Skip to main content

Sharp rise in out of pocket expenditure per delivery in public health facilities


By Sampurna Kundu, Prof. Sanghmitra Sheel Acharya*
Despite the efforts of the Reproductive and Child Health Services (RCH), that provided free or nominal cost public health services, the average out of pocket expenditure (OOPE) per delivery in public health facilities has increased for many states.
States like Manipur, Tripura, Mizoram and Assam, which are in the North-Eastern region have shown increase in average OOPE per delivery in public health facilities over the past 5 years. On the contrary, there has been a decline for West Bengal, where it has been observed that the average OOPE per delivery in public health facilities is around Rs. 2700 for both urban and rural areas in West Bengal. For the other states where OOPE has increased, it is observed that in urban areas it is higher than in rural except for Tripura where it is higher in rural areas.

The institutional births have increased for the past 5 years in public health facilities, which is quite evident because of the improvement in the availability, accessibility and quality of public health facilities after Government had allotted higher budget under National Rural Health Mission (NRHM) by introducing Janani Suraksha Yojana (JSY) scheme. The institutional births have also increased in states like Manipur, Mizoram, Nagaland and Tripura in the North eastern states, where it has been mostly in the urban areas. In West Bengal and Telangana, the increase in institutional births in public facilities has been drastic in the past 5 years, where it has been majorly in the rural areas.
The OOPE becomes higher when the the delivery is ceasarian in private institutions mainly. The latest estimates shows that ceasarian delivery births in public health facilities have increased in the last 5 years for almost all the states, that too mostly in the urban areas only.
In the National Health Mission (NHM) programme, the JSY and Janani Shishu Suraksha Karyakram (JSSK) are its key components where cash incentives are provided to mother for their deliveries in public health facilities for free and even treat the newborns up to one year for free. On the contrary, the latest estimates shows that the OOPE for delivery in public health facilities have increased, specially for North eastern region states. The basic grounds of the conditional cash transfer by JSY will be lost if the woman has to pay in accessing the health services which is supposed to be free of cost. For the poor households especially will be pushed more towards poverty. In years to come if OOPE for reproductive health purposes continues to increase then women might deter from availing services from public health facilities despite of the cash incentive scheme.

*Sampurna Kundu is PhD Scholar, Centre of Social Medicine and Community Health, School of Social Sciences, Jawaharlal Nehru University, New Delhi. Sanghmitra Sheel Acharya is Professor at the Centre of Social Medicine and Community Health, School of Social Sciences, Jawaharlal Nehru University, New Delhi

Comments

TRENDING

'Modi govt's assault on dissent': Foreign funds of top finance NGO blocked

By Rajiv Shah  In a surprise move, the Ministry of Home Affairs, Government of India, has cancelled the foreign funding license of the well-known advocacy group, Centre for Financial Accountability (CFA), known for critically examining India's finance and banking sectors from human rights and environmental angle.

Misleading ads 'manipulate, seduce, lure' to market unhealthy harmful food

By Our Representative  The Nutrition Advocacy in Public Interest (NAPI) in its new report “50 Shades of Food Advertising” has sought to expose how seductive, luring, manipulative or deceptive these advertisements can be. Consequences of such advertising are increased intake of unhealthy food products that is associated with obesity and diabetes, it says. 

A Hindu alternative to Valentine's Day? 'Shiv-Parvati was first love marriage in Universe'

By Rajiv Shah*   The other day, I was searching on Google a quote on Maha Shivratri which I wanted to send to someone, a confirmed Shiv Bhakt, quite close to me -- with an underlying message to act positively instead of being negative. On top of the search, I chanced upon an article in, imagine!, a Nashik Corporation site which offered me something very unusual. 

Swami Vivekananda's views on caste and sexuality were 'painfully' regressive

By Bhaskar Sur* Swami Vivekananda now belongs more to the modern Hindu mythology than reality. It makes a daunting job to discover the real human being who knew unemployment, humiliation of losing a teaching job for 'incompetence', longed in vain for the bliss of a happy conjugal life only to suffer the consequent frustration.

'Failure of governance': India, China account for 54% pollution-related deaths globally

By Vikas Parsaram Meshram*   A recent report jointly prepared by UNICEF and the independent research organization Health Effects Institute has been released, and the statistics within it are alarming. It states that in 2021, air pollution caused the deaths of 2.1 million Indians, including 169,000 children who hadn't yet fully experienced life. These figures are indeed distressing and raise questions about why there hasn't been more serious effort in this direction, putting policymakers to shame. 

August 9 to be observed as Corporates Quit India day: Top farmers' group

By Our Representative A recent general body meeting of the Samyukt Kisan Morcha (SKM), the top farmers' organisation, stated hat "there is no need for any illusion of change in the pro-corporate policies of the BJP-NDA government" following the recent elections in which BJP failed to achieve even simple majority. It insisted,  Prime Minister Narendra Modi "is hell bent" to continue 'business as usual' policies.

Over 3.8 billion animals at risk: India on crossroad in animal welfare practices

By Rupali Soni*  In a collaborative effort, the India Animal Fund and Dasra have unveiled their report , "Our Shared Future | Securing Animal Welfare, Human Wellbeing, and Sustainability in India." This landscape report provides a thorough overview of animal welfare and underscores its indispensable role within India's socio-economic and ecological frameworks. It also illustrates how animal welfare is intricately intertwined with public health, labor welfare, and climate resilience.

Belgian report alleges MNC Etex responsible for asbestos pollution in Madhya Pradesh town Kymore: COP's Geneva meet

By Our Representative A comprehensive Belgian report has held MNC Etex , into construction business and one of the richest, responsible for asbestos pollution in Kymore, an industrial town in in Katni district of Madhya Pradesh. The report provides evidence from the ground on how Kymore’s dust even today is “annoying… it creeps into your clothes, you have to cough it”, saying “It can be deadly.”

Women's emancipated under Mao: Girl completed primary school, began working in farm collective

By Harsh Thakor*  The book “New Women in New China”, a collection of articles projecting dramatic transformation -- political and economic -- in the status of Chinese women after liberation, originally published in 1972, and reprinted in 2023 by the Foreign Languages Press, Beijing, encompasses the period between 1949 and 1972, seeking to give justice to the subject of women’s emancipation in China after the 1949 revolution.