal complication and to understand household coping strategies for financing maternal healthcare cost. METHODS: A household survey of the 706 women with maternal complication, of whom 483 had normal delivery, was conducted to collect data at 6 weeks and 6 months post-partum. Data were collected on socio-economic information of the household, expenditure during delivery and post-partum, coping strategies adopted by households and other related information. RESULTS: Despite the high cost of health care associated with maternal complications, the majority of families were capable of protecting consumption on non-health items. Around one-third of households spent more than 20% of their annual household expenditure on maternal health care. Almost 50% were able to avoid catastrophic spending because of the coping strategies that they relied on. In general, households appeared resilient to short-term economic consequences of maternal health shocks, due to the availability of informal credit, donations from relatives and selling assets. While richer households fund a greater portion of the cost of maternal health care from income and savings, the poorer households with severe maternal complication resorted to borrowing from local moneylenders at high interest, which may leave them vulnerable to financial difficulties. CONCLUSION: Financial protection, especially for the poor, may benefit households against economic consequences of maternal complication.

Connectedness and spillover effects of US climate policy uncertainty on energy stock, alternative energy stock, and carbon future.

Global warming is pressuring policymakers to change climate policies in shifting the global economy onto a net-zero pathway. While financial assets are responsive to policy changes and development, climate change policies are becoming increasingly unpredictable, making policy decision less certain. This study investigates connectedness and spillover effects of US climate policy uncertainty on energy stocks, alternative energy stocks, and carbon emissions futures. We analyzed spillover and connectedness before and after the Paris Agreement. We employed monthly frequency data from August 2005 to March 2021 and applied DY (2012) method and MGARCH approach. We found that world energy stocks and carbon emissions futures are connected to US climate policy uncertainty. Uncertainty in climate policy and world energy stocks act as information transmitters in return spillover, while global alternative energy and carbon market are shock receivers. On volatility spillover, climate policy uncertainty, energy stocks, and carbon emissions future are shocks transmitters, while alternative energy stocks are receivers. We observe increase in connectedness following the Paris Agreement suggesting strengthened global efforts in tackling climate change. DCC and ADCC estimations revealed spillover effects of climate policy on futures returns and volatilities of world energy stocks and carbon emissions futures and the shocks could be transmitted through to the energy sector. During period of uncertainty in US climate policy, carbon allowances can potentially serve as a safe haven for energy stocks and provide downside protection for alternative energy stocks, hence hedging against climate transition risks.

Modelling the mass consumption potential of organic food: Evidence from an emerging economy.

The deterioration of the environment, shortage of resources, and frequent occurrence of food safety issues have made people increasingly concerned about themselves while maintaining their health and protecting the environment through food. Organic food, as a healthy and eco-friendly option, is gradually gaining attention. Based on the value-belief-norm theory, this study explores why individuals consume organic food and the range of factors that lead to this consumer behavior. This study adopted a cross-sectional design and collected quantitative data from conveniently selected 300 youth participants in Bangladesh using an online survey. The findings revealed that health values and motivation have a significant positive effect on healthy eating beliefs, which, together with the awareness of the consequences, affect personal norms toward organic food consumption. Personal norms also have a significant positive effect on organic food consumption behavior among Bangladeshi youth. Finally, trust on organic food positively moderates the effect of personal norms on organic food consumption. The findings of this study are expected to foster the development of a comprehensive framework to promote programs and policies focused on organic and healthy food consumption culture among youth in developing nations.

Work design, employee well-being, and retention intention: A case study of China's young workforce.

China's growing workforce of young employees has propelled its economy towards becoming a global power. However, with evolving workplace difficulties and uncertainties, the rate of employee turnover is also rising, which affects every department in companies, in addition to impacting costs and finances. This study explored the influences of five core job characteristics, work relationships, and work conditions on young Chinese employees' retention intentions, mediated by employee well-being. Using a quantitative cross-sectional approach, 804 responses were obtained from young Chinese workers. We also employed partial least squares structural equation modeling to analyze and forecast the extent of the impact of this study's independent variables. The empirical findings revealed that job autonomy, skill variety, task significance, feedback, work relationships, and work conditions indirectly influenced the retention intentions of young workers in China, with employee well-being acting as a mediator. However, the impact of task identity on employee well-being and retention intentions was insignificant. Our study contributes to the literature on employee retention intentions by demonstrating the importance of young employees' perceptions of work design-related aspects and extending the application of the job characteristics model.

Economic consequences of maternal illness in rural Bangladesh.

