Household Expenditures on Illnesses during Infancy in a Rural Community: A Cross Sectional Study from Pondicherry
Keywords:
Out of Pocket Expenditure, OOP, Infant, health expenditure, houshold expenditureAbstract
Introduction: Health status of infants is considered as a proxy measure of socio-economic development of a nation. Although infants form a vulnerable group in any population, very few studies examined expenditure for healthcare in India in this group.
Methods: A cross-sectional community based study was conducted among households giving history of illnesses among child up to one year (i.e. born between 1st April 2012 to 31st March 2013) in selected four villages of rural Pondicherry during May-June 2013. Total 187 households were interviewed after obtaining written consent using a pre-designed questionnaire by house to house visit by the investigators.
Results: The mean direct expenditure incurred for an episode of illness was Rs.383.33±1608.18 and Rs. 508.81± 1627.09 for episodes leading to hospitalisation and non hospitalisation respectively. Mean indirect expenditure for hospitalisation and non hospitalisation episodes were Rs. 716.67±686.47 and 216.56±231.49. Whereas total expenditures incurred hospitalisation and non hospitalisation episodes were Rs.2100±1594.71 and Rs. 755.78±1716.03 respectively. Proportion of out-of-pocket expenditure was 61.0%. Private health facilities were preferred for treatment.
Conclusions: In the study area, more than half of the households in rural Pondicherry are making out of pocket expenditure on illnesses during infancy.
References
Pandve HT, Pandve TK. Primary healthcare system in In-dia: Evolution and challenges. Int J Health Syst Disaster Manage 2013;1:125-8 (Online) [cited 2014 Jul 19] Available from: http://www.ijhsdm.org/text.asp?2013/1/3/125/129126
Government of India. 11th five year plan. (Online) [Cited 2014 Jul 22] Available from http://planningcommission. nic.in/plans/planrel/fiveyr/11th/11_v2/11v2_ch3.pdf
World Health Organization: Everybody‘s business: Strengthening health systems to improve health outcomes: WHO's framework for action. Geneva: WHO Press; 2007.p 21-23
Nandraj S, Devadasan N, Singh A. Healthcare financing. In: Bhalwar R (ed.) The Textbook of Public Health And Com-munity Medicine. 1st ed. AFMC, Pune;2009. P 428
National Health Accounts Cell. National Health Accounts India 2004-05. New Delhi: Ministry of Health and Family Welfare, Government of India; 2009; pp.8-10.
UNICEF. The State of the World’s Children 2009: Maternal and Newborn Health Oxford. New York: Oxford University for UNICEF; 2009. (Online) [Cited 2014 August 08] Availa-ble from https://www.unicef.org/cotedivoire/SOWC_ 2009_.pdf
Selvaraj S, Karan A. Deepening Health Insecurity in India: Evidence from National Sample Surveys since 1980s. Eco-nomic and Political Weekly. 2009;44(40):55–60.
8 Shrivastava N, Awasthi S, Agarwal G. Care-seeking behav-ior and out-of-pocket expenditure for sick newborns among urban poor in Lucknow, northern India: a prospective fol-low-up study. [Online] [Accessed on 14 September, 2014]; Available from: http://www.ncbi.nlm.nih.gov/pmc/ arti-cles/PMC2676263/.
Joseph N, Subba S, Naik V, Mahantshetti M, Mallapur M. Morbidity among infants in South India: A longitudinal study. Indian Journal of Pediatrics 2010;77(4):p456-58.
McIntyre D, Thiede M, Dahlgren G, Whitehead M. What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts? Soc Sci Med. 2006;62:858–65
Dongre AR. Deshmukh P, Garg B. Health Expenditure and Care Seeking on Acute Child Morbidities in Peri-Urban Wardha: A Prospective Study. Indian Journal of Paediatrics 2010; 77(5): p503-7.
Khanam N, Meshram GD, Athavale AV, Goyal RC, Gupta M, Gaidhane AM. A Cross Sectional Study on Pattern of Health Care Seeking Behavior and Outof- pocket House-hold Expenditure on Curative Medical Care in Rural Cen-tral India. Natl J Community Med 2013; 4(1): 70-5.
Majumdar A, Premarajan KC, Ganesh KS, Veerakumar AM, Ramaswamy G. Rural Urban Differentials of Treatment Seeking Behaviour for Acute Respiratory Infection among Children in Puducherry. Natl J Community Med 2014: 5(3);325-8
Phadke A. The Indian Medical Association and the Clinical Establishment Act, 2010: irrational opposition to regulation. [Online] [Accessed on 14 September, 2014] Available from: http://imsear.li.mahidol.ac.th/bitstream/123456789/149564/1/ijme2010v7n4p229.pdf
Srinivasan S. Regulation and the Medical Profession. Eco-nomic & Political Weekly. 2013 Jan 19;48(3):15.
Devadasan N, Nandraj S. Health insurance in India. Plan-ning and Implementing Health Insurance Programs in In-dia: An Operational Guide, Institute of Public Health, Ban-galore: New Concept International Systems pvt. Ltd. 2006:1-2.
Reddy KS, Selvaraj S, Rao KD, Chokshi M, Kumar P, Arora V, Bhokare S, Ganguly I. A critical assessment of the exist-ing health insurance models in India. Public Health Foun-dation of India. 2011 4:1-15.
National Rural Health Mission. Guidelines for Janani-Shishu Suraksha Karyakram (JSSK). New Delhi: Govern-ment of India, Ministry of Health and Family Welfare, Ma-ternal Health Division; 2011. p. 1-40.
Tripathi N, Saini SK, Prinja S. Impact of Janani Shishu Su-raksha Karyakram on out-of-pocket expenditure among ur-ban slum dwellers in Northern India. Indian paediatrics. 2014;51(6):475-7.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
The authors retain the copyright of their article, with first publication rights granted to Medsci Publications.
