Multi-Layered Catastrophic Health Spending of Inpatient Women by Broad Group of Diseases in India

2021 ◽  
Vol 30 ◽  
pp. 183-206
Author(s):  
Manali Swargiary ◽  
◽  
Hemkhothang Lhungdim ◽  
Mrinmoy Pratim Bharadwaz ◽  
◽  
...  
Keyword(s):  
Rural Areas ◽  
Economic Status ◽  
Health Spending ◽  
Binary Logistic Regression ◽  
National Sample ◽  
Sample Survey ◽  
Public Health Services ◽  
Indian Women ◽  
Catastrophic Health Spending ◽  
Out Of Pocket Payments

Healthcare for Indian women needs prioritizing, as they continue to face social and economic discrimination over their healthcare, often with high out-of-pocket payments. The study examines the amount inpatient women have to pay for treatment of major diseases, re-classified into four groups as infectious, reproductive, non-communicable diseases (NCDs), and disabilities & injuries, across the country to comprehend the extent of catastrophic health spending (CHS) they experienced. The study is based on India’s 75th round of the National Sample Survey (NSS), i.e., Household Social Consumption: Health (2017-2018), consisting of 26,938 inpatient women aged 12 and above from India's urban and rural areas. We examine the prevalence of the four categories of diseases by individual, household, community, and healthcare characteristics. Expenditure estimates were derived from cross-tabulation, followed by binary logistic regression to assess the association between covariates and inpatient expenditures for the diseases. Indian women are more likely to be hospitalized for infectious diseases (43%), but the burden of CHS (overall) is highest for disabilities and injuries (INR 24,414), followed by NCDs (INR 23,053). Duration of hospitalization and possession of health insurance by women indicate maximum variation with medical spending. Almost 97% of women have incurred out-of-pocket expenditure on hospitalization, from which we identify three layers of CHS. A substantial proportion of women (23 to 50%) experienced CHS, i.e., up to 0-10%, 11-30%, and >30%, which varies distinctively by place of residence and across the six regions. Covariates like age, economic status, and healthcare are highly significant and associated with disease-wise CHS thresholds. Women in India face divergent financial hardships for healthcare. Given the heterogeneity of morbidities and socio-economic characteristics, the need for women-sensitive public health services and interventions are evident.

Women Entrepreneurship

2019 ◽  
pp. 99-118
Author(s):  
Prachita A. Patil ◽  
Yogesh M. Deshpande
Keyword(s):  
Rural Areas ◽  
National Sample ◽  
The State ◽  
Sample Survey ◽  
Female Entrepreneurs ◽  
National Sample Survey ◽  
Leading Role ◽  
National Sample Survey Organization ◽  
State Of Mind

According to the National Sample Survey Organization (NSSO), not more than 14% of business establishments are run by female entrepreneurs in India, especially in rural areas. Entrepreneurship is not an easy step for women. It was traditionally considered as a man's bastion, but now with the due course of time, women are coming in the limelight to fulfil their aspiration as it is a fruitful opportunity where educated or illiterates can do wonders to achieve their dreams. Entrepreneurship is the state of mind which every woman has in her but has not been capitalized in India in a way it should have been. With the drastic change in modernization, people are more comfortable to accept the leading role of women in society, with some exceptions.

Examining calorie undernourishment in India: Is it due to choice or inadequacy?

2020 ◽  
pp. 026010602094973
Author(s):  
Udaya S Mishra ◽  
Balakrushna Padhi ◽  
Rinju
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Urban Poor ◽  
Food Choices ◽  
National Sample ◽  
Sample Survey ◽  
The Poor ◽  
Food Expenditure ◽  
Lower Magnitude ◽  
Common Understanding

Background: Calorie undernourishment is often associated with poverty but India presents a unique scene of decline in money-metric poverty and rise in calorie deprivation. Existing literature has varied explanation towards this effect. However, neither are the poor entirely calorie compromised nor do all the non-poor qualify calorie compliance. Aim: This is an attempt at verifying whether calorie undernourishment is a result of choice of food basket or the inadequacy of food expenditure. Method: An answer to this question is attempted with the exploration of data obtained from the National Sample Survey Organization’s Consumption Expenditure of Indian households for the periods 2004–2005 and 2011–2012. Results: Findings reveal that over the last one decade, the average per capita per day calorie intakes have slightly increased from 2040.55 Kcal in 2004–2005 to 2087.33 Kcal in 2011–2012, which has led to the increased share of well-nourished households from 20.21% in the 61st round to 22.78% in the 68th round of survey in rural areas, whereas the similar increase in urban areas is from 36.1% to 40.65%. Conclusions: Calorie undernourishment among the non-poor is observed that calorie undernourishment, if any, among the non-poor is entirely due to choice but the same among the poor has a divide between choice and inadequacy. The urban poor are calorie compromised more due to choice rather than inadequacy as against their rural counterparts. With higher poverty, calorie, non-compliance among the poor is more due to choice when compared with lower magnitude of poverty. These observations form a basis for contesting the common understanding that calorie compromise is entirely driven by inadequacy/incapacity of food expenditure. could be viewed in terms of the food choices made, especially among the poor while setting the minimum threshold of food expenditure to be calorie compliant.