We use panel data on household consumption combined with information taken from the medical records of women who gave birth in health facilities to explore the economic consequences of maternal ill health, in the context of a rural population in Bangladesh. The findings suggest that there is a large reduction in household resources associated with maternal illness, driven almost entirely by spending on health care. In spite of this loss of resources, we find that households are able to fully insure consumption against maternal ill health, although confidence intervals are unable to rule out a small effect. Households in our study area are shown to have good access to informal credit (whether it be from local money lenders or family relatives), and this appears critical in helping to smooth consumption in response to these health shocks, at least in the short term.

Costs of maternal health-related complications in Bangladesh.

This paper assesses both out-of-pocket payments for healthcare and losses of productivity over six months postpartum among women who gave birth in Matlab, Bangladesh. The hypothesis of the study objective is that obstetric morbidity leads women to seek care at which time out-of-pocket expenditure is incurred. Second, a woman may also take time out from employment or from doing her household chores. This loss of resources places a financial burden on the household that may lead to reduced consumption of usual but less important goods and use of other services depending on the extent to which a household copes up by using savings, taking loans, and selling assets. Women were divided into three groups based on their morbidity patterns: (a) women with a severe obstetric complication (n=92); (b) women with a less-severe obstetric complication (n=127); and (c) women with a normal delivery (n=483). Data were collected from households of these women at two time-points--at six weeks and six months after delivery. The results showed that maternal morbidity led to a considerable loss of resources up to six weeks postpartum, with the greatest financial burden of cost of healthcare among the poorest households. However, families coped up with loss of resources by taking loans and selling assets, and by the end of six months postpartum, the households had paid back more than 40% of the loans.

Modeling the Intention and Adoption of Wearable Fitness Devices: A Study Using SEM-PLS Analysis.

Wearable fitness devices (WFDs) are prevalent personal technology that empowers the users' management and supervision of their personal health. The current study explored the impact of health consciousness, health motivation, perceived cost, compatibility, usefulness, and perceived technology accuracy with the intention to use the WFDs. Furthermore, the users' conspicuous consumption and intention promote the usage of WFDs. A cross-sectional and quantitative research design was utilized for the current study, followed by data collection through social media and a final analysis with 1,071 samples data. The data analysis was accomplished with the partial least square regression structural equation modeling. The findings of this study revealed that the users' level of health consciousness, perceived compatibility, usefulness, perceived cost, and technology accuracy significantly influenced the intention to use WFDs. However, the conspicuous consumption and intention indicated the support for the usage behavior of the WFDs. This behavior significantly moderated the relationship between the intention and usage behavior for the WFDs. This study contributed to the theoretical realm for prompting the intention to use the WFDs with personal protection motivation that depicts the coping strategy and technology level attributes that form the intention to use WFDs. The WFDs manufacturers should therefore focus on developing WFDs features that harness usage behavior among the adults. Developing the personal responsibility to reduce the burden of the healthcare system and taking care of personal health could promote the usage of the WFDs.

Work-Life Balance, Job Satisfaction, and Job Performance of SMEs Employees: The Moderating Role of Family-Supportive Supervisor Behaviors.

Even though studies on work-life balance and family-supportive supervisor behaviors are prevalent, there are few studies in the SME setting, and the implications are yet unexplained. Thus, the study examines the effect of work-life balance on the performance of employees in SMEs, along with the mediating role of job satisfaction and the moderating role of family-supportive supervisor behaviors. We have developed a conceptually mediated-moderated model for the nexus of work-life balance and job performance. We collected data from SMEs and employed SEM-PLS to test the research hypothesis and model. Empirical results demonstrate that work-life balance positively influences job satisfaction and performance. Our empirical findings also revealed that job satisfaction partially mediates the relationship between work-life balance and job performance. We also found that when FSSB interacts with work-life balance and job satisfaction, it moderates the relationship between work-life balance and job performance and job satisfaction and job performance. Hence, our findings provide exciting and valuable insights for research and practice.

Predicting the intention to adopt wearable payment devices in China: The use of hybrid SEM-Neural network approach.

Wearable payment devices (WPD) are gaining acceptance fast and transforming everyday life and commercial operations in China. Limited research works were conducted on customers' adoption intentions to obtain a real image of the evolution of WPD in China. This study aims to investigate the effects of Performance Expectancy (PE), Effort Expectancy (EE), Social Influence (SI), Facilitating Conditions (FC), Hedonic Motivation (HM), Perceived Trust (PT), and Lifestyle Compatibility (LC) on the intention to adopt WPD among Chinese consumers by expanding unified theory of acceptance and use of technology with two impelling determinants (i.e. PT and LC). Using an online survey, empirical data were collected from 298 respondents in China. In a two-stage data analysis, partial least squares structural equation modelling (PLS-SEM) were employed to analyse the causal effects and associations between independent and dependent variables, whereas artificial neural networks (ANN) were used to evaluate the research model prediction capability. The (PLS-SEM) findings indicated that PE, SI, FC, HM, LC, and PT had substantial positive impacts on adoption intention, whilst EE had no impact on adoption intention among Chinese consumers. The ANN analysis proved the high prediction accuracy of data fitness, with ANN findings highlighting the importance of PT, FC, and PE on the intention to adopt WPD. It was suggested that the study findings assist WPD service providers and the smart wearable device industry practitioners in developing innovative products and implementing efficient marketing strategies to attract the existing and potential WPD users in China.

