Poverty due to Noncommunicable Diseases among Indian States using Human Development Survey Data

Background Non-communicable Disease (NCDs) accounts for a large amount of Out-of-Pocket expenditure (OOPE) in India. In the absence of Universal Health Coverage (UHC), such health expenditure results in financial losses and can drive into poverty. Our study examines the effect of borrowing on the level of poverty, the contribution of each disease to poverty and the determinants of borrowing. Method Pre – OOPE poverty headcount was computed using Monthly Per Capita Consumption Expenditure (MPCE) against the national poverty line. For households relying on borrowing, Post – OOPE poverty was recalculated, and the difference was used to assess the impact of borrowing. The contribution of each NCDs was computed as the proportion of poverty cases attributable to each disease. Determinants of borrowings was computed through multivariate logistic regression model. Results In 2005, states reported high incidence of poverty due to NCDs includes Bihar (1.2 %; 95% CI: 0.3 – 2.0), Madhya Pradesh (0.9 %; 0.5 – 1.3), Uttar Pradesh (0.8%; 0.3 – 1.2). In 2012, Bihar (2.1%; 1.2 – 3.14), Uttar Pradesh (0.97%; 0.63 – 1.3), Haryana (0.87%; 0.32 – 1.4), reported the highest incidence. Asthma, Paralysis, Chronic-long term diseases and Multimorbidity has highest share in poverty. Males, less educated, individuals having health insurance, younger people and smaller households are more prone to borrowing for the NCDs. Conclusion Borrowing leads to significant proportion of people diagnosed with NCDs to fall into poverty. A Strong financial protection mechanism such as primary healthcare check-ups, NCDs specific health financing policies and its implementation, centre and state joint actions are essential factor to mitigate the burden.