Out of Pocket Expenditure and Utilization of Government Financial Assistance Among Women Who Had Institutional Delivery in An Urban Slum of Telangana, India

Authors

  • Pavani Varma Apollo Institute of Medical Sciences and Research (AIMSR) Hyderabad, Telangana, India
  • Anu Mohandas Apollo Institute of Medical Sciences and Research (AIMSR) Hyderabad, Telangana, India
  • Siddu Anushruthi Apollo Institute of Medical Sciences and Research (AIMSR) Hyderabad, Telangana, India
  • Nagalla Balakrishna Apollo Institute of Medical Sciences and Research (AIMSR) Hyderabad, Telangana, India
  • Snigdha Pattnaik Apollo Institute of Medical Sciences and Research (AIMSR) Hyderabad, Telangana, India
  • Dilip Mathai Apollo Institute of Medical Sciences and Research (AIMSR) Hyderabad, Telangana, India
  • Biranchi Narayan Das Apollo Institute of Medical Sciences and Research (AIMSR) Hyderabad, Telangana, India

DOI:

https://doi.org/10.55489/njcm.140920233017

Keywords:

Out of pocket expenditure, OOPE, financial assistance, institutional delivery, urban slum

Abstract

Background: Out of Pocket Expenditure (OOPE) are expenditures directly made by households at the point of receiving health care. In Telangana State the average OOPE per delivery in public health facility is Rs. 3846. The study helps to know the OOPE among mothers undergoing institutional deliveries and emphasise on the expenditure even after utilising the government financial assistance.

Objectives: To estimate the OOPE among women undergoing institutional delivery and to find its association with government financial assistance utilization and socio-demographic factors.

Methodology: A community based cross sectional study was done among 200 mothers who delivered recently residing in an urban slum under our health and training centre. Ethical clearance was taken before the conduct of study.

Results: The median direct out of pocket expenditure among mothers in our study was Rs.500 i.e., 6.6 $ (0 to 1600). OOPE was present among 68.5% of mothers. Availability of government financial assistance, age and occupation of the mother and type of delivery was found to be significantly associated with p value <0.05.

Conclusion: The financial assistance definitely reduced the burden of OOPE among the mothers. The implementation of such schemes is important and needs to be evaluated time to time to ensure proper reach of its benefits to the community.

References

National Health Accounts Technical Secretariat. National Health Systems Research Centre. National Health Accounts Estimates: 2019-20. Ministry of Health and Family Welfare, Government of India: 2021.

Wagstaff A, Flores G, Hsu J, Smitz MF, Chepynoga K, Buisman LR, etal. Progress on catastrophic health spending in 133 countries: a retrospective observational study. The Lancet Global Health. 2018 Feb 1;6(2):e169-79. Doi: https://doi.org/10.1016/S2214-109X(17)30429-1 PMid:29248367

Mishra S, Mohanty SK. Out-of-pocket expenditure and dis-tress financing on institutional delivery in India. Internation-al journal for equity in health. 2019 Dec;18(1):99. Doi: https://doi.org/10.1186/s12939-019-1001-7 PMid:31238928 PMCid:PMC6593606

National Health Accounts Technical Secretariat. National Health Systems Research Centre. National Health Accounts Estimates: 2004-05. Ministry of Health and Family Welfare, Government of India: 2009.

International Institute for Population Sciences (IIPS) and ICF. 2021. National Family Health Survey (NFHS-5), 2019-21:State Fact Sheet. Telangana-Key indicators,India. Mumbai: IIPS.

World Health Organisation. Sustainable Developmental Goal: Overview and SDG 3. World Health Organisation. Geneva; 2015.

World Health Organisation. Universal Health Coverage: How can countries make progress. World Health Organisation. Ge-neva; 2021.

World Health Organisation. Millennium Developmental Goal: Overview: World Health Organisation. Geneva; 2000.

Janani Suraksha Yojana: Nationa Health Mission. Available at : https://www.nhm.gov.in/index1.php?lang=1&level=3&sublinkid=841&lid=309. Accessed on August 18th, 2022

KCR Kit: Hyderabad District: Government of Telangana; Sept 2017-July 2022. Available at https://hyderabad.telangana. gov.in/scheme/kcr-kit/. Accessed on August 20th 2022.

