Distress financing in coping with out-of-pocket expenditure for maternity care in India

Autor: Shalem Balla, Md Illias Kanchan Sk, Mayanka Ambade, Babul Hossain
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: BMC Health Services Research, Vol 22, Iss 1, Pp 1-14 (2022)
Druh dokumentu: article
ISSN: 1472-6963
DOI: 10.1186/s12913-022-07656-5
Popis: Abstract Background The cost of maternity care is seen as the barrier in utilizing maternity care, resulting in high maternal deaths. This study focuses on the distress financing and its coping mechanisms associated with maternity care expenditure in India so that corrective measures can be taken to reduce the burden of maternity care. Methods This study used the National Sample Survey (NSS) data conducted in 20,014–15 (71st round of NSS) and 2017–18(75th round of NSS). We define distress financing as use of formal borrowing, borrowing from friends or family or sale of asser to finance maternity care. Percentage of pregnant/delivered females using distress financing were calculated.. The present study also used multinomial logistic regression with 95% to understand the impact of socio-economic variables on distress financing and concentration index to measure the inequality in maternity care expenditure. Results This study found that the maternity care expenditure has decreased from the INR. 9379 in 2014–15 to INR. 7835 in 2017–18. The percentage of households using distress financing is higher among the poorest (13.2%). Almost 14% of the SC households experience distress financing. Among EAG + A states, particularly in Madhya Pradesh and Uttarakhand, the percentage of households are which experience a high level of distress financing increased from 8.9 to 18.3 and 0.7 to 8.1 from 2014–15 to 2017–18 respectively. The study finds that more urban households (37%) utilized insurance than rural households (26%). Among EAG + A states, 67.9 percent of households were dependent upon household savings, and it was 63.6 percent in the non-EAG states. The households with a high burden of maternity care expenditure were at higher risk of borrowing money to finance the cost of maternity as compared to use of savings/income for the same (relative risk (RR) (R: 2.59; P
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