How equitable is the uptake of conditional cash transfers for maternity care in India? Evidence from the Janani Suraksha Yojana scheme in Odisha and Jharkhand

Thongkong, Nattawut; Poel, Ellen Van de; Roy, Swati Sarbani; Rath, Suchitra; Houweling, Tanja A. J.

doi:10.1186/s12939-017-0539-5

Cited by 28 publications

(26 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On the other hand, in light of the urban-rural disparities identified, facilities in rural areas should be prioritized for improvements in infrastructure, human resources, equipment, and drug and commodity supply chains, along with strategies to promote the use of obstetric services, and improved referral to EmOC. The private sector is expected to play an increasing role in offering obstetric services in some LMICs [ 33 ], especially given current efforts to incentivize institutional deliveries by employing various financing schemes [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Linking household and health facility surveys to assess obstetric service availability, readiness and coverage: evidence from 17 low- and middle-income countries

Kanyangarara¹,

Chou²,

Creanga³

et al. 2018

Journal of Global Health

View full text Add to dashboard Cite

BackgroundImproving access and quality of obstetric service has the potential to avert preventable maternal, neonatal and stillborn deaths, yet little is known about the quality of care received. This study sought to assess obstetric service availability, readiness and coverage within and between 17 low- and middle-income countries.MethodsWe linked health facility data from the Service Provision Assessments and Service Availability and Readiness Assessments, with corresponding household survey data obtained from the Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Based on performance of obstetric signal functions, we defined four levels of facility emergency obstetric care (EmOC) functionality: comprehensive (CEmOC), basic (BEmOC), BEmOC-2, and low/substandard. Facility readiness was evaluated based on the direct observation of 23 essential items; facilities “ready to provide obstetric services” had ≥20 of 23 items available. Across countries, we used medians to characterize service availability and readiness, overall and by urban-rural location; analyses also adjusted for care-seeking patterns to estimate population-level coverage of obstetric services.ResultsOf the 111 500 health facilities surveyed, 7545 offered obstetric services and were included in the analysis. The median percentages of facilities offering EmOC and “ready to provide obstetric services” were 19% and 10%, respectively. There were considerable urban-rural differences, with absolute differences of 19% and 29% in the availability of facilities offering EmOC and “ready to provide obstetric services”, respectively. Adjusting for care-seeking patterns, results from the linking approach indicated that among women delivering in a facility, a median of 40% delivered in facilities offering EmOC, and 28% delivered in facilities “ready to provide obstetric services”. Relatively higher coverage of facility deliveries (≥65%) and coverage of deliveries in facilities “ready to provide obstetric services” (≥30% of facility deliveries) were only found in three countries.ConclusionsThe low levels of availability, readiness and coverage of obstetric services documented represent substantial missed opportunities within health systems. Global and national efforts need to prioritize upgrading EmOC functionality and improving readiness to deliver obstetric service, particularly in rural areas. The approach of linking health facility and household surveys described here could facilitate the tracking of progress towards quality obstetric care.

show abstract

Section: Discussionmentioning

confidence: 99%

Linking household and health facility surveys to assess obstetric service availability, readiness and coverage: evidence from 17 low- and middle-income countries

Kanyangarara¹,

Chou²,

Creanga³

et al. 2018

Journal of Global Health

View full text Add to dashboard Cite

show abstract

“…This study recommends developing and implementing strategies to increase awareness about CCT program among marginalized women in Mexico. India’s CCT program— Janani Suraksha Yojana (JSY) )—has increased institutional delivery and reduced perinatal and neonatal deaths [ 17 , 27 – 30 ], but like in Mexico, the poorest and least educated women were least likely to receive the JSY payments [ 17 , 31 ]. In Nepal, institutional deliveries have slowly risen since the launch of the SDIP; but many women did not know about the program and not all those who knew the program used it [ 16 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Women’s knowledge about the conditional cash incentive program and its association with institutional delivery in Nepal

