Changing Structure of Out of Pocket Expenditure in Institutional Delivery in India: An Analysis

There is great increase in institutional delivery rates is seen in India. But still one of the main obstacles faced by women for the adoption of institutional delivery is high costs especially in private sector. A significant difference in cost structure of public and private sector is seen. Large interstate differential is noted in usage pattern of services and cost structure in institutional delivery. But no in depth analysis is undertaken to reveal the trends in dependency ratio and cost structure.

The objective of this paper is to analyse the trend in utilization of public and private sectors across states and to analysethe differences in the out of pocket expenditure on delivery across states.

The study utilized the data from NSSO 71 round data conducted on January –June 2014 by government of India

The dependence of public sector is more in rural areas than in urban areas. In all states, the out of pocket expenditure in rural areas is twice lower than urban areas. Out of pocket expenditure is higher in developed states compared to low developed states. Caesarean rates are higher in private sector than in public sector. Out of pocket expenditure delivery in public source has declined over time. Three fold rate increase in caesarean rate compared to last round indicates the low health standards of Indian women though maternal mortality rates have come down. In light of findings, it is found out that facilities in public sector has to be improved and measures to check costs in private sector has to be adopted. Policies to improve the nutritional status of women has to be urgently undertaken which will help to reduce the rates of caesareans in the country.