ANNOUNCEMENTS
Developing countries since a decade have tried to make provision through policies to make healthcare services affordable for all under the guidelines for Universal Health Coverage (UHC) with a sincere focus on people living Below Poverty Line (BPL). These policy provisions have come through indirect transfer of money for treatment of various diseases via “Health Insurance Interventions” in India. Due to the financial constraints and not being able to avail treatment at the right time, many people especially women and children witness unforeseen conditions with respect to health indicators of maternal mortality rate (MMR) and infant mortality rate (IMR). The current study tries to analyse the impact of rising central and state government funded health insurance scheme on the out-of-pocket (OOP) expenditure of the poor and vulnerable households with focus on maternal and child healthcare. Further, the aspect of quality care is also studied. The same has been empirically analysed in two stages; secondary data analysis and primary data analysis. Taking account of the aspect of health insurance schemes via IHDS survey for 2004-05 and 2011-12 provides an overview of status of health insurance schemes and their effects. Further, case specific analysis of one of the most comprehensive scheme in Rajasthan i.e. Bhamashah Swasthya Bima Yojana (BSBY) has been incorporated to understand the impact of the intervention on women and children through delivery cases in an urban village of Jhalana, Jaipur. The outcome variables considered for the study are; OOP expenditure, quality of care received considering the prescribed number of antenatal check-ups, number of days of hospitalisation after delivery and level of satisfaction from availing services at the hospital. Using the methods of impact evaluation in terms of logistic and log-linear regression models inferences were drawn. Along with this Propensity Score Matching (PSM) has been used for primary dataset to consider the average treatment of treated (TOT) effect. Results in terms of secondary dataset showed a reduction in OOP expenditure for only the people in medium income group (72,000 to 1,32,000 per annum). For the primary survey, results showed a reduction in OOP for women getting delivery done through BSBY. Quality of care also improved on having a health insurance benefit affirmed by secondary and primary data analysis.
Key Words: Out-of-pocket Expenditure, Quality of Care, Health Insurance, Bhamashah Swasthya Bima Yojana, Maternal Mortality Rate, Infant Mortality Rate
