Out of pocket expenditure on utilization of ante-natal and delivery care services in India: analysis based on NSSO 60th round

Saraswati Kerketta


Background: Maternal mortality is a major concern in India; it can be reduced by providing reproductive health care services to the pregnant women. Out of pocket expenditure is a major barrier to the mothers in access to the maternal care services in India.

Methods: Data has been extracted from NSSO 60th round. Univariate and multivariate analysis has been carried out to examine the pattern and factors affecting out of pocket expenditure on ante natal and delivery care services in India.

Results: There are differentials between public and private health facilities in terms of out of pocket expenditure on maternal care services in India. The Logit Model explains that urban mothers are 1.6 times (OR=1.652) and 3.2 times (OR=3.273) significantly more likely of OoP expenditure on ANC and delivery Care. Among the social groups, a big difference can be seen in terms of expenditure on delivery care services. As women’s educational level increases, the likelihood of out of pocket expenditure on delivery care services also increases. Women in higher age groups have more chances of out of pocket expenditure in receiving ante natal and delivery care with reference category (age <= 19). Mothers with third quintile of MPCE are 6.9 times (OR= 6.983) and 11.5 times (OR= 11.547) more likely of OoP expenditure on ANC and deliver care than reference category (first quintile).

Conclusions: The out of pocket expenditure is the main barrier in access to the health care services to the pregnant women. The government must ensure a free of cost institutional delivery especially to the poor mothers so that the maternal mortality can be reduced.


Maternal Mortality, ANC, Delivery Care, Out of Pocket Expenditure, Socio-economic factors

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