Publication:

Financial burden of antenatal care services: a study in Hassan district, Karnataka

Background Antenatal care (ANC) is backbone of the maternal healthcare; yet, the financial burden for receiving these services is a key barrier in less developed and developing countries, including India. Despite schemes by governments to give free maternal and child health care, out-of-pocket expenditure remains considerable financial burden for households, particularly within financially weaker population. This study analyses the financial burden of ANC services in Hassan district, by comparing the total direct, indirect and total costs of ANC services among public, private and mixed healthcare centres.

Methods For this purpose, a cross-sectional study was conducted among 415 antenatal women who had engaged ANC services in Hassan district. Data were collected on socio-demographic elements, healthcare centres usage patterns and total cost components including total direct and indirect cost. One-way ANVOA tests was applied to evaluate cost divergence throughout healthcare centres types, accompanied by Dunn’s post-Hoc pairwise comparisons with Bonferroni correction.

Results The results of ANOVA indicated there is a significant difference in all three costs of ANC services for three types users. Catastrophic health expenditure occurred in 51.6% of public healthcare centres users, followed by 51.5% of mixed and 43.3% of private healthcare centres users.

Conclusions According to this study we found that, catastrophic health expenditure is still a significant issue in this study area. Therefore, policy measures required to emphasise on upgrade of public healthcare centres infrastructure, and the control of private healthcare centres pricing.