Using data from the household surveys on health conducted by the National Sample Survey Office between 2004 and 2014, the utilisation patterns of health facilities for childbirth and the associated
out-of-pocket expenditure are analysed. The findings reveal that the utilisation of public facilities for childbirth increased three times in rural areas and almost one and a half times in urban areas between 2004 and 2014, but that most deliveries took place in district hospitals. Also, the average medical expenditure on childbirth in government health facilities declined by 36% in rural areas and by 5% in urban areas. Considerable interstate variations in regard to oop expenditure on drugs, diagnostics and transportation were also witnessed. Though government policies to promote institutional births have improved the utilisation of public facilities and reduced the overall oop expenditure, more needs to be done for the benefits to reach the vulnerable sections, especially in urban areas.
