Ladusingh, Laishram, Sanjay Kumar Mohanty, and Melody Thangjam, “Triple Burden of Disease and out of Pocket Healthcare Expenditure of Women in India,” PLOS One 13, no.5 (May 2018), doi:10.1371/journal.pone.0196835

URL: journals.plos.org/plosone/article?id=10.1371/journal.pone.0196835

Abstract

Aim: Women, unlike men, are subjected to triple burden of disease, namely, non-communicable and communicable diseases and reproductive health related diseases. To assess prevalence of triple burden of disease of currently married women and to contrast out of pocket maternal care expenditure of these diseases in India.

Subject and methods: This study uses nationally representative unit level data from the 71st round (2014) of the National Sample Survey Organisation. Descriptive statistics and bivariate analysis are employed to assess triple burden of diseases by background of currently married women. Mean out of pocket (OOP) expenditure for healthcare care by demographic and household characteristics of women are also compared by type of diseases. Two parts model is adopted for assessment of determents of out of pocket healthcare expenditure of women.

Results: Overall medical and non-medical expenses of non–communicable disease are much higher than those of other disease and disability, reproductive health related and communicable diseases. OOP expenditure for treatment of non-communicable diseases, reproductive health and related diseases and other disease and disability are significantly higher than the inpatient treatment of communicable diseases and the differences are statistically significant.

Conclusion: Out of pocket expenditure for treatment of non-communicable diseases is the highest, followed by that of other diseases & disability, then reproductive health related diseases and the least is for communicable diseases. OOP expenditures for maternal healthcare in private health facilities are much higher than in public health facilities regardless of types of disease. Women from households having insurance of any member spent less than that of women from households not having health insurance. There is an urgent need to expand the outreach of the public health system in India to rural areas.

While the majority of women’s global health focuses on reproductive and maternal health, this study emphasizes the need for a broader outlook on the healthcare needs of women. It also notes that women in low-income settings in India are less likely to seek medical help, indicating that more women may be suffering from ill health than the data suggests. Out of pocket expenditures have impoverished over 10% of rural households.