MPhil Thesis

Interlinkages between Chronic Illness and Urban Poverty in Bangladesh

2026-04-21T00:00:00Z

Interlinkages between Chronic Illness and Urban Poverty in Bangladesh Begum, Azima Bangladesh is now in an advanced stage of the epidemiologic transition, and in the upcoming years, the burden of chronic illness will continue to rise. As chronic illnesses are the leading cause of death globally, and Out-Of-Pocket (OOP) payments for healthcare have been increasing steadily in Bangladesh, which pushes the households into poverty by catastrophic health expenditure (CHE), it is an urgent issue to investigate this area. Therefore, this study aims to identify the determinants of chronic illnesses and examine the interlinkages between chronic illness and poverty in Bangladesh, especially from an urban perspective. The study is conducted using the nationally representative and the latest Household Income and Expenditure Survey (HIES) 2022. The Cost of Basic Needs (CBN) approach is used for estimating the poverty line. Moreover, this study has estimated the poverty impact of OOP payments (i.e., impoverishment due to OOP healthcare expenditure) by comparing the difference between the average level of headcount poverty with and without OOP healthcare payments. Probit regression models are employed to identify the determinants of chronic illness and impoverishment due to OOP healthcare payments. This study identifies that approximately one-third of the urban population (29.17%) and approximately two-thirds of urban households (71.37%) in Bangladesh suffer from at least one chronic illness. Among the households with chronic illness, 33.6% are found with one chronic illness, 25.9% with two chronic illnesses, and 11.9% with more than two chronic illnesses. The most prevalent chronic illnesses include gastric/ulcer (8.28%), high blood pressure (8.01%), diabetes (5.06%), arthritis/ rheumatism (3.96%), and chronic heart disease (3.13%). The prevalence of chronic illnesses rises with age. The prevalence is only 5.11% among children aged 0–12 years, whereas it is 77.14% among the elderly (65+ years), suggesting a strong linkage between chronic health issues and aging. Gender-specific findings reveal the higher prevalence of chronic illnesses among women compared to men (male: 31.69% vs. female: 26.65 %). The prevalence is much higher among the formerly married individuals—those who are widowed, divorced, or separated— in comparison with the currently married individuals (formerly married: 68.78% vs. currently married 43.25 %). The highest prevalence is found for the households belonging to the highest income quantile (78.04%). The mean age in a household, the share of dependent members, households with a never married, widowed, divorced, or separated, proportion of literate members, and households belonging to higher income quantiles are positively and significantly associated with the presence of chronic illness. Whereas the proportion of earners in the household has a strong negative relationship, the female proportion in the household has no significant relationship with chronic illness. In urban areas, the overall OOP healthcare expenditure per month per household stands at BDT 2,503; however, the figure is significantly higher (BDT 2,980) among households that report having at least one chronic illness compared to those with no chronic illness (BDT 1,002). The share of OOP health expenditure in total household expenditure is more than double among the urban households that are suffering from at least one chronic illness (7.5%) compared to those 6 who are not suffering from any chronic disease (3.5%). Lower-income households faces higher OOP burden (21.26% of household income) compared to the highest income households (3.96%). Notably, the prevalence of CHE is alarmingly high (70.51%) among the urban households with at least one chronic illness compared to those who report having no chronic illness (29.49%), at 10% of total expenditure as the threshold level, indicating that chronic illnesses significantly increase financial vulnerability. About 2.77 percent of households fall into poverty due to OOP healthcare expenditure in urban areas in Bangladesh. Households with at least one member suffering from a chronic illness are 3.5 percentage points more likely to fall into poverty (p<0.01) in comparison to households without any members experiencing chronic illnesses. Moreover, the impoverished households are 24.2 percentage points more likely to have a chronic illness (p<0.01), which indicates that poverty enhances the risk of chronic disease. Moreover, households with at least one member suffering from a chronic illness are affected by a substantially higher impoverishment rate due to OOP health spending (3.40%), nearly three times higher than that of households without chronic illnesses (1.22%). Similar findings are also evident for normalized poverty gap as the households that face chronic illness has greater normalized poverty gap (4.29%), which is almost double than who have no chronic illness (2.31%). Thus, the findings from the Probit regression models reveal a strong interlinkage between chronic illness and poverty in urban Bangladesh.The study findings suggest that chronic illnesses are responsible for high costs, high catastrophic expenditures, and vulnerability to households (i.e., non-poor households become poor due to OOP healthcare expenditure) in urban areas in Bangladesh. The government and non-government health organizations need to address this urgently by paying proper attention to handling the burden of chronic disease in Bangladesh. An effective risk pooling mechanism might reduce household financial burden related to chronic illnesses. It is essential to take urban health protection schemes that target vulnerable urban populations to ensure that healthcare services are accessible and affordable, especially for chronic illnesses, in line with the Bangladesh National Urban Health Strategy. Some insights determined from this Bangladesh case study can also be useful in the context of other developing countries, to reduce chronic illnesses and thereby reduce the likelihood of falling into poverty, especially for urban areas. This thesis is submitted for the degree of Master of Philosophy.

