Hardship due to institutional childbirth: an Indian experience

Using large-scale health survey data for India, we tried to identify various socio-economic and health-related factors that influence hardship financing events, employing multinomial logistic framework. The findings indicate that 21% of women have resorted to some form of hardship financing, and strategies like borrowing, property selling and various hybrid strategies are significantly concentrated among various socio-economic vulnerable groups. We find that unemployed mothers and farming couples are more prone to experience hardship financing events. Instances of using saving and borrowing, a hybrid strategy, were found to increase with the usage of private facilities. However, since the majority of public facility users belong to lower wealth classes and are blue-collar workers, instances of jewelry selling increased. Apart from private health insurances, various employer and employee-funded insurances reduced several hardship-financing events. The Rasthriya Swasthya Bima Yojana, which provides insurance to unorganized sector workers below the poverty line, lowered instances of saving and borrowing, which is mostly used by the poorer section. Given widespread implementation among the masses, the Janani Suraksha Yojana was also found to reduce a few hardship financing events.