Unlike other low- and middle-income countries, infectious diseases are still predominant, and non-communicable diseases (NCDs) are emerging without replacing the burden of infectious diseases in India, where it is imposing a double burden of diseases on households in the country. This study aimed to analyse the socio-economic and demographic differentials in the magnitude of economic burden and coping strategies associated with health expenditure on infectious diseases in India. National Sample Survey Organization (NSSO) data on “Key Indicators of Social Consumption in India: Health, (2017–18)” have been employed in this study. The findings of the study revealed that more than 33% of the individuals are still suffering from infectious diseases out of the total ailing population in India. Based on the various socio-economic and demographic covariates, infectious diseases are highly prevalent among individuals with marginalized characteristics, such as individuals residing in rural areas, females, 0–14 age groups, Muslims, illiterates, scheduled tribes (STs), and scheduled castes (SCs), large family households, and economically poor people in the country. The per capita out-of-pocket (OOP) expenditure on infectious diseases is INR 7.28 and INR 29.38 in inpatient and outpatient care, respectively. Whereas, monthly per patient OOP expenditure on infectious diseases by infection-affected populations is INR 881.56 and INR 1,156.34 in inpatient and outpatient care in India. The study found that people residing in rural areas, SCs followed by other backward classes (OBCs), illiterates, poor, and very poor are more dependent on borrowings, sale of assets, and other distressed sources of financing. However, under National Health Policy 2017, many initiatives, such as “Ayushman Bharat,” PM-JAY, and National Digital Health Mission (NDHM) in 2021, have been launched by the government of India in the recent years. These initiatives are holistically launched for ensuring better health facilities, but it is early to make any prediction regarding its outcomes; hopefully, the time will define it over the passing of a few more years. Finally, the study proposed the need for proper implementations of policy initiatives, awareness against unhygienic conditions and contamination of illnesses, immunisations/vaccination campaigns, subsidized medical facilities, and the country's expansion of quality primary health-care facilities.

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Globally, injuries are the leading cause of premature deaths and disability and account for nearly 9 per cent of total deaths worldwide. Like other countries, India also faces a very high burden of injuries, with the second most common cause of death and disability. Annually, 0.15 million people lose their lives due to accidental injuries/road traffic accidents in India, which is 11 per cent of the accident-related death worldwide. This study aims to analyse the socio-economic and demographic differentials in the magnitude of economic burden and coping strategies associated with accidental injuries in India. The study used the nationally representative cross-sectional data on the ‘Key Indicators of Social Consumption in India: Health, (2017–18)’ of the National Sample Survey Organisation (NSSO). Simple descriptive statistics have been used to measure the incidence and intensity of accidental injuries. The economic burden is estimated through out-of-pocket (OOP) health expenditure on accidental injuries and the use of different sources of finance to cope with the same. In addition, the logistic regression analysis has been used to analyse the association between socio-economic covariates and the likelihood of suffering from accidental injuries in India. The findings reveal that, unlike outpatient care, the high incidence in inpatient care reveals that hospitalisation is inevitable in most cases after accidental injuries. Among various socio-economic variables, the incidence of accidental cases is higher among individuals residing in urban areas, males, educated persons, and economically better-off sections of society. Also, the mean monthly OOP expenditure on the accidental injuries-affected population has been estimated at INR 2672 .46 (US$ 41.06) and INR 3041.64 (US$ 47.09) in inpatient and outpatient care, respectively. Almost the same sections and the individuals who received insurance spend more OOP expenditure on accidental injuries. However, OOP expenditure as a share of total consumption expenditure (TCE) is significantly high among their counterparts, such as rural inhabitants, illiterates, scheduled castes, the very poor and those who do not have any kind of health insurance coverage. In addition to savings/income, individuals depend more on the distress sources such as borrowings and selling of household assets to meet their OOP health expenditure in India. In conclusion, the high incidence of accidental injuries threatens people more than some of the other ailments in India. A strict motor vehicle act, administrative and political determination, awareness campaigns through various media platforms, diverse road lane systems and traffic norms can help reduce accidental fatalities in the country. Reducing the economic burden of accidental injuries requires increasing public spending on healthcare services as a percentage share of the country’s GDP. Furthermore, comprehensive universal health insurance coverage for all, including each component of healthcare expenditure, is the need of the hour.

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