Abstract
Morbidity is a persistent condition of ill health that prohibits individuals from performing their daily activities. Therefore, measures of morbidity reflect the general conditions of health in the population. At the all India level, morbidity studies have been carried out based on large sample surveys of the NSSO and by other independent organizations at the state level; however, there is a dearth of field-based studies in the rural areas of India, specifically from the northeastern region. This case study examines the extent of morbidity, factors affecting morbidity, as well as the extent of utilization of healthcare services in one of the villages of Nagaon district of Assam. The study is based on a household survey conducted in 2014 in Bamunipathar village of Nagaon district. Based on a census enumeration of the entire village, a random sample of 40% of the households was chosen. The morbidity prevalence rate is found higher among males than females. However, cases of untreated morbidity are higher among females. Regression analysis shows that morbidity increases with increase in age of an individual. Low levels of literacy and non-availability of toilet facilities pose as risk factors to morbid conditions. Households having access to safe drinking water showed a negative causal relationship with morbidity. This case study places special focus on women and elderly people as who should be receiving increased health attention.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Notes
- 1.
The report has defined ailment or illness as ‘any deviation from the state of physical or mental well-being’ (NSSO 1998).
- 2.
Referred to as NCAER (1995) in this paper.
- 3.
See Appendix for the indicators used and the ranking of districts based on the composite index. The methodology of calculation of the composite index was adapted from Ram and Shekhar (2006).
- 4.
The backward block has been selected on the basis of the available literature on Identification of Backward Blocks by Barua (2012).
- 5.
Spell of ailment refers to a continuous period of sickness with respect to a particular ailment (NSSO 1998).
- 6.
- 7.
See Appendix for estimates of utilization of healthcare services by place of treatment and other background characteristics.
- 8.
The logistic regression estimation has been used because the dependent variable is dichotomous in nature. In a number of empirical studies related to morbidity this model has been used (Navaneetham et al. 2009; Dilip 2002; Mukherjee et al. 2001). However, some studies have also used probit regression model to identify the factors influencing morbidity (Ghosh 2009; Duraisamy 1998). In the present study, the logistic regression model has been used as there is little justification on whether to use either probit or logit model in case of dichotomous dependent variables. More or less both the models give almost the same results (Gujarati 1998; Maddala 2007).
- 9.
In order to test multicollinearity among the variables the Variance Inflation Factor Test has been conducted which shows that there is absence of multicollinearity among the variables. See Table 24.9 in Appendix.
References
Barua, J. (2012). On Identification of Backward Blocks. Research Paper Series, 4, Omeo Kumar Institute of Social Change and Development (OKDISCD), Guwahati.
Belcher, D. W., Newman, A. K., Wurapa, F. K., & Lourie, I. M. (1976). Comparison of morbidity interviews with a health examination survey in Rural Africa. American Journal of Tropical Medicine and Hygiene, 25(5), 751–758.
Dilip, T. R. (2002). Understanding levels of morbidity and hospitalization in Kerala, India. Bulletin of the World Health Organization, 80(9), 746–751.
Duraisamy, P. (1998). Morbidity in Tamil Nadu-levels, differentials and determinants. Economic and Political Weekly, 33(17), 982–990.
Ghosh, S. (2009). The utilization of Healthcare Services in India: Do Education and income Matter? A paper presented in the conference of Indian Association for Social Sciences and Health.
Getler, P., & van der Gaag, Jaques. (1990). The willingness to pay for medical care: Evidence from two developing countries. Baltimore, MD: Johns Hopkins University Press.
Gosh, S., & Arokiasamy, P. (2009). Morbidity in India-trends, patterns and differentials. Journal of Health Studies, 2, 136–148.
Government of India. (2011a). Annual Health Survey, Office of the Registrar General and Census Commissioner of India, Ministry of Home Affairs, Vital Statistics Division, 2/A, Mansingh Road, New Delhi. Available at censusindia.gov.in.
Government of India. (2011b). Census of India, Office of the Register General and Census Commissioner, Ministry of Home Affairs.
Gujarati, D. N. (1998). Basic econometrics. Singapore: McGraw-Hill Inc.
Gumber, A., & Berman, P. (1997). Measurement and pattern of morbidity and the utilization of health services: Some emerging issues from recent health interview surveys in India. Journal of Health and Population in Developing Countries, 1(1), 16–43.
Krishnaswami, P. (2004). Morbidity study-incidence, prevalence, consequences and associates. Discussion Paper No. 63, Kerala Research Programme on Local Level Development, Centre for Development Studies. Available at http://www.cds.ac.in/krpcds/publication/downloads/63.pdf.
Maddala, G. S. (2007). Introduction to econometrics. Singapore: Willy India.
Mukherjee, S., & Levesque, J. F. (2012). Morbidity and outpatient care for the elderly in Kerala, South India: Evidence from a National Population based Survey. Population Ageing, 5, 177–192.
National Council of Applied Economic Research (NCAER). (1995). Household Survey of Health Care Utilization and Expenditure, New Delhi.
National Sample Survey Organization (NSSO). (1998). Morbidity and Treatment of Ailments, Ministry of Statistics and Programme Implementation, New Delhi, Government of India. 52nd Round, July 1995–June 1996.
National Sample Survey Organization (NSSO). (2004). Morbidity Health Care and Condition of the Aged, Ministry of Statistics and Programme Implementation, New Delhi, Government of India. Report No 507(60/25/0/1), 60th Round.
Navaneetham, K., Kabir, M., & Krishnakumar, C. S. (2009). Morbidity Patterns in Kerala: Levels and Determinants. Working Paper series, 411, International Institute of Population Sciences. Available at SSRN: http://ssrn.com/abstract=1629544.
Peter, D. H., Sujatha, K. R., & Fryatt, R. (2003). Lumping and splitting: The health policy agenda in India. Health Policy Plan, 18(3), 249–260.
Ram, F., & Shekhar, C. (2006). Ranking and mapping of districts based on socio-economic and demographic indicators. International Institute of Population Sciences, Ministry of Health and Family Welfare, Government of India. Available at http://www.iipsindia.org/publications05_b_13a.htm.
Sekhar, P. S. (1997). Levels of morbidity in Andhra Pradesh. Economic and Political Weekly, 32(13), 17–21.
Sundar, R., & Sharma, A. (2002). Morbidity and utilization of health care services—A survey of urban poor in Delhi and Chennai. Economic and Political Weekly, 37(47), 4729–4740.
Sundararaman, T., & Muraleedharan, V. R. (2015). Falling sick, paying price, NSS 71st round on morbidity and costs of healthcare. Economic and Political Weekly, 12(33), 17–20.
Vadiyanathan, A. (1995). An assessment of nutritional and health status. Discussion Paper No. 3, UNDP Research Project, CDS. Available at http://203.200.22.249:8080/jspui/bitstream/2014/8539/1/ISEC%3DRR-GD15064.pdf.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Appendix
Appendix
See Tables 24.7, 24.8, 24.9 and 24.10.
Rights and permissions
Copyright information
© 2018 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Devi, N., Bedamatta, R. (2018). Factors Affecting Morbidity and Utilization of Healthcare Services: A Case Study of Nagaon District of Assam. In: De, U., Pal, M., Bharati, P. (eds) Issues on Health and Healthcare in India. India Studies in Business and Economics. Springer, Singapore. https://doi.org/10.1007/978-981-10-6104-2_24
Download citation
DOI: https://doi.org/10.1007/978-981-10-6104-2_24
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-10-6103-5
Online ISBN: 978-981-10-6104-2
eBook Packages: Business and ManagementBusiness and Management (R0)