Overcoming the Methodological Limitation in Estimating Catastrophic Health Expenditure on Institutional Delivery Using Indian Demographic Health Survey

Suyash Mishra, International Institute for Population Sciences (IIPS)

he most preferred measures of household economic well-being are income and consumption expenditure. Researchers commonly use the Principal Component Analysis-based wealth index as an economic proxy due to the lack of food expenditure data in Demographic Health Surveys (DHS), preventing us from estimating health outcomes' catastrophic effects on households. This study aims to impute consumption expenditure data from the 78th round of the National Sample Survey Office (NSSO) into the fourth round of the National Family Health Survey (NFHS-5) and estimate the incidence of Catastrophic Health Expenditure (CHE) and impoverishment associated with institutional delivery in India using the capacity-to-pay approach. We found that the incidence of CHE related to institutional delivery in India was approximately 21%, and the extent of impoverishment was 5%. The proportion of CHE was higher in rural areas (24.8%) compared to urban areas (12.6%). The incidence of CHE varied significantly by state, ranging from 7.2% in Goa to 33% in West Bengal. Households in the richest quintile had a lower likelihood of incurring CHE (AOR: 0.04), while households in rural areas faced more than twice the likelihood of incurring CHE (AOR: 2.13). We observed a similar pattern with varying magnitudes for impoverishment.

Keywords: Data and Methods, Linked data sets , Inequality, Disadvantage and Discrimination, Econometrics

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