State and socio-demographic group variation in out-of-pocket expenditure, borrowings and Janani Suraksha Yojana (JSY) programme use for birth deliveries in India

Modugu, Hanimi Reddy; Kumar, Manish; Kumar, Ashok; Millett, Christopher

doi:10.1186/1471-2458-12-1048

Cited by 60 publications

(54 citation statements)

References 6 publications

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“…Several studies have highlighted that the out of pocket expenditure for institutional delivery is higher than the monetary incentive provided by the government in many settings [67–69]. …”

Section: Discussionmentioning

confidence: 99%

Do women’s perspectives of quality of care during childbirth match with those of providers? A qualitative study in Uttar Pradesh, India

Bhattacharyya

Srivastava

Saxena

et al. 2018

Global Health Action

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Background: Persistently high maternal mortality levels are a concern in developing countries. In India, monetary incentive schemes have increased institutional delivery rates appreciably, but have not been equally successful in reducing maternal mortality. Maternal outcomes are affected by quality of obstetric care and socio-cultural norms. In this light there is need to examine the quality of care provided to women delivering in institutions. Objective: This study aimed to examine pregnant women’s expectations of high-quality care in public health facilities in Uttar Pradesh, India, and to contrast this with provider’s perceptions of the same, as well as the barriers that limit their ability to provide high-quality care. Methods: A qualitative descriptive analysis was conducted on data from two studies – focus group discussions with rural women in their last trimester of pregnancy (conducted in 2014) to understand women’s experience and satisfaction with maternal care services, and in-depth interviews with care providers (conducted in 2016–17) to understand provision of person-centred care. Provider perspectives were matched with themes of women’s perspectives on quality of childbirth care in facilities. Results: Major themes of care prioritised by women included availability of doctors at the facility; availability of medicines; food; ambulance services; maintenance of cleanliness and hygiene; privacy; good and safe delivery with no complications; client-provider interaction; financial cost of care. Many women also voiced no expectation of care, indicating disillusionment from the existing system. Providers concurred with women on all themes of care except availability of doctors, as they felt that trained nurses were proficient in conducting deliveries. Conclusions: This study shows that women have clear expectations of quality care from facilities where they go to deliver. Understanding their expectations and matching them with providers’ perspectives of care is critical for efforts to improve the quality of care and thereby impact maternal outcomes.

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Section: Discussionmentioning

confidence: 99%

Do women’s perspectives of quality of care during childbirth match with those of providers? A qualitative study in Uttar Pradesh, India

Bhattacharyya

Srivastava

Saxena

et al. 2018

Global Health Action

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“…It is also noted that out of pocket (OOP) expenditure on cancer hospitalization is about 2.5 times of overall average hospitalization expenditure [27]. While catastrophic expenditure on cancer inpatient treatment is highest among all NCDs, poor health financing mechanisms and heavy reliance on out-of-pocket healthcare payments compels several cancer patients to resort to distressed means for treatment financing [28–30]. In fact, previous studies on India suggest that about 60 and 32 percent households resort to borrowings and contributions (from friends and relatives) respectively for cancer hospitalization [27].…”

Section: Introductionmentioning

confidence: 99%

Economic burden of cancer in India: Evidence from cross-sectional nationally representative household survey, 2014

2018

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With the ongoing demographic and epidemiological transition, cancer is emerging as a major public health concern in India. This paper uses nationally representative household survey to examine the overall prevalence and economic burden of cancer in India. The age-standardized prevalence of cancer is estimated to be 97 per 100,000 persons with greater prevalence in urban areas. The evidence suggests that cancer prevalence is highest among the elderly and also among females in the reproductive age groups. Cancer displays a significant socioeconomic gradient even after adjusting for age-sex specifics and clustering in a multilevel regression framework. We find that out of pocket expenditure on cancer treatment is among the highest for any ailment. The average out of pocket spending on inpatient care in private facilities is about three-times that of public facilities. Furthermore, treatment for about 40 percent of cancer hospitalization cases is financed mainly through borrowings, sale of assets and contributions from friends and relatives. Also, over 60 percent of the households who seek care from the private sector incur out of pocket expenditure in excess of 20 percent of their annual per capita household expenditure. Given the catastrophic implications, this study calls for a disease-based approach towards financing such high-cost ailment. It is suggested that universal cancer care insurance should be envisaged and combined with existing accident and life insurance policies for the poorer sections in India. In concluding, we call for policies to improve cancer survivorship through effective prevention and early detection. In particular, greater public health investments in infrastructure, human resources and quality of care deserve priority attention.

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“…According to Modugu and Lim, during 2006-07 national average for the utilization of JSY was 6% which ranged from 5% to 44%. 10,11 In tribal areas of Mysore, during 2011-12 only 69% of those submitted the necessary documents had got the benefit. 8 This improved beneficiary rate could be due to change in socioeconomic background of the study areas and increasing awareness with the time.…”

Section: Discussionmentioning

confidence: 99%

“…5,7 Major reasons for delay was lack of funds, delay in producing documents, lack of awareness in many parts of the country including the study area. 7,8,10 The amount transferred was not meeting the expenses of frequent trips to PHC and Bank. ASHAs also said that people open account with minimum or nil balance.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of availability and utilization of obstetric care services and entitlements under Janani Suraksha Yojana in Mysore, India

Siddalingappaa

Murthy

Mascarenhas³

et al. 2016

Int J Community Med Public Health

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State and socio-demographic group variation in out-of-pocket expenditure, borrowings and Janani Suraksha Yojana (JSY) programme use for birth deliveries in India

Cited by 60 publications

References 6 publications

Do women’s perspectives of quality of care during childbirth match with those of providers? A qualitative study in Uttar Pradesh, India

Do women’s perspectives of quality of care during childbirth match with those of providers? A qualitative study in Uttar Pradesh, India

Economic burden of cancer in India: Evidence from cross-sectional nationally representative household survey, 2014

Evaluation of availability and utilization of obstetric care services and entitlements under Janani Suraksha Yojana in Mysore, India

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