Addressing Women's Non-Maternal Healthcare Financing in Developing Countries: What Can We Learn from the Experiences of Rural Indian Women?

Background and Objectives: This paper focuses on the inadequate attention on women’s non-maternal healthcare in lowand middle-income countries. The study assessed the purchase of and financial access to non-maternal healthcare. It also scoped for mainstreaming household financial resources in this regard to suggest for alternatives. Methods: A household survey through multi-stage stratified sampling in the state of Orissa interviewed rural women above 15 years who were neither pregnant nor had any pregnancy-related outcome six weeks preceding the survey. The questions explored on the processes, determinants and outcomes of health seeking for non-maternal ailments. The outcome measures were healthcare access, cost of care and financial access. The independent variables for bivariate and multivariate analyses were contextual factors, health seeking and financing pattern. Results: The survey obtained a response rate of 98.64 % and among 800 women, 43.8 % had no schooling and 51 % were above 60 years. Each woman reported at least one episode of non-maternal ailment; financial constraints prevented 68% from receiving timely and complete care. Distress coping measures (e.g. borrowings) dominated the financing source (67.9%) followed by community–based measures (32.1%). Only 6 % had financial risk-protection; financial risk of not obtaining care doubled for women aged over 60 years (OR 2.00, 95 % CI 0.84–4.80), seeking outpatient consultation (OR 2.01, 95 % CI 0.89–4.81), facing unfavourable household response (OR 2.04, 95 % CI 1.09–3.83), and lacking other financia

Predictors of reported financial access to timely and complete non-maternal healthcare.

<p>*<i>Reference category in the multiple logistic regression.</i></p>#<p> <i>- Adjusted for social classes, house type, family type, poverty status, personal income, and educational status.</i></p

Trajectory of the proposed ‘integrated financing approach’ for non-maternal healthcare in LMICs.

<p>Trajectory of the proposed ‘integrated financing approach’ for non-maternal healthcare in LMICs.</p

Determinants of cost of care of non-maternal healthcare.

<p>*<i>Reference group in the multiple logistic regression.</i></p>#<p> <i>- Adjusted for house type, family type, poverty status, personal income, and educational status.</i></p

Characteristics of households (N = 800).

<p>*<i>Scheduled tribe and scheduled caste are considered as socioeconomically marginalized populations and receive special focus and privileges from the Federal Government.</i></p>#<p> <i>Below poverty line households are those living on <$1 per capita/day as per current Indian estimation. In our survey a household was listed as ‘below poverty line’ if it possessed the social security identification card issued by the Federal Government indicating its poverty status, not based on income reported by respondents.</i></p

Particulars of non-maternal ailments, care seeking and determinants.

<p>Particulars of non-maternal ailments, care seeking and determinants.</p

Existing healthcare financing context for women in low- and middle-income countries.

<p>Existing healthcare financing context for women in low- and middle-income countries.</p