Cost and Utilisation of Hospital Based Delivery Care in Empowered Action Group (EAG) States of India
Large scale investment in the National Rural Health Mission is expected to increase the utilization and reduce the cost of maternal care in public health centres in India. The objective of this paper is to examine recent trends in the utilization and cost of hospital based delivery care in the Empowered Action Group (EAG) states of India. The unit data from the District Level Household Survey 3, 2007–2008 is used in the analyses. The coverage and the cost of hospital based delivery at constant price is analyzed for five consecutive years preceding the survey. Descriptive and multivariate analyses are used to understand the socio-economic differentials in cost and utilization of delivery care. During 2004–2008, the utilization of delivery care from public health centres has increased in all the eight EAG states. Adjusting for inflation, the household cost of delivery care has declined for the poor, less educated and in public health centres in the EAG states. The cost of delivery care in private health centres has not shown any significant changes across the states. Results of the multivariate analyses suggest that time, state, place of residence, economic status; educational attainment and delivery characteristics of mother are significant predictors of hospital based delivery care in India. The study demonstrates the utility of public spending on health care and provides a thrust to the ongoing debate on universal health coverage in India.
KeywordsIndia EAG states NRHM Cost of delivery
- 1.Ministry of Health and Family Welfare (MOHFW), & Government of India. (2005). National Rural Health Mission (2005–2012), Mission document. Accessed through http://mohfw.nic.in/NRHM/Documents/Mission_Document.pdf.
- 2.Ministry of Health and Family Welfare (MOHFW), & Government of India. (2009). National Health Accounts India 2004–2005.Google Scholar
- 3.High Level Expert Group. (2011). High Level Expert Group Report on Universal Health Coverage for India, (New Delhi).Google Scholar
- 4.Ministry of Health and Family Welfare (MOHFW), & Government of India. (2006). Maternal Health Division, New Delhi. Janani Suraksha Yojana: Features & frequently asked questions and answers. New Delhi: Ministry of Health and Family Welfare, Government of India. Accessed March 8, 2012.Google Scholar
- 5.Jones, N., Samuels, F., Gisby, L., & Presier-Marshall, E. (2011). Rethinking cash transfers to promote maternal health: Good practice from developing countries. Background Note, Overseas Development Institute.Google Scholar
- 6.Rowlings, L. B., & Rubio, G. M. (2005). Evaluating the Impact of conditional cash transfer programs. International Bank for Reconstruction and Development. Oxford: The World Bank, OUP.Google Scholar
- 10.Skordis-Worrall, J., Pace, N., Bapat, U., Das, S., More, N. S., Joshi, W., Pulkki-Brannstron, A. M., Osrin, D. (2011). Maternal and neonatal health expenditure in Mumbai slums (India): A cross sectional study. BMC Public Health. Accessed through www.biomedcentral.com/content/pdf/1471-2458-11-150.pdf.
- 11.Sharma, S., Smith, S., Pine, M., & Winfrey, W. (2005). Formal and informal Reproductive Healthcare User Fees in Uttaranchal, India. Washington: United States Agency for International Development.Google Scholar
- 13.International Institute for Population Sciences (IIPS). (2010). District level household and facility survey (DLHS-3), 2007–08. Mumbai, India: International Institute for Population Sciences.Google Scholar
- 14.Union Budget and Economic Survey. (2012–2013). Annual Financial Statement. Accessed through http://indiabudget.nic.in/afs.asp, on June 12, 2012.
- 15.Mohanty, S. K. (2009). Alternate wealth index and health estimates in India. Genus, 65(2), 113–137.Google Scholar
- 16.Ministry of Finance, Government of India. (2009). Economic Survey 2008–09. New Delhi: Oxford University Press.Google Scholar
- 21.Khan, M. E., Hazra, A., & Bhatnagar, I. (2010). Impact of Janani Suraksha Yojana on selected family health behaviour in rural Uttar Pradesh. The Journal of Family Welfare, 56(Special Issue), 9–22.Google Scholar
- 22.Office of the Registrar General of India (ORGI). (2011). Special bulletin on maternal mortality in India 2007–09. New Delhi, India: Office of the Registrar General.Google Scholar
- 24.Ministry of Health and Family Welfare (MOHFW), & Government of India. (2011). Report of the working group on Drugs & Food Regulations. Accessed through http://planningcommission.nic.in/aboutus/committee/wrkgrp12/health/WG_4drugs.pdf.