title: High Spending on Maternity Care in India: What Are the Factors Explaining It?
abstract: OBJECTIVE
  High maternity-related health care spending is often cited as an important barrier in utilizing quality health care during pregnancy and childbirth. This study has two objectives: (i) to measure the levels of expenditure on total maternity care in disaggregated components such as ANCs, PNCs, and Natal care expenditure; (ii) to quantify the extent of catastrophic maternity expenditure (CME) incurred by households and identify the factors responsible for it.
  
  
  RESULTS
  Data from the 71st round of the National Sample Survey (2014) was used to estimate maternity expenditure and its predictors. CME was measured as a share of consumption expenditure by different cut-offs. The two-part model was used to identify the factors associated with maternity spending and CME. The findings show that household spending on maternity care (US$ 149 in constant price) is much higher than previous estimates (US$ 50 in constant price). A significant proportion of households in India (51%) are incurring CME. Along with economic and educational status, type of health care and place of residence emerged as significant factors in explaining CME.
  
  
  CONCLUSIONS
  Findings from this study assume importance in the context of an emerging demand for higher maternity entitlements and government spending on public health care in India. To reduce CME, India needs to improve the availability and accessibility of better-quality public health services and increase maternity entitlements in line with maternity expenditure identified in this study.
authors.affiliation: Centre for the Study of Regional Development (CSRD), School of Social Sciences (SSS), Jawaharlal Nehru University (JNU), New Delhi, India.
authors.forename: Srinivas
authors.identifier: http://orcid.org/0000-0002-8481-484X
authors.initials: S
authors.lastname: Goli
authors.affiliation: Centre for the Study of Regional Development (CSRD), School of Social Sciences (SSS), Jawaharlal Nehru University (JNU), New Delhi, India.
authors.lastname: Moradhvaj
authors.affiliation: Discipline of Economics, University of Western Australia, Crawley, WA, Australia.
authors.forename: Anu
authors.initials: A
authors.lastname: Rammohan
authors.affiliation: Discipline of Economics, Faculty of Social Sciences, Banaras Hindu University (BHU), Varanasi, Uttar Pradesh, India.
authors.lastname: Shruti
authors.affiliation: Department of Humanities & Social Sciences, National Institute of Technology, Rourkela, Orissa, India.
authors.forename: Jalandhar
authors.initials: J
authors.lastname: Pradhan
mesh_terms: D000293:Adolescent; D000328:Adult; D005163:Factor Analysis, Statistical; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D007194:India; D008875:Middle Aged; D015233:Models, Statistical; D018743:Perinatal Care / Q000191:economics*; D011247:Pregnancy; D012959:Socioeconomic Factors; D055815:Young Adult