Back to browse results
Gender-specific inequalities in coverage of Publicly Funded Health Insurance Schemes in Southern States of India: evidence from National Family Health Surveys
Authors: Santosh Kumar Sharma, Devaki Nambiar, Hari Sankar, Jaison Joseph, Surya Surendran, and Gloria Benny
Source: BMC Public Health, Volume 23, Article 2414; DOI:
Topic(s): Gender
Country: Asia
Published: DEC 2023
Abstract: Background Publicly Funded Health Insurance Schemes (PFHIS) are intended to play a role in achieving Universal Health Coverage (UHC). In countries like India, PFHISs have low penetrance and provide limited coverage of services and of family members within households, which can mean that women lose out. Gender inequities in relation to financial risk protection are understudied. Given the emphasis being placed on achieving UHC for all in India, this paper examined intersecting gender inequalities and changes in PFHIS coverage in southern India, where its penetrance is greater and of longer duration. Data and methods This study used the fourth (NFHS-4, 2015–16) and fifth (NFHS-5, 2019–21) rounds of India’s National Family Health Survey for five southern states: namely, Andhra Pradesh, Karnataka, Kerala, Tamil Nadu, and Telangana. The World Health Organization’s Health Equity Assessment Toolkit (HEAT) Plus and Stata were used to analyse PFHIS coverage disaggregated by seven dimensions of inequality. Ratios and differences for binary dimensions; Between Group Variance and Theil Index for unordered dimensions; Absolute and Relative Concentration Index (RCI) for ordered dimensions were computed separately for women and men. Results Overall, PFHIS coverage increased significantly (p?