Do we provide affordable, accessible and administrable health care? An assessment of SES differential in out of pocket expenditure on delivery care in India

Abstract

BackgroundReproductive and Child Health (RCH) financing is a key area of focus which can lead towards an overall empowerment of women through financial inclusion. The major objectives of this paper are: first; to examine the socio-economic differentials in Out of Pocket Expenditure (OOPE) on delivery care, second; to look into the role of insurance coverage, third; to analyse various sources of financing, and fourth; to measure the adjusted effect of various covariates on the level of OOPE. MethodsData were extracted from the National Sample Survey Organisations (NSSO), 71st round “Key indicators of social consumption in India, Health” conducted by the GoI during January to June 2014. Multivariate Generalised Linear Regression Model (GLRM) has been used to analyse the various covariates of OOPE on maternity care. FindingsMultivariate analysis has demonstrated a significant association between socioeconomic status of women and the level of OOPE on delivery care. Level of education, urban residence, higher caste and social group affiliation, strong economic conditions, and use of private facilities for the child birth among the mothers were a significant predictor of the expenditure on maternity care. ConclusionDespite various efforts by the central and state governments to reduce financial burden, still a large number of households are paying a significant amount from their own pockets. There is an immediate need to re-look in the aspects of insurance coverage and high level of OOPE in delivery care.