Ambade M, Sarwal R, Mor N, Kim R, Subramanian SV. Compo-nents of Out-of-Pocket Expenditure and Their Relative Con-tribution to Economic Burden of Diseases in In-dia. JAMANetwOpen. 2022;5(5):e2210040. Doi: https://doi.org/10.1001/jamanetworkopen.2022.10040 PMid:35560051 PMCid:PMC9107026

International Institute for Population Sciences (IIPS) and ICF. 2016. National Family Health Survey (NFHS-4), 2015-16: In-dia. Mumbai: IIPS.

International Institute for Population Sciences (IIPS) and ICF. 2016. District Family Health Survey (DFHS-5), 2015-16: State Fact Sheet. Telangana-Key indicators. India. Mumbai: IIPS.

Sahu KS, Bharati B. Out-of-Pocket health expenditure and sources of financing for delivery, postpartum, and neonatal health in urban slums of Bhubaneswar, Odisha, India. Indian J Public Health 2017;61:67-73.

Skordis Worrall J, Pace N, Bapat U, Das S, More NS, Joshi W, et al. Maternal and neonatal health expenditure in Mumbai slums (India): A cross sectional study. BMC Public Health 2011;11:150. Doi: https://doi.org/10.1186/1471-2458-11-150 PMid:21385404 PMCid:PMC3061914

Gupta N. Out of pocket expenditure in health care; result of study in five states of India. Rajasthan: Prayas; 2011.

Das S, Sundaramoorthy L, Bhatnagar T. Out-of-pocket ex-penditure for delivery at home and public health facilities in the context of conditional cash transfer and free delivery care programs: An analytical cross-sectional study in South 24 Parganas district, West Bengal, India, 2017. Clinical Epidemi-ology and Global Health. 2020 Dec 1;8(4):1395-401. Doi: https://doi.org/10.1016/j.cegh.2020.06.007

Issac A, Chatterjee S, Srivastava A, Bhattacharyya S. Out of pocket expenditure to deliver at public health facilities in In-dia: a cross sectional analysis. Reproductive health. 2016 Dec;13(1):1-9. Doi: https://doi.org/10.1186/s12978-016-0221-1 PMid:27557904 PMCid:PMC4997742

Modugu : State and socio-demographic group variation in out-of-pocket expenditure, borrowings and Janani Suraksha Yojana (JSY) programme use for birth deliveries in India. BMC Public Health 2012; 12:1048. Doi: https://doi.org/10.1186/1471-2458-12-1048 PMid:23217140 PMCid:PMC3570391

Mondal J, Mukhopadhyay DK, Mukhopadhyay S, Sinhababu A. Does Janani Shishu Suraksha Karyakram ensure cost-free in-stitutional delivery? A cross-sectional study in rural Banku-ra of West Bengal, India. Indian J Public Health 2015;59:279-85. Doi: https://doi.org/10.4103/0019-557X.169655 PMid:26584167

Goli, Srinivas; Rammohan, Anu; Moradhvaj.Out-of-pocket ex-penditure on maternity care for hospital births in Uttar Pra-desh, India. Health Economics Review. Springer, Heidel-berg.2018; 8(5): 1-16. ISSN 2191-1991. Doi:https://doi.org/10.1186/s13561-018-0189-3 PMid:29484490 PMCid:PMC5826910

Gupt A, Kaur P, Kamraj P, Murthy BN. Out of Pocket Expendi-ture for Hospitalization among Below Poverty Line House-holds in District Solan, Himachal Pradesh, India. PLoS ONE. 2016;11 (2): e0149824. Doi: https://doi.org/10.1371/journal.pone.0149824 PMid:26895419 PMCid:PMC4764511

Downloads

Published

2023-09-01

How to Cite

1.
Varma P, Mohandas A, Siddu Anushruthi, Nagalla Balakrishna, Pattnaik S, Mathai D, Das BN. Out of Pocket Expenditure and Utilization of Government Financial Assistance Among Women Who Had Institutional Delivery in An Urban Slum of Telangana, India. Natl J Community Med [Internet]. 2023 Sep. 1 [cited 2024 Nov. 29];14(09):575-80. Available from: https://njcmindia.com/index.php/file/article/view/3017

Issue

Section

Original Research Articles