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

Post a Comment

NOTE: Hateful, abusive comments won't be published. -- Editor

TRENDING

Neville Cardus: The man who turned cricket writing into poetry

By Harsh Thakor*  Neville Cardus was one of the most remarkable literary figures of the twentieth century. A prolific English writer and critic, he achieved distinction in two vastly different fields: cricket and classical music. Entirely self-taught, Cardus rose from humble beginnings to become both the cricket correspondent and chief music critic of The Manchester Guardian . His achievements in these contrasting disciplines earned him widespread acclaim and established him as one of the foremost critics of his generation. In February 2025, the cricketing and literary world marked the fiftieth anniversary of his death, which occurred in February 1975.
Post a Comment
»

​Ideological shifts and structural realities within India's left-wing insurgency

​By Harsh Thakor*  The Maoist insurgency in India is arguably at its weakest point since the formation of the Communist Party of India (Maoist) in 2004. Years of sustained counterinsurgency operations, leadership losses, shrinking territorial influence, declining recruitment, and growing technological advantages enjoyed by the state have significantly eroded the movement's operational capabilities. 
Post a Comment
»

The Dalit body on screen: Stereotypes, sacrifice, and subjugation in Hindi films

By Dr. Prem Singh*  Despite centuries of reformist efforts, from Gandhi and Ambedkar to contemporary activists, the caste system remains deeply embedded in the Indian psyche. One of the primary reasons for this persistence is the religious sanction provided by Brahminical scriptures, which have shaped not only social structures but also cultural and artistic expressions.
1 comment
»