Jolene Skordis?Worrall|Noemi Pace|Ujwala Bapat|Sushmita Das|Neena Shah More|Wasundhara Joshi|Anni?Maria Pulkki?Brännström|David Osrin
Maternal and neonatal health expenditure in mumbai slums (India): A cross sectional study
University College London|London International Development Centre|Ca' Foscari University of Venice|Society for Nutrition Education and Health Action|Society for Nutrition Education and Health Action|Society for Nutrition Education and Health Action|Society for Nutrition Education and Health Action|University College London|London International Development Centre|University College London|London International Development Centre
cost maternity care barrier access may increase maternal neonatal mortality risk analyzed spending maternity care urban slum communities mumbai better understand equity spending impact spending household poverty used expenditure data maternal neonatal care collected postpartum interviews interviews conducted 20052006 sample 1200 slum residents mumbai india analysed expenditure socioeconomic status ses calculating kakwani index range spending categories also calculated catastrophic health spending without adjustment coping strategies identified level catastrophic payments incurred household prevalence catastrophic payments population analysis also gave understanding protection medical poverty afforded coping strategies example saving borrowing high proportion respondents spent catastrophically care lower ses associated higher proportion informal payments indirect health expenditure found weakly regressive poorest likely use wage income meet health expenses less poor likely use savings overall incidence catastrophic maternity expenditure 41 15 controlling coping strategies found significant difference incidence catastrophic spending across wealth quintiles could conclude total expenditure regressive high expenditure proportion household resources alert policymakers burden maternal spending context differences informal payments significantly regressive indirect spending use savings versus wages finance spending highlight heavier burden borne poor policy objective increase institutional deliveries without forcing households deeper poverty inequities need addressed reducing outofpocket payments better regulating informal payments direct benefits poor alternatively targeted schemes aimed assisting poor coping maternal spending including indirect spending could reduce household impact high costs