Impact of Low Birth Weight on the Prevalence and Economic Burden of Common Childhood Illnesses Among Under-Five Children in India: Findings From Nationally Representative Surveys

Background Common childhood illnesses such as diarrhea, fever, and acute respiratory infection impose substantial health burdens among under-five children, and Low Birth Weight (LBW) has been associated with an increased prevalence of these illnesses. However, the impact of LBW on healthcare utilization and the economic burden of these illnesses remains understudied. Aim To assess the impact of LBW on the prevalence, healthcare utilization, and Out of Pocket Expenditure (OOPE) for outpatient (OP) treatment of selected Common Childhood Illnesses (CCHI) among under-five children in India. Methodology This study utilized data from two nationally representative surveys conducted in India; National Family Health Survey (NFHS-5) (2019-2021) and the National Sample Survey Organization (NSSO) 75th Round Schedule Social Consumption: Health (2017-2018). Data from the NFHS-5 was analyzed to assess the impact of LBW on the prevalence of selected CCHI and healthcare utilization. Comparison of OOPE for OP treatment of selected CCHI between LBW and Normal Birth Weight (NBW) children done using the median OOPE for OP visits of CCHI estimated from the NSSO data. Results The two-week prevalence of selected CCHI among LBW and NBW children was found to be 20.0% (95% CI 19.6 -20.4) and 18.0% (95% CI 17.8 -18.2), respectively. There was no significant difference between LBW and NBW children on healthcare utilization for the treatment of CCHI; both groups had a similar proportion (around 70%) of formal medical treatment utilization for CCHI. The median OOPE spending for OP visits per episode of CCHI was comparable between LBW and NBW children. However, families of LBW children had higher annual OOPE spending for OP visits related to CCHI, with projected estimates of INR 1,446 ($19.56) for LBW children and INR 1,271 ($17.2) for NBW children. Conclusion LBW was associated with a higher prevalence of CCHI. Even though healthcare utilization was similar among LBW and NBW children, a higher prevalence of CCHI among LBW children led to higher OOPE. LBW children have approximately 13% higher annual OOPE spending for the OP visits related to selected CCHI compared to NBW children.