Toxoplasma gondii Infection Is Associated with Low Birth Weight: Findings from an Observational Study among Rural Bangladeshi Women.

Gestational Toxoplasma gondii (T. gondii) infection may cause substantial adverse effects on developing fetuses, newborns and also mothers. This study aims to estimate the seroprevalence of T. gondii among rural Bangladeshi pregnant women and determine the risk of a low birth weight (LBW). We followed a longitudinal design where 208 pregnant women were followed until the birth of their infants. Levels of IgG and IgM of T. gondii were assessed using chemiluminescent immunoassay. Modified Poisson regression was used to estimate crude and adjusted associations and multiple regression analysis was performed to understand the confounding and modifying effects of the variables. Thirty-nine (19%) children were born with LBW, among whom 15 (39%) mothers were positive for T. gondii IgG during pregnancy. After adjusting for several confounders and modifiers, pregnant women with T. gondii IgG or IgM seropositivity were significantly associated with LBW of infants (aRR: 2.00, 95% CI: 1.17-3.42). The strength of this association increased after adjusting for maternal education (aRR: 4.88, 95% CI: 1.74-13.69). The final model had an AROC of 0.84 with a sensitivity of 36% and specificity of 97%. Although causality is yet to be established, the study observed an association between T. gondii infection during pregnancy among rural Bangladeshi women and LBW of newborns.

Effect of the Integrated Management of Childhood Illness strategy on childhood mortality and nutrition in a rural area in Bangladesh: a cluster randomised trial.

BACKGROUND: WHO and UNICEF launched the Integrated Management of Childhood Illness (IMCI) strategy in the mid-1990s to reduce deaths from diarrhoea, pneumonia, malaria, measles, and malnutrition in children younger than 5 years. We assessed the effect of IMCI on health and nutrition of children younger than 5 years in Bangladesh. METHODS: In this cluster randomised trial, 20 first-level government health facilities in the Matlab subdistrict of Bangladesh and their catchment areas (total population about 350 000) were paired and randomly assigned to either IMCI (intervention; ten clusters) or usual services (comparison; ten clusters). All three components of IMCI-health-worker training, health-systems improvements, and family and community activities-were implemented beginning in February, 2002. Assessment included household and health facility surveys tracking intermediate outputs and outcomes, and nutrition and mortality changes in intervention and comparison areas. Primary endpoint was mortality in children aged between 7 days and 59 months. Analysis was by intention to treat. This study is registered, number ISRCTN52793850. FINDINGS: The yearly rate of mortality reduction in children younger than 5 years (excluding deaths in first week of life) was similar in IMCI and comparison areas (8.6%vs 7.8%). In the last 2 years of the study, the mortality rate was 13.4% lower in IMCI than in comparison areas (95% CI -14.2 to 34.3), corresponding to 4.2 fewer deaths per 1000 livebirths (95% CI -4.1 to 12.4; p=0.30). Implementation of IMCI led to improved health-worker skills, health-system support, and family and community practices, translating into increased care-seeking for illnesses. In IMCI areas, more children younger than 6 months were exclusively breastfed (76%vs 65%, difference of differences 10.1%, 95% CI 2.65-17.62), and prevalence of stunting in children aged 24-59 months decreased more rapidly (difference of differences -7.33, 95% CI -13.83 to -0.83) than in comparison areas. INTERPRETATION: IMCI was associated with positive changes in all input, output, and outcome indicators, including increased exclusive breastfeeding and decreased stunting. However, IMCI implementation had no effect on mortality within the timeframe of the assessment. FUNDING: Bill & Melinda Gates Foundation, WHO's Department of Child and Adolescent Health and Development, and US Agency for International Development.

Price perception and price appearance on repurchase intention of Gen Y: do brand experience and brand preference mediate?

The study examines the effect of price perception and price appearance on Gen Y's repurchase intention towards snack products of small and medium-sized enterprises (SMEs), along with the mediating roles of consumers' brand experience and preference. A survey method for data collection in the study used with a structured questionnaire, in which the respondents were requested to give their responses to the experiment conducted on local specialty snack products produced by SMEs. Covariance-based structural equation modeling (CB-SEM) was used to analyze the hypothesized relationships in the research model. The findings show that all the direct effects in the proposed model have a significant effect, except for the relationship between price perception and brand preference that there is no significant effect. Similarly, the mediating roles of consumer brand experience and consumer-based brand preference proved to have a significant effect. Finally, the implications of this study will be discussed further.

