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Financial hardship in accessing inpatient care for childbirth and newborn sickness in India: Results from a national household survey
kavitha ak, Pratap Kumar Jena

Last modified: 2018-08-20


Background: In the context of out-of-pocket payments (OOPs) being the major source of health financing in India, this study explores the financial burden due to hospitalization for childbirth and sick-newborn-care.

Materials and methods: Using R-Survey design package, the National Sample Survey Organization(NSSO-2014) data on Indian healthcare expenses was analyzed. The OOPs, catastrophic-health-expenses (CHE) at 10% level of household annual expenses, and distress-health-financingwere analyzed.

Results:The average OOPs due to sick newborn inpatient care(INR17,470.7) was higher than that of child birth(INR9647.2). Out-of-pocket payments constituted more than half of the total health expenses in 99.2% and 99.8% cases for childbirth and sick-newborn inpatient-care respectively.The childbirth and sick-newborn inpatient-care had resulted in CHE among 27.6%(CI:26-29%) and 36%(CI:27-44%) of households respectively. Childbirth and sick-newborn care together resulted in CHE among 70.2% of households. About 16%(CI:15-18%) and 33%(CI:23-41%) of households had suffered from distress-health-financing owing to childbirth and sick-newborn inpatient care respectively. Regression model suggests variation in independent predictors (care-level, sector, social-group, religion, insurance-coverage, household-size) of CHEdue to childbirthor newborn-care.

Conclusions:High catastrophic expenses despite of flagship programme for mother and newborn and its further contextual variation a concern. Urgent implementation of people-centric contextual interventions for financial security is needed.


Acknowledgements: Prof.Dr. Ambarish Dutta and Prof. Dr. S K Satpathy (Director), KIIT School of Public Health, KIIT Deemed to be University, Bhubaneswar, India

Keywords:  Out-of-pocket expenditure, catastrophic health expenses, child births, sick new-born, inpatient care