Growth and Distribution Effects of Changes in Levels of Living in Rural India: A Decomposition Analysis

2020 ◽  
Vol 14 (3) ◽  
pp. 407-423
Author(s):  
Jayanta Sen
Keyword(s):  
Rural Areas ◽  
Decomposition Analysis ◽  
National Sample ◽  
Sample Survey ◽  
Growth Effect ◽  
Farm Income ◽  
Consumer Expenditure ◽  
Indian States ◽  
Expenditure Data ◽  
Physical Infrastructure

This article deals with the changing pattern of levels of living in the rural regions of India during the period of 1993–1994 to 2011–2012 which also corresponds to the on-going economic reforms. These changes may be attributed either to the change in growth component or to the change in equity component or to both. The article therefore examines the effects of growth and distribution components on the variations in levels of living and their relative roles by a scheme of algebraic decomposition. It also investigates the influence of socio-economic factors on levels of living using econometric models. National Sample Survey Organisation consumer expenditure data for 15 major states of India are used for this analysis. Results show an improvement in levels of living (actual) in rural areas of all Indian states. Positive growth effect more than compensates the negative distribution effect and yield positive changes in some of the states. Further, this article argues that the main drivers of this positive change in the levels of living are development of rural physical infrastructure, attainment in education, farm income per capita, non-farm employment and livelihood diversification.

scholarly journals Financial risk protection of Thailand’s Universal Health Coverage: results from series of national household surveys between 1996 and 2015

2020 ◽  
Author(s):  
Viroj Tangcharoensathien ◽  
Kanjana Tisayaticom ◽  
Rapeepong Suphanchaimat ◽  
Vuthiphan Vongmongkol ◽  
Shaheda Viriyathorn ◽  
...  
Keyword(s):  
Universal Health Coverage ◽  
Financial Risk ◽  
Health Spending ◽  
Poverty Line ◽  
Health Coverage ◽  
Financial Risk Protection ◽  
Catastrophic Health Spending ◽  
Out Of Pocket Payments ◽  
Risk Protection ◽  
Universal Health

Abstract Background: Thailand, an upper-middle income country, has demonstrated exemplary outcomes of Universal Health Coverage (UHC). The country achieved full population coverage and a high level of financial risk protection since 2002, through implementing three public health insurance schemes. UHC has two explicit goals of improved access to health services and financial protection where use of these services does not create financial hardship. Prior studies in Thailand do not however provide evidence of long-term UHC financial risk protection. This study assessed financial risk protection as measured by the incidence of catastrophic health spending and impoverishment in Thai households prior to and after UHC in 2002.Methods: We used data from a fifteen-year series of annual national household socioeconomic surveys between 1996 and 2015, which were conducted by the National Statistical Office. The survey covered about 52,000 nationally representative households in each round. Descriptive statistics were used to assess the incidence of catastrophic payment as measured by the share of out-of-pocket payments for health by households exceeding 10% and 25% of household total consumption expenditure, and the incidence of impoverishment as determined by the additional number of non-poor households falling below the national and international poverty lines after making health payments. Results: Using the 10% threshold, the incidence of catastrophic spending dropped from 6.0% in 1996 to 2% in 2015. This incidence reduced more significantly when the 25% threshold was applied from 1.8% to 0.4% during the same period. The incidence of impoverishment against the national poverty line reduced considerably from 2.2% in 1996 to approximately 0.3% in 2015. When the international poverty line of US$ 3.1 per capita per day was applied, the incidence of impoverishment was 1.4% and 0.4% in 1996 and 2015 respectively; and when US$ 1.9 per day was applied, the incidence was negligibly low. Conclusion: The significant decline in the incidence of catastrophic health spending and impoverishment was attributed to the deliberate design of Thailand’s UHC, which provides a comprehensive benefits package and zero co-payment at point of services. The well-founded healthcare delivery system and favourable benefit package concertedly support the achievement of UHC goals of access and financial risk protection.

scholarly journals Impact of different sources of credit in creating extreme farmer distress in India

