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Background: Cost of getting health services is a major concern in Bangladesh as well as in many other countries. A family has to bear more than half of the health care cost despite many facilities provided by the public hospitals. This out-of-pocket (OOP) expenditure drives many families under the poverty line. The aim of this study was to find out the exact cost incurred by the family for a surgical operation of their child in the public and private sectors in Bangladesh.Methods: A cross-sectional study was conducted to find out the cost of child surgery in different settings of public and private hospitals in Chittagong division, Bangladesh. Cost of herniotomy was then compared across different settings.Results: In this study, cost of operation in urban private hospitals was highest mostly due to surgeon and anesthetist fee. The cost was lowest in outreach programs as surgeon fee, anesthetist fee and accommodation cost was nil; food and transport cost was minimum. However, cost of accommodation, food, transport and medicine contributed significantly to OOP expenditure especially in tertiary-level public hospitals, in both indoor and day care settings, and also in private urban hospitals.Conclusions: Our study provides some insight into the OOP expenditure in different health care settings in Bangladesh. This study might be useful in developing a strategy to minimize the OOP expenditure in this country. [ABSTRACT FROM AUTHOR]