Gender Analysis Of Publicly Funded Health Insurance Schmes

Abstract

The WHO estimates that around 800 million are spending 10% of their household budget on newlineout of pocket health expenses and above 100 million is being pushed to extreme poverty each newlineyear due to health care costs (WHO 2017). The National Health Accounts of India points out newlinethat 69.1% of all healthcare expenditures were borne by the households (Government of newlineIndia 2016b). In response to these growing health insecurities across the world, there is a newlinewave of initiatives under the umbrella of Universal Health Coverage (UHC). However, the newlinerelationship between Universal Health Coverage and Gender Equity remains a less newlineunderstood. Even though India has been the experimental ground since 2007 for several newlinePublicly Funded Health Insurance Schemes (PFHIS), the study of gender dimensions in such newlineschemes has not received its due attention. The literature review revealed that not only the newlineschemes but research on PFHIS might themselves carry gender-based assumptions that newlineobscure the realities of women. Acknowledging that there is a need to go beyond the unitary newlinehousehold model, this thesis aimed to study the Chief Minister s Comprehensive Health newlineInsurance Scheme (CMCHIS) of Tamil Nadu with a gender lens. newlineBased on the theories of equity, social relations and access to health care, the study was newlineformulated to include a mixed methods design involving secondary data as well as primary newlinedata collected from one urban and one rural low-income location in two districts of Tamil newlineNadu. Initially, the data from Tamil Nadu Central sample of NSSO 71st Round (3917 newlinehouseholds) was disaggregated. Findings revealed that women had equal rates of newlinehospitalization and membership in PFHIS, but health expenditures were low for women than newlinemen. Next, the official data on the CMCHIS scheme on empanelment of hospitals, newlineenrollment, and claims (totaling 924362) were disaggregated. These analyses revealed newlinegeographical inequities, the lower share of insurance claims from women and marginalized newlinesocial groups and the dominance of the