Pandey

2018

PLoS ONE

View full text Add to dashboard Cite

Background and purposeHome deliveries increase the risk of maternal and child mortality. To increase institutional deliveries, South Asian countries have introduced various forms of Conditional Cash Transfer (CCT) schemes that offer women cash if they come to deliver at a health facility. In 2005, Nepal introduced its Safe Delivery Incentive Programme (SDIP)—a cash incentive program nationwide to boost the rate of institutional delivery and care from health professionals at childbirth. This study asks the following research questions: How informed were Nepalese women about the cash incentive program? Does knowledge about the cash incentive program correlate with institutional delivery?MethodsData to answer these questions come from the 2011 Nepal Demographic and Health Survey (NDHS). This is a nationally representative data collected from 12,674 women between 15 and 49 years of age, of which 4,036 had given births in the past five years. Multiple logistic regression was employed to predict if knowledge about the cash incentive program increased the odds of institutional delivery controlling for sociodemographic and geographic factors.ResultsApproximately 90% of the women knew about the SDIP. About 42% of the women who knew about the SDIP and 13% of the women who did not know about the SDIP had their most recent delivery at a health institution. The odds of institutional delivery increased nearly three-fold (OR = 2.70; CI: 1.59–4.59) among women who knew about the SDIP compared to women who did not know about the SDIP. Other factors that predicted institutional delivery included education, wealth, urban status, first birth, the number of antenatal care visits, and exposure to news media.ConclusionThis study shows that there is a correlation between women’s knowledge about the SDIP and increased institutional delivery. Nepal’s health and social work professionals should inform all women of reproductive age about the program so that they can make more informed delivery decisions.

show abstract

“…Challenge in equity was detected with low receipt of JSY bene ts among mothers in Odisha and Jharkhand area, India 37 . Receipt of the bene ts is highly variable, not equally distributed, favoring wealthier groups.…”

Section: B Healthcare Nancingmentioning

confidence: 96%

“…To achieve UHC in MCH, under the national health mission of India, several cash schemes such as Janani Suraksha Yojana Janani Shishu Suraksha Karyakram and Chiranjeevanie Yojana have been introduced. These programmes provide improvements in maternal health care in India 14,18,27,34,37,40 . They further provide contracting in EmOC specialists in private sector as a measure to reduce maternal mortality 29 .…”

Section: B Healthcare Financingmentioning

confidence: 99%

“…Receipt of the bene ts is highly variable, not equally distributed, favoring wealthier groups. The JSY scheme is currently not su cient to close the poor-rich gap in institutional delivery rate 37 . Shortage of human resources was a major health system barrier for implementation of National Rural Health Mission which implemented in India from 2005 to 2012 to reduce MCH inequalities 17 .…”

Section: B Healthcare Nancingmentioning

confidence: 99%

See 1 more Smart Citation

Successes, Challenges and Opportunities Towards Universal Health Coverage for Maternal and Child Health in South East Asian Countries: A Systematic Review

Perera

Gilks

Alemu

2020

Preprint

View full text Add to dashboard Cite

Background: Sustainable Development Goal 3 (SDG-3) aims to ensure healthy lives and promote wellbeing for all. Universal Health Coverage (UHC) assures delivering health services to all who need without suffering from financial hardships. This paper aims to identify the successes, challenges and opportunities towards achieving UHC for maternal and childcare in countries in the World Health Organization, South East Asian Region (SEAR). Methods: We conducted a systematic review of the literature. We searched PubMed, Embase, Scopus, CINAHL, PsycINFO, WHO research portal and Google scholar for studies published in English from 2010 to 2020. We included studies conducted in maternal and childcare focusing on challenges, opportunities or successes towards UHC in countries in SEAR. Data was synthesized and presented as a narrative description, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Results: We identified 62 studies with different study designs from eight SEAR countries , majority were from India. We observed successes or opportunities in access and quality in MCH with government cash transfer schemes and private sector contribution in India, Bangladesh and Indonesia. Politically prioritized MCH care was identified as an opportunity in a state of India. Inadequate healthcare infrastructure including trained human resources, medical products and other supplies were identified as the main challenges in the region. Facilities are overcrowded in Bangladesh and Indonesia. From provider perspective, health care workers’ knowledge and skills as well as attitudes and behaviors were also identified as issues in the region. Lack of health literacy, misconceptions and cultural barriers are identified as challenges from clients’ side. Difficulties in geographical distribution and transport were contributing to poor healthcare access in four countries. Deficiencies in government policies and administration were identified in some fields. Poverty was detected as an overarching barrier.Conclusions: SEAR countries have demonstrated improvements in access, quality and equity on MCH towards UHC. There are, however, challenges related to human and other resources, health care facilities and socio-economic determinants of health. Regional bodies as well as authorities in individual countries should work on these issues to address challenges to achieve UHC.Registration: PROSPERO: CRD42020166404

show abstract

How equitable is the uptake of conditional cash transfers for maternity care in India? Evidence from the Janani Suraksha Yojana scheme in Odisha and Jharkhand

Cited by 28 publications

References 15 publications

Linking household and health facility surveys to assess obstetric service availability, readiness and coverage: evidence from 17 low- and middle-income countries

Linking household and health facility surveys to assess obstetric service availability, readiness and coverage: evidence from 17 low- and middle-income countries

Women’s knowledge about the conditional cash incentive program and its association with institutional delivery in Nepal

Successes, Challenges and Opportunities Towards Universal Health Coverage for Maternal and Child Health in South East Asian Countries: A Systematic Review

Contact Info

Product

Resources

About