Australia India Institute (AII) NGN Research Fellow, The University of Western Australia, 35 Stirling Highway, Perth, WA, 6009, Australia; Population Studies, Centre for the Study of Regional Development, School of Social Sciences (SSS-3), Jawaharlal Nehru University (JNU), Room No. 102, New Delhi, 110067, India.
Population Studies, Centre for the Study of Regional Development, Jawaharlal Nehru University (JNU), New Delhi, 110067, India.
Public Health. 2021 Apr;193:43-47. doi: 10.1016/j.puhe.2021.01.029. Epub 2021 Mar 13.
This study aims to address the question that whether out-of-pocket expenditure (OOPE) on institutional deliveries remained high or reduced over time in India, in particular after the introduction of conditional cash transfer (CCT) incentive programmes such as Janani Suraksha Yojana (JSY) in 2005.
The study presents the trends in average OOPE on institutional deliveries in India, in an effort to evaluate the impact of the JSY programme on it.
For the purpose, the study used recently released 75th round of National Sample Survey data, 2017/18 about household social consumption (Health) and two of its previous rounds in 2004 and 2014.
The results suggest that, except at rural public facilities, the average OOPE for institutional delivery has increased significantly in both rural and urban areas from 2004 to 2017/18, even after adjusting to inflation in the prices. In addition, the results have shown that overall 14 of 33 states for rural public facilities, 20 of 25 states in rural private facilities, 21 of 32 states in urban public facilities and 29 of 32 states in urban private facilities have experienced more than 50% raise in OOPE on institutional delivery during 2004-2017/18, despite JSY incentives.
The findings suggest that the current level of JSY incentives will not be sufficient to avoid catastrophic spending on institutional deliveries for the households as the incentives in several states are much less than the state average OOPE per delivery. Thus, there is a need to consider a raise in the state or central contribution for CCT under the JSY programme to reduce the burden of OOPE on institutional deliveries through recently launched Pradhan Mantri Matru Vandana Yojana.
本研究旨在探讨印度的住院分娩自费支出（OOPE）是否随着时间的推移而居高不下或有所下降，特别是在 2005 年引入有条件现金转移（CCT）激励计划（如 Janani Suraksha Yojana，简称 JSY）之后。
本研究展示了印度住院分娩自费支出的趋势，以评估 JSY 计划对其的影响。
为此，本研究使用了最近发布的第 75 轮国家抽样调查数据，即 2017/18 年关于家庭社会消费（健康）的数据，以及前两轮 2004 年和 2014 年的数据。
结果表明，除了农村公共设施外，2004 年至 2017/18 年期间，农村和城市地区的住院分娩自费支出在农村和城市地区均显著增加，即使考虑到价格通胀因素也是如此。此外，结果显示，在农村公共设施方面，33 个邦中有 14 个、农村私人设施方面，25 个邦中有 20 个、城市公共设施方面，32 个邦中有 21 个以及城市私人设施方面，32 个邦中有 29 个邦的住院分娩自费支出在 2004-2017/18 年间增长了 50%以上，尽管有 JSY 激励措施。
研究结果表明，目前 JSY 激励措施的水平不足以避免家庭因住院分娩而产生灾难性的支出，因为在几个邦，激励措施远低于每个分娩的邦平均自费支出。因此，有必要考虑提高 JSY 计划下的国家或中央贡献，以通过最近启动的 Pradhan Mantri Matru Vandana Yojana 来减轻住院分娩自费支出的负担。
