State and socio-demographic group variation in out-of-pocket expenditure, borrowings and Janani Suraksha Yojana (JSY) programme use for birth deliveries in India.
State and socio-demographic group variation in out-of-pocket expenditure, borrowings and Janani Suraksha Yojana (JSY) programme use for birth deliveries in India.
复制标题
DOI：
10.1186/1471-2458-12-1048
复制
发表时间：
2012-12-05
影响因子：
4.5
通讯作者：
Millett C
中科院分区：
文献类型：
--
作者：
Modugu HR;Kumar M;Kumar A;Millett C
高额的自付支出(OOPE)阻碍了家庭寻求技术/机构护理。Janani Suraksha Yojana(JSY)是印度政府为实现千年发展目标4和5所做努力的一部分，于2005年启动了一项有条件的现金转移计划，旨在减轻OOPE和促进穷人的机构接生。这项研究的目的是估计印度正常/剖腹产接生、JSY方案使用和接生相关借款的差异，以及家庭的社会人口特征。对2007-2008年地区住户调查(DLHS-3)的数据进行二次分析。估计了机构和家庭分娩的平均OOPE和中位数OOPE、JSY使用百分比以及需要借钱支付分娩相关支出的家庭百分比。2007/08年度，印度一半(52%)的分娩发生在家里。接受机构分娩的妇女的OOPE仍然很高，各州和联邦地区之间的差异很大。在印度，公共机构和私人机构正常分娩的平均OOPE(SD)分别为R。1,624和R.4458卢比，剖腹产是卢比。5935和R.分别为14,276人。在全国范围内，使用JSY方案进行正常分娩的比例差异很大(全国为15%；在果阿邦为0%，在中央邦为43%)，以及在私人机构不得不借钱支付剖腹产费用的家庭比例(全国为47%；果阿为7%，比哈尔邦为69%)。识字率和财富的增加与机构提供的可能性更高、OOPE更高有关，但JSY的使用没有重大变化。我们的研究强调了印度分娩机构护理的持续高OOPE和贫困影响。为了提高机构分娩的比例，需要支持家庭进行产妇保健财务规划，对JSY方案进行额外投资，并加强国家一级的规划。
High out-of-pocket-expenditure (OOPE) deters families from seeking skilled/institutional care. ‘Janani Suraksha Yojana (JSY), a conditional cash transfer programme launched in 2005 to mitigate OOPE and to promote institutional deliveries among the poor, is part of Government of India’s efforts to achieve Millennium Development Goals (MDGs) 4 and 5. The objective of this study is to estimate variations in OOPE for normal/caesarean-section deliveries, JSY-programme use and delivery associated borrowings - by states and union territories, and socio-demographic profiling of families, in India. Secondary analysis of data from the District Level Household Survey (DLHS-3), 2007–08. Mean and median OOPE, percentage use of JSY and percentage of families needing to borrow money to pay for delivery associated expenditure was estimated for institutional and home deliveries. Half (52%) of all deliveries in India occurred at home in 2007/08. OOPE for women having institutional deliveries remained high, with considerable variation between states and union territories. Mean OOPE (SD) of a normal delivery in public and private institution respectively in India were Rs. 1,624 and Rs. 4,458 and for a caesarean-section it was Rs. 5,935 and Rs. 14,276 respectively. There was considerable state-level variation in use of the JSY programme for normal deliveries (15% nationally; ranging from 0% in Goa to 43% in Madhya Pradesh) and the percentage of families having to borrow money to pay for a caesarean-section in a private institution (47% nationally; ranging from 7% in Goa to 69% in Bihar). Increased literacy and wealth were associated with a higher likelihood of an institutional delivery, higher OOPE but no major variations in use of the JSY. Our study highlights the ongoing high OOPE and impoverishing impact of institutional care for deliveries in India. Supporting families in financial planning for maternity care, additional investment in the JSY programme and strengthening state level planning are required to increase the proportion of institutional deliveries.
登录
查看更多内容
影响因子：
3.1
作者：
Kesterton, Amy J.;Cleland, John;Ronsmans, Carine
通讯作者：
Ronsmans, Carine
影响因子：
168.9
作者：
Lim, Stephen S.;Dandona, Lalit;Gakidou, Emmanuela
通讯作者：
Gakidou, Emmanuela
影响因子：
3.2
作者：
Bonu, Sekhar;Bhushan, Indu;Anderson, Ian
通讯作者：
Anderson, Ian
影响因子：
168.9
作者：
Paul, Vinod Kumar;Sachdev, Harshpal Singh;Mavalankar, Dileep;Ramachandran, Prema;Sankar, Mari Jeeva;Bhandari, Nita;Sreenivas, Vishnubhatla;Sundararaman, Thiagarajan;Govil, Dipti;Osrin, David;Kirkwood, Betty
通讯作者：
Kirkwood, Betty
影响因子：
168.9
作者：
Balarajan, Y.;Selvaraj, S.;Subramanian, S. V.
通讯作者：
Subramanian, S. V.