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Determinants and Trends in Distress Financing for Childbirth Delivery in India Evidence from NFHS 4 and NFHS 5
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- Determinants and Trends in Distress Financing for Childbirth Delivery in India Evidence from NFHS 4 and NFHS 5
Abstract Content (not more than 300 word, should include: Introduction, Objective, Methodology, critical findings & Conclusion):
Introduction: Distress financing for childbirth delivery by borrowing from friends/relatives or selling assets/jewellery to pay for delivery which undermines financial risk protection. This study assesses socio-economic and regional correlates across NFHS-4 and NFHS-5.
Method: Using nationally representative NFHS data, we fit logistic regressions on a binary indicator of distress financing. Covariates included multidimensional poverty (MPI; Alkire–Foster, 2011), out-of-pocket (OOP) expenditure, residence, region, religion, caste, household size, maternal age, and health insurance; we tested an MPI×urban interaction. Multicollinearity was low (mean VIF ≈ 1.04 in NFHS-4; 1.07 in NFHS-5). Model fit was assessed using pseudo-R2 and likelihood-ratio tests.
Results: The sample comprised 39,283 (NFHS-4) and 41,748 (NFHS-5) births. Higher OOP was consistently associated with higher odds (OR ≈ 1.00004 per currency unit, p < 0.001). Urban residence was protective (NFHS-4 OR = 0.68; NFHS-5 OR = 0.73; p < 0.001). The MPI association reversed: MPI-poor had slightly higher odds in NFHS-4 (OR = 1.02, p < 0.001) but lower odds in NFHS-5 (OR = 0.76, p < 0.001); the MPI×urban term suggested added protection among the urban poor (NFHS-5 OR = 0.90, p < 0.001). Insurance shifted from harmful (NFHS-4 OR = 1.15, p < 0.001) to protective (NFHS-5 OR = 0.92, p < 0.001). Heterogeneity persisted: Muslims vs Hindus (OR = 1.22) and Scheduled Castes (OR = 1.29) had higher odds; Scheduled Tribes (OR = 0.78) and General caste (OR = 0.81) had lower odds. Regional disparities were marked, with elevated odds in Eastern, North-Eastern, and Southern regions. Model performance improved (pseudo-R2: 0.062 to 0.087).
Conclusions: Inequities persist in residence, caste, region and religion. Distress financing remains driven by OOP, financial protection must improve, and region-specific strategies are needed to reduce OOP and protect vulnerable groups.
Abstract theme:
In case of not been selected for oral presentation, do you want to be considered for the poster presentation ?:
Yes
Do you require financial support to attend the seminar ? (Not applicable for virtual meet):
Yes-full
Gender:
Male
Evaluation Status:
No