Abstract
Using data from 60th round of the National Sample Survey, this study attempts to measure the incidence and intensity of ‘catastrophic’ maternal health care expenditure and examines its socio-economic correlates in urban and rural areas separately. Additionally, it measures the effect of maternal health care expenditure on poverty incidence and examines the factors associated with such impoverishment due to maternal health care payments. We found that maternal health care expenditure in urban households was almost twice that of rural households. A little more than one third households suffered catastrophic payments in both urban and rural areas. Rural women from scheduled tribes (ST) had more catastrophic head counts than ST women from urban areas. On the other hand, the catastrophic head count was greater among illiterate women living in urban areas compared to those living in rural areas. After adjusting for out-of-pocket maternal health care expenditure, the poverty in urban and rural areas increased by almost equal percentage points (20% in urban areas versus 19% in rural areas). Increasing education level, higher consumption expenditure quintile and higher caste of women was associated with increasing odds of impoverishment due to maternal health care expenditure. To reduce maternal health care expenditure induced poverty, the demand-side maternal health care financing programs and policies in future should take into consideration all the costs incurred during prenatal, delivery and postnatal periods and focus not only on those women who suffered catastrophic expenditure and plunged into poverty but also those who forgo maternal health care due to their inability to pay.
Highlights
The Millennium Development Goals (2000) have reiterated the need to reduce maternal mortality by 75%between 1990 and 2015
We made an attempt to examine the factors associated with the incidence of impoverishment due to maternal health care expenditure
It presents the distribution of mean catastrophic overshoot—a measure of intensity of catastrophic maternal health care expenditure
Summary
The Millennium Development Goals (2000) have reiterated the need to reduce maternal mortality by 75%. The question here is how large the maternal health expenditure needs to be to force a household to a state where they decide either to forgo maternal health care or sacrifice consumption of other goods (including basic needs sometimes) Such levels of health care expenditure are generally referred to as “catastrophic” [15]. Poor households generally have very little to spend on health care because most of the household resources are absorbed by items related to basic needs, such as food This catastrophic expenditure has been shown to have effects on poverty levels in many other countries [19,20,21,22].
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