India's Janani Suraksha Yojana: further review needed – Authors' reply

Lim, Stephen S; Dandona, Lalit; Hoisington, Joseph A; Hogan, Margaret C.; Gakidou, Emmanuela

doi:10.1016/s0140-6736(11)60086-x

Cited by 5 publications

(4 citation statements)

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“…The mothers in this study gave birth in the year 2000. Since then, Sukhibhawa, the conditional cash transfer scheme relevant to the period of this study, was replaced by Janani Suraksha Yojana in 2005, which is by far the largest cash incentive scheme in the world in terms of the number of beneficiaries 27,36 . Government of India spent more than US$300 million in the scheme in the financial year 2009-2010 36 .…”

Section: Discussionmentioning

confidence: 99%

“…Government of India spent more than US$300 million in the scheme in the financial year 2009-2010 36 . Nevertheless, a recent study that analysed the impact of Janani Suraksha Yojana inferred that 'the poorest and the least educated women did not have the highest odds of receiving the incentive' 36 . The conditional cash transfer schemes have evolved, but this does not seem to have influenced the less educated and economically deprived women in rural areas to undergo skilled institutional delivery.…”

Section: Discussionmentioning

confidence: 99%

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What influences the decision to undergo institutional delivery by skilled birth attendants? A cohort study in rural Andhra Pradesh, India

Nair

Ariana²,

Webster³

2012

RRH

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Introduction: Despite continuing efforts to promote skilled institutional delivery, eight women die every hour in India due to causes related to pregnancy and child birth. The objectives of this study were to assess the prevalence and the determinants of institutional delivery by skilled birth attendants in a rural population in Andhra Pradesh, India. Methods: This cross-sectional study used data from 'Young Lives', a longitudinal study on childhood poverty, and the study population was a cohort of 1419 rural, economically deprived women (from the Young Lives study) in Andhra Pradesh, India. The data are from round-1 of Young Lives younger cohort recruited in 2002 and followed until 2015. The participation rate of households was 99.5%. Results: Prevalence of skilled institutional delivery was 36.8%. Women's education (odds ratio [OR] for secondary education 2.06; 95% confidence interval [95%CI] 1.33-3.19), desire to be pregnant (OR 1.89; 95% CI 1.12-3.22) and adequate prenatal care (OR 1.69; 95% CI 1.30-2.21) were found to be the positive determinants of skilled institutional delivery. High birth order (OR for second birth 0.44; 95% CI 0.32-0.60, OR for third birth 0.47; 95% CI 0.30-0.72 and OR for ≥fourth 0.47; 95% CI 0.27-0.81), schedule caste / schedule tribe social background (OR 0.70; 95% CI 0.53-0.93) and poor economic status of the household (OR for the poorest households 0.67; 95% CI 0.46-0.99) were negatively associated with skilled institutional delivery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

What influences the decision to undergo institutional delivery by skilled birth attendants? A cohort study in rural Andhra Pradesh, India

Nair

Ariana²,

Webster³

2012

RRH

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“…The Government is still attempting to search for the best possible strategies so that improvement in maternal health could be accelerated further. One way could be to improve maternal and neonatal health by promoting institutional delivery [1,2]. Studies have documented an inverse relationship between the use of maternal health care and maternal and neonatal mortality [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Estimating the impact of antenatal care visits on institutional delivery in India: A propensity score matching analysis

Dixit¹,

Dwivedi²,

Ram³

2013

Health

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Literature asserts that prenatal care is an imperative factor for subsequent health care utilization. However, in the Indian settings presence of selection bias while determining the impact of ANC visits on institutional delivery has been overlooked by the researchers. Therefore this paper aims to examine the net impact of ANC visits on subsequent utilization of institutional delivery after removing the presence of selection bias using recent round of National Family Health survey data. The analysis has been carried out in two separate models, in the first model 1 -2 ANC visits been compared with no visit and in the second model three or more antenatal care visits with no visit. The propensity score matching analysis used in this study sheds new light into this line of research which provides an effective strategy for controlling the confounding influence of institutional delivery. Employing the propensity score matching estimation approach we found women who made 1 -2 ANC visits had 6.6 percent higher chance to deliver in an institution compared to women who made no visit. In addition, if a woman visited health centre three or more than three times, her chances were 31 percent higher to deliver in an institution. Result based on sensitivity analysis suggests that selection bias on unobserved covariates would have to be around 40 percent to alter the impact of 1 -2 ANC visits. Findings suggest that interventions which plan to increase institutional delivery should target pregnant women who come for ANC checkups at institution first time, and health workers should encourage women to return to the health centre for more numbers of visits, as our results indicate that three or more ANC visits significantly change the women's attitudes towards institutional delivery.

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“…[5,6] Lim et al, analysed the secondary data and reported that the JSY program resulted in 43.5% increase of institutional deliveries. [7] Sharma et al, also reported an increase in institutional deliveries following implementation of JSY at different levels of health care in Jaipur District, Rajasthan, but the quality aspects of these institutional deliveries were far from desired levels. [8] A community based cross-sectional study in Ujjain district, Madhya Pradesh, by Sidney et al, [9] found that 89% of the women had an institutional delivery, out of which 70% deliveries occurred in a CHC and 26% in the district hospital, whereas in the present study maximum number of deliveries were conducted in PHC i.e., 29.4%.…”

Section: Discussionmentioning

confidence: 99%

Utilization of Health Services under Janani Suraksha Yojna in Rural Haryana

Malik¹,

Kalhan²,

Punia³

et al. 2013

Int J Med Public Health

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Objective: To study the utilization of health services by mothers during antenatal, natal and post-natal period under Janani Suraksha Yojna (JSY). Materials and Methods: This cross-sectional study was conducted in rural areas of two districts of Haryana as per the rate of institutional deliveries. A total of 48 sub-centers were selected by multistage random sampling. 1386 JSY benefi ciary mothers were interviewed by house-to-house visits, after obtaining informed consent. Results: Majority 1216 (87.5%) of the study subjects were registered between 12-26 weeks of pregnancy whereas only 170 (12.3%) of them were registered within fi rst 12 weeks. Around one-fourth of the mothers did not receive the recommended minimum three antenatal check-ups. The coverage of TT immunization was 92.1%. Majority 1253 (90.4%) of the deliveries were institutional. More than three-fourth of the home deliveries were conducted by trained dais and 15% of the home deliveries were conducted by untrained persons. Out of the 1253 institutional deliveries, 84.6% were conducted in Government institutions while 15.4% deliveries were conducted in Private hospitals. About two-third mothers received at least three post-natal care visits by the health functionaries. Discussion: Janani Suraksha Yojna is an ambitious scheme serving as a safe motherhood intervention under NRHM. It has been fairly successful in promoting institutional deliveries but the key components of Essential Obstetric Care i.e., early antenatal registration, minimum three antenatal care visits, three post-natal care visits still need strengthening.

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India's Janani Suraksha Yojana: further review needed – Authors' reply

Cited by 5 publications

References 0 publications

What influences the decision to undergo institutional delivery by skilled birth attendants? A cohort study in rural Andhra Pradesh, India

What influences the decision to undergo institutional delivery by skilled birth attendants? A cohort study in rural Andhra Pradesh, India

Estimating the impact of antenatal care visits on institutional delivery in India: A propensity score matching analysis

Utilization of Health Services under Janani Suraksha Yojna in Rural Haryana

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