2019 ◽  
Vol 26 (6) ◽  
pp. 1676-1691 ◽  
Author(s):  
Bhavna Pandey ◽  
Prabir Bandyopadhyay ◽  
Alain Guiette
Keyword(s):  
Financial Institutions ◽  
Rural Areas ◽  
Statistical Tests ◽  
Reliability And Validity ◽  
State Intervention ◽  
National Sample ◽  
Sample Survey ◽  
Significant Information ◽  
Content Type ◽  
The Government

Purpose According to the published report by the National Sample Survey 2014 the data says that the incidence of indebtedness among households in the rural areas of Maharashtra, India, is almost twice that of other rural places in India. Around 64 percent of rural households are indebted in Maharashtra as against 31 percent other households in India. The purpose of this paper is to examine which source of credit is creating more distress among the farmers. Further the researchers also wanted to find out the reasons why the farmers choose private moneylender over the formal financial institutions. Design/methodology/approach To achieve the objective, the authors used the mixed method methodology. The qualitative study was done using the ethnography approach .In depth interviews were conducted and coded accordingly to find out the themes. The interviews conducted were semi structured and had open ended questions in it, followed by a structured questionnaire. Different statistical tests were also applied on the responses obtained from the questionnaire to check the reliability and validity of the interviews. This methodology gave a robustness to the findings of the study. Findings The results show that sources of loan play a major role in causing farmer distress in Maharashtra. The findings also show major reasons like grapevine bureaucracy, lengthy documentation, etc. as the major reasons for choosing private lenders over the formal financial institutions. The most interesting finding of the study was a phenomena observed during the field study. The borrowers first borrow from financial institutions for their credit needs, when they fail to repay the debt borrowed they again borrow money from the private money lenders and with this borrowed money they try repaying a part of the old existing loan in order to make themselves eligible for the next loan cycle. Research limitations/implications The limitation of the study is that due to time constraint only two districts with high number of farmer suicide could be visited. Given more time and fund a comparative study can be done among different states of India. Practical implications This study will help the policy makers in identifying the real cause of farmer distress. The motive behind the policies made by the government is very noble but the implementation of these policies is inadequate and without a strong research base. The paper will be able to highlight how much the state intervention is required at multiple levels in order to ensure that the benefits reaches to those who deserve it. Social implications It is imperative that we have yet not realized the gravity of the situation where people belonging from a community which is so essential to the economy are killing themselves because of lack of money. This is not just about the fact that the people who give us food are unable to access food themselves. Originality/value The paper contains significant information with regard to indebtedness. It focuses on the issue troubling the authorities the most. It provides the ground realities of the incidence of indebtedness in Maharashtra, one of the most distressed states of India. Lot of studies have been done in the past but very few studies have used mixed methodology to study this incidence of debt among the farmers of Maharashtra. This study also unveils a new phenomena of borrowing happening among the farmers of Maharashtra.

scholarly journals Right to Education Act: Universalisation or Entrenched Exclusion?

2019 ◽  
Vol 5 (1) ◽  
pp. 89-111 ◽  
Author(s):  
Abhay Kumar ◽  
Sudheer Kumar Shukla ◽  
Mary Panmei ◽  
Vir Narayan
Keyword(s):  
Elementary Education ◽  
Rural Areas ◽  
National Sample ◽  
Sample Survey ◽  
Right To Education ◽  
Capita Expenditure ◽  
Level Data ◽  
Per Capita ◽  
Education Act ◽  
The Government

Right to Education (RTE) Act is intended to provide free and compulsory elementary education to all children aged 6–14 years. This article examines key constituents of elementary education in view of the RTE Act such as current attendance rate, types of institutions, medium of instruction, neighbourhood schools, Monthly per capita expenditure on elementary education (MPCEE)and incentives during pre- and post-RTE period using National Sample Survey Organisation’s 64th (2007–2008) and 71st (2014) round of unit level data. The result shows that far from the universalisation, exclusion is getting entrenched across gender, sector, and socio-religious and economic groups. Female children, children from deprived socio-religious groups, rural areas and from the bottom MPCE quintile have not only fared lower in most of the studied parameters during the pre-RTE period, but the gap from their counterpart has widened immensely during the post-RTE period. Free education has declined and monthly per capita expenditure on elementary education has increased sharply. Children are moving out of the government to private schools. The findings raise serious questions on the intention of the government to fulfil its mandate under RTE.

