Coping with the financial hardships caused by ill health – Urban Slums of Jaipur, India

Abstract

Accountability of any health system does not ends with improving health. The vulnerability (to incur catastrophic health expenditure and coping mechanism) of this slum population was mostly pertaining to availability of acceptable healthcare services, accessing healthcare services and being forced to pay for it out-of-pocket. Determinant factors for vulnerability to incur catastrophic health expenditure and coping mechanism majorly included services availed. Determinants that affected the choice of coping mechanism were availing ANC/PNC services (OR = 3.8; P < 0.05); availed out-patients services for two or more times (OR = 2.6; P < 0.05); and availed in-patients services for one or more times (including deceased members in last one year) (OR = 10.2; P < 0.001). Similarly, households vulnerable to incur CHE were those which paid to avail in-patients services for one or more times (OR = 55.3; p < 0.001), childbirth services for one or more times (OR = 6.5; p < 0.05) Out-patient services (OR = 11.3; p < 0.001), and ANC/PNC services (OR = 6.7; p < 0.05. The household with more number of the households were two times more likely to incur CHE (OR = 2.5; p < .0001).