AccScience Publishing / GHES / Online First / DOI: 10.36922/GHES025160033
BRIEF REPORT

Understanding health insurance coverage and its socio-demographic associations among women in Bangladesh: Evidence from the 2022 Bangladesh Demographic and Health Survey

Md Fuad Al Fidah1* Md Ridwan Islam2 Sharif Mohammad3
Show Less
1 Research Wing, Bibliophile, Dhaka, Bangladesh
2 Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
3 Department of Respiratory Medicine, Asgar Ali Hospital, Dhaka, Bangladesh
Received: 15 April 2025 | Revised: 23 June 2025 | Accepted: 24 June 2025 | Published online: 7 July 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Health insurance is vital for healthcare financing and aligns with the 2030 Sustainable Development Goal agenda. Women of reproductive age face unique barriers to affordable care due to higher health risks and caregiving responsibilities. This study aims to estimate the proportion of women with health insurance coverage (HIC) and to identify factors associated with such coverage. Data were drawn from the latest round of the Bangladesh Demographic and Health Survey 2022, comprising a total sample of 19,987 women. Unadjusted odds ratios (UORs) with 95% confidence intervals (CIs) were reported. The median age of the women was 32.0 years (interquartile range: 25.0 – 39.0). Only 0.3% of respondents reported having HIC. The odds of having HIC were significantly higher among the women in the study who had an account with a bank or other financial institution (UOR: 2.27; 95% CI: 1.36 – 3.79), those with post-secondary education (either themselves or their husbands), those in the richest wealth quintile (UOR: 3.32; 95% CI: 1.45 – 7.60), and those with adequate media exposure (UOR: 2.78; 95% CI: 1.41 – 5.47). The study highlights the need for promoting higher education for both sexes, addressing wealth-based disparities, and leveraging mass media to increase the uptake of HIC.

Keywords
Health insurance
Women
Reproductive age
Bangladesh
Bangladesh demographic and health survey 2022
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
References

Al Fidah, M.F., Haider, T., Roy, D., Hossain, M.E., & Efa, S.S. (2024). Temporal trends of diarrheal diseases and associated treatment responses among children aged under five: Insight from the multiple indicator cluster surveys from 2006 to 2019. Pediatrics Neonatology, 66:203-208. https://doi.org/10.1016/j.pedneo.2024.03.010

 

Al Fidah, M.F., Islam, M.R., Rahman, M.M., Chisti, M.J., Faruque, A.S.G., Ahmed, T., et al. (2025). Community-level expenses for under-5 diarrhoeal cases prior to reporting at Dhaka hospital: A cross-sectional analysis in Bangladesh. Clinical Epidemiology Global Health, 31:101846: https://doi.org/10.1016/j.cegh.2024.101846

 

Caley, M., & Sidhu, K. (2011). Estimating the future healthcare costs of an aging population in the UK: Expansion of morbidity and the need for preventative care. Journal Public Health (Oxford), 33(1):117-122. https://doi.org/10.1093/pubmed/fdq044

 

Chauluka, M., Uzochukwu, B.S.C., & Chinkhumba, J. (2022). Factors associated with coverage of health insurance among women in Malawi. Frontiers Health Services, 2:780550. https://doi.org/10.3389/frhs.2022.780550

 

Croft, T.N., Allen, C.K., & Zachary, B.W. (2023). Guide to DHS Statistics. ICF. Available from: https://www.dhsprogram.com/pubs/pdf/dhsg1/guide_to_dhs_statistics_dhs-8.pdf [Last accessed on 2025 Apr 13].

 

Dowou, R.K., Atanuriba, G.A., Adzigbli, L.A., Balame, S.K., Tahidu, I., Aggrey-Korsah, J., et al. (2024). Determinants of health insurance coverage among women in Mauritania: A multilevel analysis. BMC Public Health, 24(1):229. https://doi.org/10.1186/s12889-024-17691-y

 

Ewerling, F., Raj, A., Victora, C.G., Hellwig, F., Coll, C.V., & Barros, A.J. (2020). Swper global: A survey-based women’s empowerment index expanded from Africa to all low- and middle-income countries. Journal Global Health, 10(2):020434. https://doi.org/10.7189/jogh.10.020434

 

Field, E., Pande, R., Rigol, N., Schaner, S., & Moore, C.T. (2021). On her own account: How strengthening women’s financial control impacts labor supply and gender Norms. American Economic Review, 111(7):2342-2375. https://doi.org/10.1257/aer.20200705

 

Health Economics Unit and MoHFW. (2025). Health Insurance. URL: Bangladesh National Portal. Available from: https://heu.gov.bd/site/page/2a89bd26-1b0b-4c33-84a5-bb486d92 dc8c/http%3a%2f%2fheu.gov.bd%2fsite%2fpage%2f2a89bd26-1b0b-4c33-84a5-bb486d92d c8c%2f [Last accessed on 2025 Apr 13].

 

Huq, N.M., Al-Amin, A.Q., Howlader, S.R., & kabir, M.A. (2015). Paying out of pocket for healthcare in Bangladesh - a burden on poor? Iranian Journal Public Health, 44(7):1024-1025.

 

Kansanga, M.M., Asumah Braimah, J., Antabe, R., Sano, Y., Kyeremeh, E., & Luginaah, I. (2018). Examining the association between exposure to mass media and health insurance enrolment in Ghana. International Journal Health Planning Management, 33(2):e531-e540. https://doi.org/10.1002/hpm.2505

 

Kessy, S.A., Tibenderana, J.R., Gimonge, J., & Moshi, F.V. (2024). Determinants of healthcare insurance coverage among women of reproductive age in Tanzania: A multilevel mixed effect analysis. PLoS One, 19(12):e0302806. https://doi.org/10.1371/journal.pone.0302806

 

NIPORT and ICF. (2023). Bangladesh Demographic and Health Survey 2022. Bangladesh: NIPORT.

 

Paul, P. (2024). Bangladesh’s Insurance Landscape: Progress and Prospects. URL: The Daily Star. Available from: https://www.thedailystar.net/supplements/national-insurance-day-2024/ news/bangladeshs-insurance-landscape-progress-and-prospects-3556131 [Last accessed on 2025 Apr 13].

 

Peduzzi, P., Concato, J., Kemper, E., Holford, T.R., & Feinstein, A.R. (1996). A simulation study of the number of events per variable in logistic regression analysis. Journal Clinical Epidemiology, 49(12):1373-1379. https://doi.org/10.1016/S0895-4356(96)00236-3

 

Shao, L., Wang, Y., Wang, X., Ji, L., & Huang, R. (2022). Factors associated with health insurance ownership among women of reproductive age: A multi country study in sub-Saharan Africa. PLoS One, 17(4):e0264377. https://doi.org/10.1371/journal.pone.0264377

 

Tsala Dimbuene, Z., Muanza Nzuzi, R., & Nzita Kikhela, P.D. (2022). Poverty, education and health insurance coverage among women of reproductive ages in the democratic republic of the Congo: A cross-sectional and multilevel analysis. BMJ Open, 12(12):e064834. https://doi.org/10.1136/bmjopen-2022-064834

Share
Back to top
Global Health Economics and Sustainability, Electronic ISSN: 2972-4570 Print ISSN: 3060-8546, Published by AccScience Publishing