Dataset Information

Sub-national health accounts: Experience from Punjab State in India.

ABSTRACT: INTRODUCTION:Public health spending in India has been traditionally one of the lowest globally. Punjab is one of the states with highest proportion of out-of-pocket expenditures for healthcare in India. We undertook this study to produce the sub-national health accounts (SNHA) for Punjab state in India. METHODOLOGY:We used System of Health Accounts (SHA) 2011 framework for preparing health accounts for Punjab state. Data on health spending by government was obtained from concerned public sector departments both at state and central level. Estimates on Out-of-Pocket Expenditures (OOPE) expenditure were derived from National Sample Survey (NSS) 71st round data, Consumer Expenditure Survey (CES) data and Pharmatrac. Primary surveys were done for assessing health expenditure data by firms and non-governmental organizations. All estimates of healthcare expenditures reported in our paper pertain to 2013-14, and are reported in both Indian National Rupee (INR) and United States Dollar (US $),using average conversion rate of INR 60.50 per US $. RESULTS:In 2013-14, the current health expenditures (CE) in Punjab was INR 134,680million (US $ 2245 million) which was 4.02% of its gross state domestic product (GSDP).However, public spending on health was 0.95% of GSDP i.e. 21% of the total health expenditure (THE), while 79% was private expenditure. In per capita terms, THE in Punjab was INR 4963 (US $ 82.03). In terms of functions, medical goods (41.6%) and curative care (37%) consumed larger share of expenditure in the Punjab state. Households spent 52% of expenditures for medicines and other pharmaceutical goods. Risk pooling mechanisms are being adopted to a lesser extent in the state. CONCLUSION:The healthcare in Punjab is largely financed through private OOPE. Currently, public health spending in Punjab is inadequate to meet the healthcare demands of population, which is less than 1% of state's GSDP. Monitoring public resources is very important for better resource allocations. Health Accounts production is useful in order to assess future trends and impact of health financing policies on goals of universal health coverage and should be made a part of routine monitoring system both at national and sub-national level.

SUBMITTER: Bahuguna P

PROVIDER: S-EPMC6287852 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Sub-national health accounts: Experience from Punjab State in India.

Bahuguna Pankaj P Mukhopadhyay Indranil I Chauhan Akashdeep Singh AS Rana Saroj Kumar SK Selvaraj Sakthivel S Prinja Shankar S

PloS one 20181210 12

<h4>Introduction</h4>Public health spending in India has been traditionally one of the lowest globally. Punjab is one of the states with highest proportion of out-of-pocket expenditures for healthcare in India. We undertook this study to produce the sub-national health accounts (SNHA) for Punjab state in India.<h4>Methodology</h4>We used System of Health Accounts (SHA) 2011 framework for preparing health accounts for Punjab state. Data on health spending by government was obtained from concerned ...[more]

PMID: 30532271

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Project description:OBJECTIVE:The National Family Health Survey-4 in India provided the first nationally representative estimates of hysterectomy among women aged 15-49. This paper aims to examine the national and state-level age-specific prevalence of hysterectomy, individual and household level factors associated with the procedure, and state-level indicators that may explain variation across states. DESIGN:Cross-sectional, nationally representative household survey. SETTING:National Family Health Survey was conducted across all Indian states and union territories between 2015 and 2016. POPULATION:The survey covered 699 686 women between the ages of 15 and 49 years. METHODS:Descriptive analyses and multivariate logistic regression. MAIN OUTCOME MEASURES:Women who reported ever having a hysterectomy and age at hysterectomy. RESULTS:Age-specific prevalence of hysterectomy was 0.36% (0.33,0.39) among women aged 15-29; 3.59% (3.45,3.74) among women aged 30-39; and 9.20% (8.94,9.46) among women 40-49 years. There was considerable variation in prevalence by state. Four states reported age-specific prevalence similar to high-income settings. Approximately two-thirds of hysterectomies were conducted in private facilities, with similar patterns across age groups. At the national level, higher age and parity (at least two children); not having had formal schooling; rural residence (adjusted odds ratio [AOR] 1.36; 95% CI 1.27,1.45; P < 0.01) and higher wealth status were associated with higher odds of hysterectomy. Previously sterilised women had lower odds (AOR 0.64; 95% CI 0.61,0,68; P < 0.01) of reporting hysterectomy. Exploratory analyses suggest state-level factors associated with prevalence of hysterectomy include caesarean section, female illiteracy, and women's employment. CONCLUSIONS:Hysterectomy patterns among women aged 15-49 in India indicate the critical need to ensure treatment options for gynaecological morbidity and to address hysterectomy among young women in particular. FUNDING:This study was part of the RASTA initiative of the Population Council's India country office under the Evidence Project supported by USAID. TWEETABLE ABSTRACT:Hysterectomy patterns in India highlight the need for alternatives to treat gynaecological morbidity among younger women.

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Sub-national health accounts: Experience from Punjab State in India.

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Sub-national health accounts: Experience from Punjab State in India.

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