Maternal Health Financing in Gujarat: Preliminary Results from a Household Survey of Beneficiaries under Chiranjeevi Scheme

The objective of this paper is to provide preliminary analysis of information collected at household level from beneficiaries of the Chiranjeevi scheme and from those who have not used the scheme (non-user group). The key findings have been discussed. Some of the questions which have guided this exercise are: understanding the socio-economic profile and differences of the households who have used the scheme and those who have not used the scheme, ability of scheme to target the poor and out-of-pocket expenditures incurred both users and non-users of the scheme. We have discussed this by analysing education, land holding, number of earning members in the family, possession of specific assets, age of women at the time of delivery, ANC services received, place of delivery, distance and time taken to reach the facility, status (normal or complication) of delivery, complications experienced, and cost incurred during the process. The total sample size consists of 656 respondents from 3 talukas of Dahod District. Of these total 656 respondents, 262 (40 per cent) are Chiranjeevi clients and 394 (60 per cent) comprise the non-user group. Key findings of the study are: * The Chiranjeevi scheme is being used by relatively younger mothers and having lesser number of children at the time of index delivery. * Most of the Chiranjeevi users have income levels less than Rs. 12,000 per annum indicating the scheme is able to target the poor families in these three blocks of the district, * The expenditure incurred by non-user group on index (recent) delivery at a private facility is Rs. 4000. * The average expenditure incurred by the Chiranjeevi beneficiary on their previous delivery was Rs. 3070. On index delivery a Chiranjeevi client has spent out-of- pocket on an average Rs. 727 per delivery on medicine (self Rs. 297, child Rs. 358) and transportation Rs.72 indicating that the delivery is not really cash-less. However, the average amount saved by the Chiranjeevi client by availing the benefit of the scheme is Rs 3273 (Rs. 4000 minus Rs. 727). * The average distance travelled by a Chiranjeevi client to reach the health care facility is 13.79 kms and the average time taken is 44 minutes. * The average expenditure on transportation using mostly private transport by a Chiranjeevi client is Rs.272 as compared to Rs. 200 which the Chiranjeevi client is reimbursed, * Private doctors have conducted 41 per cent of deliveries where as rest of the deliveries have been conducted by staff at the private health care facility under the Chiranjeevi scheme, * ANMs have been the source of information to 55 per cent of Chiranjeevi scheme users. Anganwadi workers provided information to 17 percent of the clients and Female Health Workers to 10 per cent of the Chiranjeevi clients. Thus, 82 per cent of the total beneficiaries of the Chiranjeevi scheme were provided information by the community health workers.