Foreign Direct Investment and the Pollution Haven Hypothesis: Evidences from Bangladesh

2025-07-08T00:00:00Z

Foreign Direct Investment and the Pollution Haven Hypothesis: Evidences from Bangladesh Chowdhury, Tonmoy This study investigates the potential existence of the Pollution Haven Hypothesis (PHH) in Bangladesh. The objective is to examine the impact of lax environmental policies on foreign direct investment (FDI) inflows and evaluate the subsequent effects of these inflows on pollution levels within the country. Employing both quantitative and qualitative approaches, the analysis incorporates the Johansen cointegration test, Vector Error (VECM), and Granger causality test, complemented by Key Informant Interviews (KII) with 12 experts. The Johansen cointegration test identifies a long-run relationship between CO2 emissions and FDI inflows, though this connection lacks statistical robustness. The VECM results suggest that FDI inflows are shaped by a combination of economic and environmental factors, with inflation emerging as a significant deterrent. The Granger causality test reveals no significant causal relationships between FDI and CO2 emissions, inflation, or trade openness, although FDI significantly impacts GDP per capita and electric power consumption. The qualitative findings emphasize low labour costs, market size, and geopolitical considerations as key determinants of FDI, while concerns are raised about the environmental risks posed by FDI in polluting industries. Overall, the study has found limited evidence in support of the pollution haven hypothesis (PHH) in Bangladesh, concluding that weak environmental regulations are not the primary factor attracting FDI in Bangladesh. The study advocates for strengthened environmental enforcement, the diversification of FDI into less polluting sectors, and the promotion of cleaner technologies to achieve sustainable industrial growth without compromising environmental integrity. This thesis is submitted for the degree of Master of Philosophy.

Sustainable Industrialization in Bangladesh: A Case Study of the Ready-Made Garments and the Leather Industries

2025-02-05T00:00:00Z

Sustainable Industrialization in Bangladesh: A Case Study of the Ready-Made Garments and the Leather Industries Islam, Sadia The world has already witnessed by the massive growth and this boom of economy brought detrimental changes in environmental quality. Due unplanned industrial development, the environment is losing its own balance. There is anxiety about the future of the world. So, to solve this problem the world need to find out some solutions. The world needs a kind of development process which will increase economic growth, but without harming the balance of the environment. Moreover, Sustainable development is a universally agreed development process to address all these challenging issues. Considering these issues the main goal of the study was to find out the prospects of Bangladesh to promote sustainable industrialization by 2030, and to examine the impact of the eco-innovation in the environmental sustainability performance to formulate long term policy for sustainable industrialization program. The nature of the work demands the collection and analysis of both primary and secondary data. Hence, to project how close the Bangladesh to achieve the target of SDG 9.2, this study considers indicator 9.2.1a and 9.2.1b. To forecast the country’s overall progress related with sustainable industrialization this study use ARIMA model and after forecasting the value this paper found that the manufacturing value added as a percentage of GDP will be 21.26 percent and Manufacturing value added per capita (in USD) for the year 2030 will be 354.33 USD in Bangladesh by 2030. This study found that indicator 9.2.1a is still far from achieving the target of manufacturing share of GDP by 2030. However, from the forecasting value of indicator 9.2.1.b this paper can claim that, the forecasted value USD 354.33 is very close to the targeted value USD 360.96. To fulfill the second specific objective, this study collected data from the manufacturing sector (RMG industry and Leather industry). The questionnaire was collected and complied from different important documents from the literature reviewed, but considering the data collection problem (during this Covid-19 pandemic), the study used only total 50 RMG and leather industries for collection of primary data. The collected data from the questionnaire survey was analyzed both by factor analysis to form an index for environmental sustainability performance, eco-innovation and eco-process innovation. The Classical Liner Regression Model was employed to prove the hypotheses. From the descriptive analyses of the study it is found that, eco-innovation concentrated on the reduction of materials use, reduction of energy use, reduction of pollution and replacing of materials with less polluting substitutes. The empirical result of this study has shown the eco- innovation has a positive relationship with environmental sustainability performance in the case of the manufacturing sector and also in the case of RMG sector of the Bangladesh. Specifically, from the empirical results it was found that eco-product innovation has a positive impact on environmental sustainability performance, but the eco-process innovation does not have any positive impact on environmental sustainability performance in the case of overall manufacturing industry and as well as RMG industry. But due to the inappropriateness of the data for factor analysis this study could not able to identify the impact of eco-innovation in the case of the leather sector. Therefore, for the implementation of sustainable industrialization in the manufacturing sector of the Bangladesh, it is necessary to implement various policies and programs covering all these factors. A Thesis submitted as a requirement for the degree of Master of Philosophy in Economics.

Relevance of export expansion and import substitution strategies for industrialization in Bangladesh

2024-03-20T00:00:00Z

Relevance of export expansion and import substitution strategies for industrialization in Bangladesh Imdad, Mohammed Parvez This thesis submitted for the degree of Master of Philosophy.