Paper short abstract:

The present study aimed to examine the disease burden and financial burden of water, sanitation and hygiene (WASH) related diseases among individuals using the 75th Round of the National Sample Survey in India.

Paper long abstract:

This study aimed to examine the disease burden and financial burden of water, sanitation and hygiene (WASH) related diseases among individuals in India. Data were drawn from the 75th Round of the National Sample Survey: ‘Household social consumption: Health’. A multilevel logistic regression model was employed to assess the effect of community-level factors on the prevalence of these diseases. The prevalence of WASH-related diseases in India was at 5.7% of all outpatient visits and 6.9% of all hospital admissions during 2017–18. Nearly 66% of all outpatient malaria visits in rural areas were associated with restrictions on daily activities of ailing individuals. The mean out-of-pocket expenditure across all WASH-related diseases was ₹703 per outpatient visit and ₹9656 per hospital admission. The monthly OOPE on outpatient care for 74% of persons with jaundice in rural areas was greater than their monthly per capita consumption expenditure and 97% of persons with malaria in urban areas faced catastrophic OOPE on outpatient care. Each hospital admission for jaundice in urban areas led to an earning loss of ₹2260. The intra-class correlation from the multilevel logistic regression for diseases prevalence were 0.28 and 0.26 for outpatient and inpatient cases, indicating the role of household and community-level factors in the prevalence of disease variation. However, there is a high prevalence, financial burden and effect of community-level factors on WASH-related diseases in India. The findings reinforced that the holistic strengthening of WASH facilities is required to mitigate the avoidable burden of these diseases in India.