Evaluation study of Out Of Pocket Expenditure Incurred for Maternal Health Care by BPL Women in Karnataka in Public Health facilities.

According to WHO’s Global Health Expenditure Database, "Out-of-Pocket-Expenditure (OOPE)" in India is among the highest in the world. The nature of expenditure on maternal health care is not an exception even among the BPL families as a major share of it comes from OOPE of the households. This study explored levels and components of out-of-pocket health expenditures in 5 districts — Bangalore Rural, Belgaum, Bellary, Chikmagalur and Haveri. Survey captured OOPE data on maternal health spending starting from the confirmation of pregnancy to post-natal period of 45 days. Expenditure data on service utilization or purchase of service, like consultations, lab tests, scanning, medicines purchase, in kind payments transportation and food were collected.


Project Snapshot:

Project Name Evaluation study of Out Of Pocket Expenditure Incurred for Maternal Health Care by BPL Women in Karnataka in Public Health facilities.
Project Sanction Date 30 Jan 2019
Project Period Jan 2019 to Mar 2020
Project Location Bangalore rural, Belgaum, Bellary, Chikmagalur, Haveri District in Karnataka
Project Supported By
Project Team

Project objectives:

• Examine the magnitude and dimensions of OOPE at macro and micro household level.

• Identify the various sources through which OOPE is met by the family.

• Find out the reach of the Maternal Health schemes to the targeted beneficiaries across the regions and suggest appropriate measures for improving for improving the "better reach" of the maternal schemes and in turn improving their effectiveness.

• Examine the financial adequacy of various maternal health schemes, the regularity, and real time disbursement of the cash and other incentives under the schemes.

• Examine the component of transport cost in the OOPE.

Project Result / Accomplishments:

  • Give a minimum of hundred rupees to pregnant women towards the travel and food expenditure per ANC visit to ensure appropriate check-ups / follow up and enhancing compliance rate for complete ANC check-ups.   
  • The Government may take appropriate decision to upgrade the PHCs in to 24X7 based on the need and feasibility.
  • Improve the service availability at CHC by converting them to First Referral Units which help handle emergency obstetric care and complicated deliveries. Allocate Adequate human resource for health at CHC and sub divisional hospitals to handle referrals.
  • Look for feasibility of appointing an Ombudsman public health at state level. Also suggested to appointment upa-lokayukta at district level to enhance the grievance redressal and accountability mechanisms. 
  •  Improve the Ambulance services for delivery care transportation as it helps compensate transportation expenditures. Follow what other states are following with respect to JSSK Ambulance and drop back.



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