OBJECTIVES:

In India, 5 women die hourly during childbirth and the risk of death is significantly higher postpartum. Increased health care spending is often cited as an important barrier in quality service utilization, both during childbirth, and postpartum. Our goal was to identify the determinants of post-natal care spending to address this financial barrier.

METHODS:

Social consumption and health data from the National Sample Survey Organization Round 71 (2014) from the Ministry of Statistics and Implementation of the Government of India was used. General Linear Model was used to identify the various determinants on expenditure for postnatal care using STATA version 14.1.

RESULTS:

A sample of 19,532 postnatal women was studied. Average cost of deliveries and postnatal care for women was INR1921. Main sources of postnatal care were public tertiary hospitals (31.09%), private tertiary hospitals (27.38%), Primary Health Center- PHC (8.05%), private clinic (8.05%), and health workers (7.23%). Majority of the women used allopathic medicine (84.76%). Mothers delivering in private clinic spent INR946.41 (CI: 187.90-1704.92) and women delivering in private hospital spent INR659.91 (CI: 47.50-1272.32) higher than delivery in a sub-center. Compared to women who received care in sub-centers, women who received postnatal care in a private clinic for the last 365 days spent INR1107.11 (CI: 833.04-1381.18) higher followed by those who received care in PHCs 1182.45 (CI: 889.35-1475.56). Women using allopathic medicines spent INR317.60 (CI: -614.626 to -20.57) less compared to women receiving alternative medicine

CONCLUSIONS:

Utilization of private sector hospitals and clinics were found to lead to higher expenses for postnatal care. Cost saving solutions for labor and postnatal care include conducting deliveries and the effective training of health care workers at the grass roots, sub-center level. Furthermore, since allopathic medicines resulted in lower health care costs, steps should be taken to encourage the use of allopathic medicines.