Private Sector Utilization of HIV/AIDS Services & Health Expenditures by People Living with HIV/AIDS in India: Findings from Five High-Prevalence States

The private health sector in India is large and heterogeneous, and includes for-profit providers of varying capacity, informal providers such as drug sellers, and nongovernmental organization (NGO) providers (Gupta and Bollinger 2006). The proportion of wholly, privately run health care institutions1 in India has grown from about 8 percent at the country’s independence in 1947 to nearly 60 percent by the 1990s, and has continued its expansion (Radwan 2005). As of 2004, the private sector accounted for 80 percent of all outpatient care and 60 percent of inpatient care, with virtually no difference in urban versus rural areas (Over 2009; Sengupta and Nundy 2005) or income level (Mahal et al. 2001). The proportion of private health expenditures is also quite high with nearly 75 percent of all health expenditures borne by Indian households (Merson et al. 2004). Currently, little information exists about the private sector’s role in delivering HIV/AIDSrelated services or the health expenditures of PLWHIV in India. It is important to understand the private sector’s role in order to assess whether—and how—to enter into publicprivate partnerships to deliver HIV/AIDS-related services. To address this information gap, the Private Sector PartnershipsOne (PSP-One) project examined two existing household survey datasets to gain insights on this important topic in five states with high HIV prevalence.