Faculty of Public Health - Andalas University - OCS, 13th IEA SEA Meeting and ICPH - SDev

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Gender disparity in health expenses and health financing: evidence from a national household survey in India
Pratap Kumar Jena

Last modified: 2018-08-11


Background: Gendered health expense undermines health for all strategy of universal health coverage. This study explores gender disparity in health expenses, insurance coverage and out-of-pocket payments (OOPs) owing to inpatient care in India.

Materials and methods : The national sample survey data on health consumption (NSSO-2014) was analyzed to examine gender disparity in health expenses, insurance coverage and OOPs owing to 17 broad categories of ailment excluding childbirth.

Results: Overall 19.36 and 19.81 million male and females respectively were hospitalized in the last year preceding NSSO. While infection(27.42%), injuries(16.14%), gastrointestinal(10.81%), cardiovascular(9.32%) and psychiatric(6.29%) diseases forced male for inpatient-care; Infection(24.1%), gastro-intestinal(11.6%), obstetric(9.3%), genitourinary(7.6%) and cardiovascular(7.5%) remains the cause of female inpatient care. Average total health expenses were significantly 1.2-1.7 times higher for males than female for all ailments except blood, ear and musculoskeletal ailments. Insurance coverage among male (14.7%) was significantly higher than female(9.9%). In an average male received higher financing from insurance than females except blood, respiratory and musculoskeletal ailments. The average OOPs were significantly (p<0.05) higher among males than females for infection, cancer, endocrinal, psychiatric, cardiovascular and genitourinary ailments. Gender difference in other ailments remains insignificant.

Conclusions: Gender disparity for insurance coverage, health spending and OOPs is a concern. Gender analysis of health financing indicators should be given priority while evaluating health policies and programmes.

Keywords:  Gender, ailment, inpatient care, India, health expenses