An assessment of the impact of the JSY cash transfer program on maternal mortality reduction in Madhya Pradesh, India

Ng, Marie; Misra, Archana; Diwan, Vishal; Agnani, Manohar; Levin‐Rector, Alison; Costa, Ayesha De

doi:10.3402/gha.v7.24939

Cited by 72 publications

(53 citation statements)

References 23 publications

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“…Rates of institutional delivery have more than doubled since the advent of National Rural Health Mission (NRHM), and currently more than 74 % of total births in India are occurring at institutions [13]. However, various studies have failed to show a commensurate reduction in maternal and neonatal mortality [14, 15]. Thus, just having a contact with the health system for deliveries has not proven to be enough for improving outcomes, which suggests a need to focus on the quality of care during these contacts.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, just having a contact with the health system for deliveries has not proven to be enough for improving outcomes, which suggests a need to focus on the quality of care during these contacts. Experience from JSY also indicates that while the focus on bringing women to institutions may have influenced the first and second delay in care, the third delay, i.e., in timely and high-quality care provision at institutions is still a challenge [14]. …”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of the WHO SCC on improving adherence to essential practices during childbirth, in resource constrained settings

Kumar¹,

Yadav²,

Balasubramaniam³

et al. 2016

BMC Pregnancy Childbirth

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BackgroundIndia accounts for 27 % of world’s neonatal deaths. Although more Indian women deliver in facilities currently than a decade ago, early neonatal mortality has not declined, likely because of insufficient quality of care. The WHO Safe Childbirth Checklist (SCC) was developed to support health workers to perform essential practices known to reduce preventable maternal and new-born deaths around the time of childbirth. Despite promising early research many outstanding questions remain about effectiveness of the SCC in low-resource settings.MethodsIn collaboration with the Ministry of Health SCC was modified for Indian context and introduced in 101 intervention facilities in Rajasthan, India and 99 facilities served as comparison to study if it reduces mortality. This Quasi experimental Observational intervention-comparison was embedded in this larger program to test whether a program for introduction of SCC with simple implementation package was associated with increased adherence to 28 evidence-based practices. This study was conducted in 8 intervention and 8 comparison sites. Program interventions to promote appropriate use of the SCC included orienting providers to the checklist, modest modifications of the SCC to promote provider uptake and accountability, ensuring availability of essential supplies, and providing supportive supervision for helping providers in using the SCC.ResultsThe SCC was used by providers in 86 % of 240 deliveries observed in the eight intervention facilities. Providers in the intervention group significantly adhered to practices included in the SCC than providers in the comparison group controlling for baseline scores and confounders. Women delivering in the intervention facilities received on an average 11.5 more of the 28 practices included compared with women in the comparison facilities. For selected practices provider performance in the intervention group increased as much as 93 % than comparison sites.ConclusionUse of the SCC and provider performance of best practices increased in intervention facilities reflecting improvement in quality of facility childbirth care for women and new-born in low resource settings.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effectiveness of the WHO SCC on improving adherence to essential practices during childbirth, in resource constrained settings

Kumar¹,

Yadav²,

Balasubramaniam³

et al. 2016

BMC Pregnancy Childbirth

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show abstract

“…Previous studies also reported that the poor availability of laboratory facilities and diagnostic equipment are also obstacles to patient assessment and diagnosis, even when providers are aware of the necessary tests [32]. India learned this with Janani Suraksha Yojana, a cash incentive programme for facility births, which massively increased facility delivery but did not measurably reduce maternal or newborn mortality [33]. High-quality care is determined by thorough assessment, detection of asymptomatic and co-existing conditions, precise diagnosis, proper and timely treatment, referral when needed for hospital care and surgery, and the ability to follow the patient and regulate the treatment course as needed.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Institutional and Management Capacities Against Health Conditions in Indian Early Intervention Centre

Pagolu¹,

Tamanam

2020

Preprint

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Background: Rashtriya Bal Swasthya Karyakram (RBSK) is aimed at screening children for 4 Ds - Defects at birth, Diseases during childhood, Deficiencies and Developmental delays including disabilities and early intervention of these conditions. The aim of this study is to discover the pattern of various health conditions screened under the 4D’s approach and the institutional capacities like infrastructural, manpower and their training capacities. Methods: This is an observational study done in District Early Intervention Centre (DEIC), Visakhapatnam, Andhra Pradesh, India for a period of one year. Children referred to DEIC were screened by the pediatrician as per Rashtriya Bal Swasthya Karyakram (RBSK) norms. The information of the children who attended the DEIC such as age, sex, source of referral, diagnosis, treatment given and outcome were tabulated and analyzed. An analysis of the manpower available existing at the center during the study period was also done. Results: During the study period, a total number of 6572 children were found to have one of the listed 30 conditions under 4D’s approach of screening. Developmental delays and disabilities were seen in 4801 (73.05%) children, followed by children with childhood diseases which were observed in 1277 (19.43%), children with defects at birth were 255 (3.88%) and children with deficiencies were 239 (3.63%). Among the defects at birth, congenital deafness was the most commonly screened condition found in 84 (1.27%) children. About 53 (0.80%) neonates were found to have club foot of varying grades. On analysis of deficiencies, severe acute malnutrition was observed in 236 (3.59%) children. There was 1(0.01%) child each with Vitamin A deficiency (Bitot’s Spot), Vitamin D deficiency and Goiter (Due to Iodine Deficiency). On analysis diseases during childhood, dental caries were seen in 1219 (18.54%) children and skin conditions in 26 (0.39%) children. About 44 (0.6%) children were found to have rheumatic heart disease. On analysis of developmental delays and disabilities, language delay was the commonest screened condition seen in 941(14.31%) children. Hearing impairment was seen in 917 (13.95%) children, learning disorder in 704 (10.71%) children and neuro motor impairment in 584 (8.88%) children, vision impairment was seen in 505 (7.68%) children, motor delay was seen in 462 (7.02%) and cognitive delay was seen in 205 (3.11%). There were 68 (1.03%) cases of behavioral disorders (Autism) and were treated with multi modal therapy including sensory integration. Regarding manpower at the center, all the posts were occupied throughout the study period except medical officer, psychologist, dental hygienist and DEIC manager.Conclusion: We observed that many curable diseases are undiagnosed among the children and hence they were deprived of treatment for the same. Promotion of Early Intervention Services is most beneficial for improvement in health status of children and therefore RBSK purview should be extended to reach every individual child.

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“…This programme has been instrumental in the gains achieved by the recent conditional cash transfer programme, Janani Suraksha Yojana (JSY), to enhance facility based births 36. The uptake of the JSY programme has been varied but it has been associated with a reduction of 3.7 perinatal deaths per 1000 pregnancies and 2.3 neonatal deaths per 1000 livebirths 37…”

Section: Community Based Models To Tackle Inequitiesmentioning

confidence: 99%

Rethinking community based strategies to tackle health inequities in South Asia

Bhutta

Bang²,

Afsana

et al. 2018

BMJ

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An assessment of the impact of the JSY cash transfer program on maternal mortality reduction in Madhya Pradesh, India

Cited by 72 publications

References 23 publications

Effectiveness of the WHO SCC on improving adherence to essential practices during childbirth, in resource constrained settings

Effectiveness of the WHO SCC on improving adherence to essential practices during childbirth, in resource constrained settings

Assessment of Institutional and Management Capacities Against Health Conditions in Indian Early Intervention Centre

Rethinking community based strategies to tackle health inequities in South Asia

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