Household costs of healthcare during pregnancy, delivery, and the postpartum period: a case study from Matlab, Bangladesh.

A household survey was undertaken in Matlab, a rural area of Bangladesh, to estimate the costs incurred during pregnancy, delivery, and the postpartum period for women delivering at home and in a health facility. Those interviewed included 121 women who delivered at home, 120 who delivered in an ICDDR,B basic obstetric care (BEOC) facility, 27 who delivered in a public comprehensive obstetric care (CEOC) hospital, and 58 who delivered in private hospitals. There was no significant difference in total costs incurred by those delivering at home and those delivering in a BEOC facility. Costs for those delivering in CEOC facilities were over nine times greater than for those delivering in BEOC facilities. Costs of care during delivery were predominant. Antenatal and postnatal care added between 7% and 30% to the total cost. Services were more equitable at home and in a BEOC facility compared to services provided at CEOC facilities. The study highlights the regressive nature of the financing of CEOC services and the need for a financing strategy that covers both the costs of referral and BEOC care for those in need.

Effects of occupational illness on labor productivity: A socioeconomic aspect of informal sector workers in urban Bangladesh.

OBJECTIVES: The informal sector is the dominant area of employment and the economy for any developing country including Bangladesh. The cost of productivity loss due to absence from work or presenteeism with illness has rarely been examined in the Bangladesh context. This current study, therefore, attempted to examine the impact of ill health of informal sector workers on labor productivity, future earning, and healthcare-related expenditure. METHODOLOGY: A cross-sectional survey was conducted among three occupational groups of informal workers (rickshaw pullers, shopkeepers and restaurant workers) that were generally found in all urban areas in Bangladesh. A total of 557 informal workers were surveyed for this study. RESULTS: Most of the respondents (57%) reported that they had been affected by some type of illness for the last six months. The overall average healthcare expenditure of informal workers was US$48.34, while restaurant workers expended more (US$53.61). Self reported sickness absenteeism was highest (50.37days) in the case of shop keepers, followed by rickshaw pullers (49.31 days), in the last six months. Considering the income loss due to illness in the past six months, the rickshaw pullers were exposed to the highest income loss (US$197.15), followed by the shop keepers (US$151.39). CONCLUSIONS: Although the informal sector contributes the most to the economy of Bangladesh, the workers in this sector have hardly any financial protection. This study provides critical clues to providing financial and social protection to informal sector workers in Bangladesh.

Willingness-to-Pay for Community-Based Health Insurance among Informal Workers in Urban Bangladesh.

INTRODUCTION: Reliance on out-of-pocket payment for healthcare may lead poor households to undertake catastrophic health expenditure, and risk-pooling mechanisms have been recommended to mitigate such burdens for households in Bangladesh. About 88% of the population of Bangladesh depends on work in the informal sector. We aimed to estimate willingness-to-pay (WTP) for CBHI and identify its determinants among three categories of urban informal workers rickshaw-pullers, shopkeepers and restaurant workers. METHODS: The bidding game version of contingent valuation method was used to estimate weekly WTP. In three urban locations 557 workers were interviewed using a structured questionnaire during 2010 and 2011. Multiple-regression analysis was used to predict WTP by demographic and household characteristics, occupation, education level and past illness. RESULTS: WTP for a CBHI scheme was expressed by 86.7% of informal workers. Weekly average WTP was 22.8 BDT [Bangladeshi Taka; 95% confidence interval (CI) 20.9-24.8] or 0.32 USD and varied significantly across occupational groups (p = 0.000) and locations (p = 0.003). WTP was highest among rickshaw-pullers (28.2 BDT or 0.40 USD; 95% CI: 24.7-31.7), followed by restaurant workers (20.4 BDT 0.29 USD; 95% CI: 17.0-23.8) and shopkeepers (19.2 BDT or 0.27 USD; 95% CI: 16.1-22.4). Multiple regression analysis identified monthly income, occupation, geographical location and educational level as the key determinants of WTP. WTP increased 0.196% with each 1% increase in monthly income, and was 26.9% lower among workers with up to a primary level of education versus those with higher than primary, but less than one year of education. CONCLUSION: Informal workers in urban areas thus are willing to pay for CBHI and socioeconomic differences explain the magnitude of WTP. The policy maker might think introducing community-based model including public-community partnership model for healthcare financing of informal workers. Decision making regarding the implementation of such schemes should consider worker location and occupation.