George Institute for Global Health Reports Findings in Public Health (Gender-specific inequalities in coverage of Publicly Funded Health Insurance Schemes in Southern States of India: evidence from National Family Health Surveys): Health and Medicine – Public Health

2023 DEC 20 (NewsRx) -- By a News Reporter-Staff News Editor at Education Daily Report -- New research on Health and Medicine - Public Health is the subject of a report. According to news originating from New Delhi, India, by NewsRx correspondents, research stated, “Publicly Funded Health Insurance Schemes (PFHIS) are intended to play a role in achieving Universal Health Coverage (UHC). In countries like India, PFHISs have low penetrance and provide limited coverage of services and of family members within households, which can mean that women lose out.”

Financial support for this research came from Wellcome Trust/DBT India Alliance Fellowship.

Our news journalists obtained a quote from the research from George Institute for Global Health, “Gender inequities in relation to financial risk protection are understudied. Given the emphasis being placed on achieving UHC for all in India, this paper examined intersecting gender inequalities and changes in PFHIS coverage in southern India, where its penetrance is greater and of longer duration. This study used the fourth (NFHS-4, 2015-16) and fifth (NFHS-5, 2019-21) rounds of India’s National Family Health Survey for five southern states: namely, Andhra Pradesh, Karnataka, Kerala, Tamil Nadu, and Telangana. The World Health Organization’s Health Equity Assessment Toolkit (HEAT) Plus and Stata were used to analyse PFHIS coverage disaggregated by seven dimensions of inequality. Ratios and differences for binary dimensions; Between Group Variance and Theil Index for unordered dimensions; Absolute and Relative Concentration Index (RCI) for ordered dimensions were computed separately for women and men. Overall, PFHIS coverage increased significantly (p < 0.001) among women and men in Andhra Pradesh, and Kerala from NFHS-4 to NFHS-5. Overall, men had higher PFHIS coverage than women, especially in Andhra Pradesh, Tamil Nadu, and Telangana in both surveys. In both absolute and relative terms, PFHIS coverage was concentrated among older women and men across all states; age-related inequalities were higher among women than men in both surveys in Andhra Pradesh, Kerala, and Telengana. The magnitude of education-related inequalities was twice as high as among women in Telangana (RCI: -12.23; RCI -9.98) and Andhra Pradesh (RCI: -8.05; RCI -7.84) as compared to men in Telangana (RCI: -5.58; RCI -2.30) and Andhra Pradesh (RCI: -4.40; RCI -3.12) and these inequalities remained in NFHS-5, suggesting that lower education level women had greater coverage. In the latter survey, a high magnitude of wealth-related inequality was observed in women (RCI: -15.78; RCI: -14.36) and men (RCI: -20.42; RCI: -13.84) belonging to Kerala, whereas this inequality has decreased from NFHS-4 to NFHS-5., again suggestive of greater coverage among poorer populations. Caste-related inequalities were higher in women than men in both surveys, the magnitude of inequalities decreased between 2015-16 and 2019-20. We found gender inequalities in self-reported enrolment in southern states with long-standing PFHIS. Inequalities favoured the poor, uneducated and elderly, which is to some extend desirable when rolling out a PFHIS intended for harder to reach populations. However, religion and caste-based inequalities, while reducing, were still prevalent among women.”

According to the news editors, the research concluded: “If PFHIS are to truly offer financial risk protection, they must address the intersecting marginalization faced by women and men, while meeting eventual goals of risk pooling, indicated by high coverage and low inequality across population sub-groups.”

For more information on this research see: Gender-specific inequalities in coverage of Publicly Funded Health Insurance Schemes in Southern States of India: evidence from National Family Health Surveys. BMC Public Health, 2023;23(1):2414. BMC Public Health can be contacted at: Bmc, Campus, 4 Crinan St, London N1 9XW, England. (BioMed Central - http://www.biomedcentral.com/; BMC Public Health - http://www.biomedcentral.com/bmcpublichealth/)

The news correspondents report that additional information may be obtained from Santosh Kumar Sharma, George Institute for Global Health, New Delhi, India. Additional authors for this research include Devaki Nambiar, Hari Sankar, Jaison Joseph, Surya Surendran and Gloria Benny.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1186/s12889-023-17231-0. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

The publisher’s contact information for the journal BMC Public Health is: Bmc, Campus, 4 Crinan St, London N1 9XW, England.

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