Women Entrepreneurship

2021 ◽  
pp. 36-56
Author(s):  
Prachita A. Patil ◽  
Yogesh M. Deshpande
Keyword(s):  
Rural Areas ◽  
National Sample ◽  
The State ◽  
Sample Survey ◽  
Female Entrepreneurs ◽  
National Sample Survey ◽  
Leading Role ◽  
National Sample Survey Organization ◽  
State Of Mind

According to the National Sample Survey Organization (NSSO), not more than 14% of business establishments are run by female entrepreneurs in India, especially in rural areas. Entrepreneurship is not an easy step for women. It was traditionally considered as a man's bastion, but now with the due course of time, women are coming in the limelight to fulfil their aspiration as it is a fruitful opportunity where educated or illiterates can do wonders to achieve their dreams. Entrepreneurship is the state of mind which every woman has in her but has not been capitalized in India in a way it should have been. With the drastic change in modernization, people are more comfortable to accept the leading role of women in society, with some exceptions.

Caste and Class

2016 ◽  
Vol 8 (3) ◽  
pp. 135-151
Author(s):  
Bharti Nandwani
Keyword(s):  
Rural Areas ◽  
National Sample ◽  
Sample Survey ◽  
Economic Opportunities ◽  
Economic Class ◽  
Education Outcomes ◽  
Disadvantaged Groups ◽  
Caste Groups ◽  
The Impact ◽  
Over Time

This article revisits the question of intersection of caste and class in India by employing the concept of cross-cuttingness. Using five rounds of the National Sample Survey, we find that disadvantaged groups are heavily concentrated in the lower economic class category and this pattern has changed only marginally over time. Results also show that disadvantaged castes possess smaller landholdings and mainly reside in rural areas, which offer less economic opportunities as compared to urban. These findings point that for some caste groups in India access to economic opportunities is still correlated with their caste, even after decades of affirmative action. However, an encouraging finding is that the impact of caste on education outcomes is progressively falling over time. This has the potential to lower the influence of caste on the attainment of future economic opportunities.

Mobility in India: Recent Trends and Issues Concerning Database

Social Change ◽  
2018 ◽  
Vol 48 (4) ◽  
pp. 634-644
Author(s):  
Amitabh Kundu
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Population Distribution ◽  
National Sample ◽  
Sample Survey ◽  
Age Cohorts ◽  
Passenger Traffic ◽  
Social Divisions ◽  
The People ◽  
Recent Trends

Dismissing the postulate that the geographical, linguistic and other social divisions are constraining the movement of Indians across states, researchers have presented evidences—pattern of rail passenger traffic, changes in population distribution across different age cohorts and so on to show that the movement of people across states is much larger than what has been generally determined, using the data from the census and National Sample Survey. The basic objective of the paper is to examine if the process of migration and urbanisation in India is indeed unconstrained so that the people in backward regions and rural areas, who get dispossessed of their livelihood options or social linkages, can freely move into the developed regions or urban areas, It analyses these processes and recent trends while probing into methodological and data related issues in migration studies in India. The migration trends for socio-economically vulnerable sections of population are presented in the context of their access to urban and metropolitan space.

Does remittance protect the household from catastrophic health expenditure in India

2020 ◽  
Vol 16 (4) ◽  
pp. 481-493
Author(s):  
Milan Das ◽  
Kaushalendra Kumar ◽  
Junaid Khan
Keyword(s):  
Health Expenditure ◽  
Health Care Expenditure ◽  
Health Spending ◽  
Binary Logistic Regression ◽  
Catastrophic Health Expenditure ◽  
Economic Research ◽  
National Council ◽  
Data Set ◽  
Content Type ◽  
Catastrophic Health Spending

Purpose The purpose of this paper is to examine the dynamic nature of the catastrophic health expenditure (CHE) on remittances receiving households between 2005 and 2012 in India. Design/methodology/approach The study adopted Xu’s (2005) definition of catastrophic health-care expenditure. And also used binary logistic regression to examine the effects of remittances being received on CHE in households across India. The data were drawn from the two rounds of the India Human Development Survey conducted by the University of Maryland, the USA, and the National Council of Applied Economic Research, New Delhi, India. Findings The results show that the percentage of households received remittances, and that the amount of remittances received has substantially increased during 2005 and 2012, though variation is evident by socioeconomic and demographic characteristics of the household. Apparently, the variation (percentage of households received remittances) is more pronounced for factors such as household size, number of 60+ elderly, sectors and by regions. Household’s catastrophic health spending and remittances being received show a statistically significant association. Households which received remittances during both the time showed the lowest likelihood (AOR:0.82; p-value < 0.10; 95% CI:0.64–1.03) to experience catastrophic health spending. Originality/value The paper identified the research gap to examine the occurrence of catastrophic health spending by remittances receiving status of the household using a novel panel data set.

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