Divya Nair, Sitanshu Sekhar Kar, Kalaiselvi Selvaraj, Archana Ramalingam
Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Background: Information on out of pocket (OOP) health care expenditure is essential for health planning and devising strategies for Universal Health Coverage (UHC). Aims and objectives: To describe morbidity profile, treatment preferences and OOP expenditure toward health care of under five children in an urban primary health center of Puducherry. Materials and Methods: A cross-sectional study was conducted in four Anganwadi centers selected randomly from a total of 13 centers in the urban service area of JIPMER, Puducherry. All mothers of under five children from selected centers were interviewed regarding sociodemographic details, treatment preferences, and expenditure incurred on illness of under five children by the family for a period of 15 days and 3 months (exclusive of past 15 days) preceding the day of interview. Results: Among the 164 children studied, 23.8% and 30% reported illnesses in the past 15 days and 3 months, respectively. Most frequent illness reported was respiratory infections. Private facilities (60%) were the preferred sources for seeking health care. Median OOP expenditure in last 15 days was Rs. 375 and Rs. 450 for the past 3 months, amounting to 8% and 6.8% of the total family income, respectively. The majority of the health care expenditure was toward drugs (71%). No money was spent toward healthcare in government facilities. Conclusion: Almost all OOP health care expenditure was incurred when the illnesses were managed by private providers. Hence, strategies can be planned to include private providers under UHC.
Keywords: Acute illness, out of pocket expenditure, preferred provider, under five children.