ABSTRACT
Health insurance is an efficient way to help people prepare for contingency health care. Health care would be more equitable under community-based insurance than the out-of-pocket system. Such a scheme is especially important for the marginalized population. Objective: To study the awareness and willingness to participate in a community-based scheme among the families. Study Design: Cross-sectional community based. Setting: Urban slums and resettlement colonies in East Delhi. Participants: Head of families or available adult member of 510 families. Statistical Analysis: Proportions, Chi square test. Results: Most of the families had a per capita income of Rs.200-600 per month. Average out-of-pocket expenditure on healthcare per person per month was Rs.38.50. Nearly one-fourth of the families had some hospitalization in past 6 months, with loss of man-days and loss of wages. More than three-fourths of the respondents were aware about ‘insurance’, believed that health insurance is beneficial, and expressed willingness to participate. There is a need for health insurance among this population, and with government assistance and proper planning and education, community-based health insurance can possibly help these families manage their health care costs better.
Subject(s)
Community Health Planning/economics , Delivery of Health Care/economics , Health Expenditures/economics , Health Expenditures/methods , Humans , Insurance, Health/economics , Insurance, Health/education , Insurance, Health/methods , Insurance, Health/trends , Insurance, Health/statistics & numerical data , Poverty Areas , Urban PopulationABSTRACT
OBJECTIVE: To assess the immunization coverage of BCG, DPT, OPV, Measles, MMR and Hepatitis B vaccines in two urbanized villages of East Delhi and study the factors affecting the coverage. METHODS: Children of age 24-47 months were selected using systematic random sampling. Information on socio-demographic factors and immunization status was obtained by house-to- house visit. Immunization coverage of all vaccines was computed and analysis of association between immunization coverage and socio-demographic factors was done. RESULTS: The coverage levels were 82.7% for BCG, 81.5% for DPT/OPV 1, 76.8% for DPT/OPV 2, 70.7% for DPT/OPV 3 and 65.3% for measles vaccine. It was 41.4% and 41.6% for DPT booster and MMR vaccine. Higher education of mother (OR=1.96) and father (OR=1.80), father's occupation (OR=1.86), residential status (OR=1.76), place of birth (OR=2.64) and presence of immunization card (OR=5.8) were significant determinants for complete immunization on univariate analysis. On regression analysis mother's education (OR=1.43), presence of immunization card OR=2.05 and place of birth (OR=3.80) remained significant. CONCLUSION: Immunization evaluation surveys have shown a wide variation across regions, states and different strata of the society.