Correction to: Benefit incidence analysis in public health facilities in India: utilization and benefits at the national and state levels

Bowser, Diana; Patenaude, Bryan; Bhawalkar, Manjiri; Duran, Denizhan; Berman, Peter

doi:10.1186/s12939-019-0945-y

Cited by 4 publications

(14 citation statements)

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“…These ndings may be due to implementation of JSY and other schemes under NHM that led to increase in utilization of maternal services [30,54,[56][57]. The trend of pro-poor utilization of public health facilities in India is consistent with literatures.…”

Section: Discussionsupporting

confidence: 84%

“…Studies have used various approaches to understand the impact of public health investment (bene t-incidence analysis, individual preference, concentration curve, and concentration index). Among these, bene t incidence analyses (BIA) is being increasingly used in health economics literature [22,26,[28][29][30][31][32][33]. Bene t incidence analysis is a tool to access whether the subsidies are helping the poorer section, or the better-off section of the society.…”

Section: Introductionmentioning

confidence: 99%

“…[32]. A recent study suggests that inpatient and delivery services at public health facilities in India are pro-poor [30].…”

Section: Introductionmentioning

confidence: 99%

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Understanding equity of institutional delivery in public health centre by level of care in India: An assessment using Benefit Incidence Analysis

Mohanty

Mishra

et al. 2020

Preprint

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Background: The National Health Mission (NHM), the largest ever publicly funded health programme worldwide, used over half of the national health budget in India and primarily aimed to improve maternal and child health in the country. Though large scale public health investment in India has improved the health care utilization and health outcomes across states and socio-economic groups, little is known on the equity concern of NHM. In this context, this paper examines the utilization pattern and net benefit of public subsidy for institutional delivery by the level of care in India. Methods: Data from the most recent round of the National Family Health Survey (NFHS 4), conducted during 2015-16, was used in the study. A total of 148,645 last birth delivered in a health centre during the five years preceding the survey were used for the analyses. Out-of-pocket (OOP) payment on delivery care was taken as the dependent variable and was analysed by primary care and secondary level of care. Benefits Incidence Analysis (BIA), descriptive statistics, concentration index (CI), and concentration curve (CC) were used to do the analysis. Results: Institutional delivery from the public health centres in India is pro-poor and has a strong economic gradient. About 28% mothers from richest wealth quintile did not pay for delivery in public health centres compared to 16% among the poorest wealth quintile. Benefit incidence analyses suggests a pro-poor distribution of institutional delivery both at primary and secondary level of care. In 2015-16, at the primary level, about 32.29% of subsidies were used by the poorest, 27.22% by poorer, 20.39% by middle, 13.36% by richer and 6.73% by the richest wealth quintile. The pattern at the secondary level was similar, though the magnitude was lower. The concentration index of institutional delivery in public health centres was -0.161 [95% CI: -0.158, -0.165] compared to 0.296 [95% CI: 0.289, 0.303] from private health centres.Conclusion: Provision and use of public subsidy for institutional delivery in public health centres is pro-poor in India. Improving the quality of service in primary health centres is recommended to increase utilisation and reduce OOP payment for health care in India.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Understanding equity of institutional delivery in public health centre by level of care in India: An assessment using Benefit Incidence Analysis

Mohanty

Mishra

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…It also involves the estimates of monetary value of the services and its distribution along the population [25]. Effectiveness of the distribution of limited resources to meet the needs of the poor is captured along with extent of e cient resource allocation [21].…”

Section: Introductionmentioning

confidence: 99%

“…Across rural areas, the share of public subsidy in Tamil Nadu and Rajasthan shifted from lower middle section to poorest section of population during 2004-14 whereas in West Bengal, the richer section continued to avail the subsidy during same period [45]. In India, though the utilisation of delivery care services was higher among the poor, the bene ts of public subsidy for delivery care services were pro-rich in nature [21].…”

Section: Introductionmentioning

confidence: 99%

Understanding equity of institutional delivery in public health centre in India: An assessment using Benefit Incidence Analysis

Mohanty

Mishra

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The National Health Mission (NHM), the largest ever publicly funded health programme worldwide used over half of the national health budget in India and primarily targeted to improve maternal and child health in the country. Though increased public health investment in India has improved the health care utilization and health outcomes across geographies and socio-economic groups, little is known on equity aspect of such large scale investment. In this context, this paper examines the utilisation pattern of delivery care and equity aspect of public investment in India.Methods: Data from the recent round of National Family Health Survey (NFHS 4) conducted during 2015-16 used in the analyses. A total of 148,645 last birth delivered in an institution in a reference period of five years has been used in the analyses. The out-of-pocket (OOP) payment on delivery care is the dependent variable. Benefits Incidence Analysis (BIA), descriptive statistics, concentration index (CI), and concentration curve (CC) used in the analysis.Results: Utilization of natal care from public health centres in India is pro-poor and have a strong economic gradient. However, about 28% mothers in richest wealth quintile did not pay for delivery in public health centres compared to 16% among the poorest wealth quintile. The median OOP payments for institutional delivery from public health centre was ₹1200 for mothers belonging to the poorest wealth quintile compared to ₹2000 for mothers belonging to richest wealth quintile. Benefit incidence analyses suggests that about 17.4 % of subsidies were used among poorest, 19.3% among richest quintile and 21.9% in the middle quintile. The concentration index of institutional delivery from public health centres was -0.161 [95% Confidence Interval: -0.158, -0.165] compared to 0.296 [95% Confidence Interval: 0.289, 0.303] from private health centres.Conclusion: Utilisation of natal care services from public health centres in India is pro-poor. However, benefit-incidence analyses suggest that the use of subsidy is relatively higher among wealthier and better off mothers in India.

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Going Granular: Equity of Health Financing at the District and Facility Level in India

Chatterjee¹,

Smith²

2021

Health Systems & Reform

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Health financing equity analysis rarely goes below the state level in India. This paper assesses the equity and effectiveness of public spending on health in the state of Odisha. Using district-level public spending data for the first time, it sheds light on the incidence of public spending by geography and by type of services. There are three key findings. First, it identifies the weak link between district spending and district need, proxied by poverty rates or lagging sectoral outcomes, highlighting the potential for a more needs-based approach to public resource allocation. Second, the results indicate that at the household level health spending by the state is not pro-poor, especially in public hospitals, underscoring the need to improve access to care for the bottom 40% at these facilities. Third, an exhaustive analysis of micro-level treasury data brings into focus the importance of reforming public finance data systems to support evidence-based policy at the sub-state level. Significant district-wise variation in key health financing and equity indicators, combined with growing policy interest in the district level, underscore the utility of further empirical work in this area.

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Correction to: Benefit incidence analysis in public health facilities in India: utilization and benefits at the national and state levels

Cited by 4 publications

References 1 publication

Understanding equity of institutional delivery in public health centre by level of care in India: An assessment using Benefit Incidence Analysis

Understanding equity of institutional delivery in public health centre by level of care in India: An assessment using Benefit Incidence Analysis

Understanding equity of institutional delivery in public health centre in India: An assessment using Benefit Incidence Analysis

Going Granular: Equity of Health Financing at the District and Facility Level in India

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