Incidence, its correlates and effects of maternal health care expenditure in India

This study measures the incidence and intensity of ‘catastrophic’ and impoverishment effect of maternal health care expenditure of households and its socio-economic correlates in urban and rural areas separately. Using data from 60th round of National Sample Survey, we find that urban household spent almost twice that of rural households on maternal health care. A little more than one third households suffered catastrophic payments in both urban and rural areas. On the other hand, the head count was greater among illiterate women living in urban areas compared to those living in rural areas. After adjusting out-of-pocket maternal health care expenditure, the poverty in urban and rural areas increased by almost equal percentage points. Increasing education level, higher consumption expenditure quintile and, higher caste of women was associated with increasing odds of impoverishment due to maternal health care expenditure. To reduce maternal health care expenditure induced poverty, the demand-side maternal health care financing programs and policies in future should take into consideration all the costs incurred during prenatal, delivery and postnatal periods and focus not only on those women who suffered catastrophic expenditure and plunged into poverty but also those who forgo maternal health care due to their inability to pay.