From Rupee to Remedy and Identity to Illness: What Household Spending Reveals About India’s Health

Bio: Vaibhavi Awasthi is an Economics graduate from St. Xavier’s College, Ahmedabad, and recently completed her Master’s in Public Policy from the Kautilya School of Public Policy, with a specialisation in Economics, Technology, and Society. She was part of the 14th cohort of the Gandhi Fellowship by the Piramal Foundation, where she worked with the Jharkhand government on school education reform. She also interned with the Centre for Research on Innovation and Science Policy (CRISP), conducting field research in 17 schools under NITI Aayog’s Aspirational Block Program and delivering policy recommendations on bilingual education and resource allocation to improve learning outcomes in Meghalaya. Vaibhavi has now joined KPMG India as an Associate Consultant, where she will work on education and skilling initiatives. With experience spanning public systems, research, and grassroots implementation, her interests lie in strengthening inclusive, data-driven policies for systemic transformation.

Project Outline: In her capstone, Vaibhavi explores how household-level medical expenditure reflects and shapes India's healthcare landscape, especially when stratified by caste and region. Drawing on National Family Health Survey (NFHS) and Household Consumption Expenditure Survey (HCES) datasets, the research focuses on the shift from non-institutional to institutional healthcare spending over time, particularly among Scheduled Castes (SC) and Scheduled Tribes (ST). It assesses the correlation between healthcare spending and health outcomes (e.g., anaemia, BMI), with a focus on access disparities between urban and rural regions. By applying non-parametric statistical tools such as the Mann-Whitney U test and Vargha-Delaney A effect size, the study quantifies emerging trends and gaps. The findings point to an increasing financial burden on marginalized groups despite growing access, revealing persistent inequities in healthcare service utilisation and outcomes. The paper concludes with policy recommendations around region-specific insurance reforms, targeted scheme redesign, and inclusive service provisioning.