Background

India contributes significantly to the global burden of maternal deaths. More than 20% of all maternal deaths occur in India. To tackle this and especially to promote institutional deliveries, the government of India has introduced a conditional cash assistance programme called the Janani Suraksha Yojana (JSY). Under this programme, poor women who have had three antenatal check ups and who deliver in a health facility would get money soon after delivery to take care of their direct and indirect costs.

Aims and Objectives

The main objective of the study was to study the effect of JSY on utilization of maternal health services

Methods

We interviewed staff and women who had recently delivered from four Indian states, to determine how the JSY is functioning in the field and whether it is meeting its original objective of increasing institutional deliveries.

Key Findings

While there is some evidence to suggest that there has been an increase in institutional deliveries, we were able neither to quantify it nor attribute it to the JSY. This is because of the paucity of good quality data at the state and district levels. Both the staff as well as the pregnant women were happy with the scheme and felt that it met an important need. However, there were some important gaps in the implementation of the scheme. We found that some of the poor women were not aware of the programme; that the documentation processes had become very cumbersome and that there was a considerable delay in the women getting the cash benefit. Some women also mentioned that they received only partial amounts – the rest being pocketed by the health staff. The most significant issue was that the scheme has been changed to permit the cash benefit to go to all women who deliver, irrespective of the site of delivery. This has resulted in this scheme actually promoting home deliveries, a perversion of the original objective.