rupees . . . How can we afford to pay this amount?’’
(Respondent 14)
Reasons for using private facilities
Respondents cited a number of reasons for using private
hospitals. The most commonly cited reason was that the private
hospital was nearby to the respondent’s home:
‘‘(We chose the private hospital) only because it was nearby and
she (Respondent 11) was in a great deal of pain. It was an
emergency and the first hospital that I thought of was this nearby
private hospital.’’ (Relative of respondent 11)
Several respondents also expressed the belief that private
hospitals are of higher quality than public:
‘‘We do not use the public hospital, as the treatment given there is
not good. It is very dirty and unhygienic. The private hospital is
very clean and well maintained.’’ (Respondent 18)
Poor people rely on multiple coping strategies.
Respondents generally reported using multiple (two or more)
different strategies for coping with the costs of hospitalization.
Respondent 8, for example, was a young woman from
Vadodara city, hospitalized in a public facility for gastroenteritis.
In order to cover the cost of the hospital stay—Rs. 600—the
family drew on their savings and borrowed money from
relatives:
‘‘I bought medicines using the money I borrowed from him (my
brother) . . . I took 400 rupees from my brother, and I gave
approximately 100 rupees from my own (savings). As well, I later
borrowed 100 rupees from another relative in order to pay the
medical shop.’’ (Mother of respondent 4)
Respondent 1, a recent migrant to Vadodara, was also
hospitalized in a public hospital, for fever of unknown origin.
His family, who earn a living by selling rags and scraps
salvaged from garbage, drew on savings and sold a small
amount of jewellery:
‘‘. . . we paid using our own money—money that we had saved for
Diwali . . . We also had to pawn our belongings. We pawned a silver
ornament that was on my son’s leg. We removed (that ornament)
and pawned it . . . Now it is gone. I could not repay the money (to
the pawn-broker) so we lost the ornament.’’ (Sister-in-law of
respondent 1)
Poor who use public facilities can pay from savings, income or
relying on social networks
As was suggested by the exit survey data, respondents who
used public hospitals could generally cope with the costs either
through their savings and income or through borrowing from
friends, family or employers:
‘‘We paid using money that we had saved for Diwali. We do not
have any relatives from whom we can borrow.’’ (Respondent 1)