Equity and extent of financial risk protection indicators during COVID-19 pandemic in rural part of Tamil Nadu, India
Catastrophic health expenditure [CHE] in India is on a rise. This situation would worsen even further when resources are disproportionately distributed across various socioeconomic classes. Hence, we conducted this study to determine the equity and extent of out-of-pocket [OOP] payments, Catastrophi...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-08-01
|
| Series: | Heliyon |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844023061108 |
| _version_ | 1797732935972945920 |
|---|---|
| author | Yuvaraj Krishnamoorthy Sathish Rajaa Isha Sinha Murali Krishnan Gerald Samuel Krishna Kanth |
| author_facet | Yuvaraj Krishnamoorthy Sathish Rajaa Isha Sinha Murali Krishnan Gerald Samuel Krishna Kanth |
| author_sort | Yuvaraj Krishnamoorthy |
| collection | DOAJ |
| description | Catastrophic health expenditure [CHE] in India is on a rise. This situation would worsen even further when resources are disproportionately distributed across various socioeconomic classes. Hence, we conducted this study to determine the equity and extent of out-of-pocket [OOP] payments, Catastrophic health expenditure and impoverishment among rural households during COVID-19 pandemic in Tamil Nadu, India. A cross-sectional survey covering 2409 households was conducted during November 2021 across six districts in rural part of Tamil Nadu. Information on out-of-pocket payments, Catastrophic health expenditure (based on 40% capacity-to-pay [CTP] method) and impoverishment was obtained through World Health Organization standard criteria. Point estimates were reported as proportions with 95% Confidence Interval [CI]. Our results showed that the proportion of households with out-of-pocket payments on health and Catastrophic health expenditure in the month preceding the survey was 82.8% (95%CI: 81.2%–84.3%) and 26.9% (95%CI: 25.1%–28.7%) respectively. Nuclear (couple with dependent children only) and joint family type (extended family), presence of under-five children and lower socioeconomic status were significant determinants of Catastrophic health expenditure. The prevalence of impoverishment was 6.4% (95%CI: 5.4%–7.5%). To conclude, more than three fourth of the rural households in Tamil Nadu has out-of-pocket payments for health with one-fourth having Catastrophic health expenditure. Almost one in fourteen non-poor households faced impoverishment during the COVID-19 pandemic. This shows the disproportionate distribution of health expenses especially in the rural areas. Hence, appropriate financial risk protection measures should be taken in order to progress towards universal healthcare in our country. |
| first_indexed | 2024-03-12T12:21:44Z |
| format | Article |
| id | doaj.art-803b96ea19844023af1f7814e82d2e0e |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-03-12T12:21:44Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-803b96ea19844023af1f7814e82d2e0e2023-08-30T05:53:02ZengElsevierHeliyon2405-84402023-08-0198e18902Equity and extent of financial risk protection indicators during COVID-19 pandemic in rural part of Tamil Nadu, IndiaYuvaraj Krishnamoorthy0Sathish Rajaa1Isha Sinha2Murali Krishnan3Gerald Samuel4Krishna Kanth5Corresponding author.; Department of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, IndiaDepartment of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, IndiaDepartment of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, IndiaDepartment of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, IndiaDepartment of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, IndiaDepartment of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, IndiaCatastrophic health expenditure [CHE] in India is on a rise. This situation would worsen even further when resources are disproportionately distributed across various socioeconomic classes. Hence, we conducted this study to determine the equity and extent of out-of-pocket [OOP] payments, Catastrophic health expenditure and impoverishment among rural households during COVID-19 pandemic in Tamil Nadu, India. A cross-sectional survey covering 2409 households was conducted during November 2021 across six districts in rural part of Tamil Nadu. Information on out-of-pocket payments, Catastrophic health expenditure (based on 40% capacity-to-pay [CTP] method) and impoverishment was obtained through World Health Organization standard criteria. Point estimates were reported as proportions with 95% Confidence Interval [CI]. Our results showed that the proportion of households with out-of-pocket payments on health and Catastrophic health expenditure in the month preceding the survey was 82.8% (95%CI: 81.2%–84.3%) and 26.9% (95%CI: 25.1%–28.7%) respectively. Nuclear (couple with dependent children only) and joint family type (extended family), presence of under-five children and lower socioeconomic status were significant determinants of Catastrophic health expenditure. The prevalence of impoverishment was 6.4% (95%CI: 5.4%–7.5%). To conclude, more than three fourth of the rural households in Tamil Nadu has out-of-pocket payments for health with one-fourth having Catastrophic health expenditure. Almost one in fourteen non-poor households faced impoverishment during the COVID-19 pandemic. This shows the disproportionate distribution of health expenses especially in the rural areas. Hence, appropriate financial risk protection measures should be taken in order to progress towards universal healthcare in our country.http://www.sciencedirect.com/science/article/pii/S2405844023061108Health expendituresImpoverishmentIndiaRural health |
| spellingShingle | Yuvaraj Krishnamoorthy Sathish Rajaa Isha Sinha Murali Krishnan Gerald Samuel Krishna Kanth Equity and extent of financial risk protection indicators during COVID-19 pandemic in rural part of Tamil Nadu, India Heliyon Health expenditures Impoverishment India Rural health |
| title | Equity and extent of financial risk protection indicators during COVID-19 pandemic in rural part of Tamil Nadu, India |
| title_full | Equity and extent of financial risk protection indicators during COVID-19 pandemic in rural part of Tamil Nadu, India |
| title_fullStr | Equity and extent of financial risk protection indicators during COVID-19 pandemic in rural part of Tamil Nadu, India |
| title_full_unstemmed | Equity and extent of financial risk protection indicators during COVID-19 pandemic in rural part of Tamil Nadu, India |
| title_short | Equity and extent of financial risk protection indicators during COVID-19 pandemic in rural part of Tamil Nadu, India |
| title_sort | equity and extent of financial risk protection indicators during covid 19 pandemic in rural part of tamil nadu india |
| topic | Health expenditures Impoverishment India Rural health |
| url | http://www.sciencedirect.com/science/article/pii/S2405844023061108 |
| work_keys_str_mv | AT yuvarajkrishnamoorthy equityandextentoffinancialriskprotectionindicatorsduringcovid19pandemicinruralpartoftamilnaduindia AT sathishrajaa equityandextentoffinancialriskprotectionindicatorsduringcovid19pandemicinruralpartoftamilnaduindia AT ishasinha equityandextentoffinancialriskprotectionindicatorsduringcovid19pandemicinruralpartoftamilnaduindia AT muralikrishnan equityandextentoffinancialriskprotectionindicatorsduringcovid19pandemicinruralpartoftamilnaduindia AT geraldsamuel equityandextentoffinancialriskprotectionindicatorsduringcovid19pandemicinruralpartoftamilnaduindia AT krishnakanth equityandextentoffinancialriskprotectionindicatorsduringcovid19pandemicinruralpartoftamilnaduindia |