ArticleInternational journal for equity in health2020
Understanding equity of institutional delivery in public health centre by level of care in India: an assessment using benefit incidence analysis.
Article in International journal for equity in health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 20 citations in OpenAlex.
- En Route to Midwifery Professionalisation: Contextualising Midwifery Care in the Indian Public Health System.Community health equity research & policy · 2026Article
- Data Innovation, Program Implementation, and Community Action (DIPICA) Observatory for Surgical, Anesthesia, and Obstetric (SAO) Care in India.BMC proceedings · 2025Article
- Who benefits from the donor-supported malaria programme in Enugu State, Nigeria? A benefit incidence analysis.PLOS global public health · 2025Article
- Wealth-based equity in essential newborn care practices in Ethiopia: A cross-sectional study.PloS one · 2025Article
- Article
- Are institutional deliveries equitable in the southern states of India? A benefit incidence analysis.International journal for equity in health · 2024Article
- Financing for equity for women's, children's and adolescents' health in low- and middle-income countries: A scoping review.PLOS global public health · 2024Article
- Out-of-pocket expenditure and its correlates for institutional deliveries in private and public healthcare sectors in India: findings from NFHS 5.BMC public health · 2023Article
- Universal health coverage and the poor: to what extent are health financing policies making a difference? Evidence from a benefit incidence analysis in Zambia.BMC public health · 2022Article
- Are cesarean deliveries equitable in India: assessment using benefit incidence analysis.BMC health services research · 2022Article
- Institutional deliveries in India's nine low performing states: levels, determinants and accessibility.Global health action · 2021Article
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4 authors at 1 institution in 1 country.
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Abstract
backgroundThe National Health Mission (NHM), the largest ever publicly funded health programme worldwide, used over half of the national health budget in India and primarily aimed to improve maternal and child health in the country. Though large scale public health investment has improved the health care utilization and health outcomes across states and socio-economic groups in India, little is known on the equity concern of NHM. In this context, this paper examines the utilization pattern and net benefit of public subsidy for institutional delivery by the level of care in India.
methodsData from the most recent round of the National Family Health Survey (NFHS 4), conducted during 2015-16, was used in the study. A total of 148,645 last birth delivered in a health centre during the 5 years preceding the survey were used for the analyses. Out-of-pocket (OOP) payment on delivery care was taken as the dependent variable and was analysed by primary care and secondary level of care. Benefits Incidence Analysis (BIA), descriptive statistics, concentration index (CI), and concentration curve (CC) were used to do the analysis.
resultsInstitutional delivery from the public health centres in India is pro-poor and has a strong economic gradient. However, about 28% mothers from richest wealth quintile did not pay for delivery in public health centres compared to 16% among the poorest wealth quintile. Benefit incidence analyses suggests a pro-poor distribution of institutional delivery both at primary and secondary level of care. In 2015-16, at the primary level, about 32.29% of subsidies were used by the poorest, 27.22% by poorer, 20.39% by middle, 13.36% by richer and 6.73% by the richest wealth quintile. The pattern at the secondary level was similar, though the magnitude was lower. The concentration index of institutional delivery in public health centres was - 0.161 [95% CI, - 0.158, - 0.165] compared to 0.296 [95% CI, 0.289, 0.303] from private health centres.
conclusionProvision and use of public subsidy for institutional delivery in public health centres is pro-poor in India. Improving the quality of service in primary health centres is recommended to increase utilisation and reduce OOP payment for health care in India.
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