Impact of Janani Suraksha Yojana on Institutional Delivery Rate and Maternal Morbidity and Mortality: An Observational Study in India

Abstract

The Government of India initiated a cash incentive scheme-Janani Suraksha Yojana (JSY)-to promote institutional deliveries with an aim to reduce maternal mortality ratio (MMR). An observational study was conducted in a tertiary-care hospital of Madhya Pradesh, India, before and after implementation of JSY, with a sample of women presenting for institutional delivery. The objectives of this study were to: (i) determine the total number of institutional deliveries before and after implementation of JSY, (ii) determine the MMR, and (iii) compare factors associated with maternal mortality and morbidity. The data were analyzed for two years before implementation of JSY (2003)(2004)(2005) and compared with two years following implementation of JSY (2005)(2006)(2007). Overall, institutional deliveries increased by 42.6% after implementation, including those among rural, illiterate and primary-literate persons of lower socioeconomic strata. The main causes of maternal mortality were eclampsia, pre-eclampsia and severe anaemia both before and after implementation of JSY. Anaemia was the most common morbidity factor observed in this study. Among those who had institutional deliveries, there were significant increases in cases of eclampsia, pre-eclampsia, polyhydramnios, oligohydramnios, antepartum haemorrhage (APH), postpartum haemorrhage (PPH), and malaria after implementation of JSY. The scheme appeared to increase institutional delivery by at-risk mothers, which has the potential to reduce maternal morbidity and mortality, improve child survival, and ensure equity in maternal healthcare in India. The lessons from this study and other available sources should be utilized to improve the performance and implementation of JSY scheme in India.

Identification of the hot-spot areas for sickle cell disease using cord blood screening at a district hospital: an Indian perspective

“…Therefore, hospital delivery cases are usually from these regions and some also from other nearby areas, like Dharmagarh, Jaypatna, Koksara, Madanpur Rampur, Kalampur, and Karlamunda. Since institutional delivery among pregnant women, by Janani Suraksha Yojana program, which aims at reducing maternal and neonatal mortality by promoting institutional deliveries among poor pregnant women, has been promoted and successfully implemented, an increase in institutional delivery cases has been observed (Gupta et al 2012;Randive et al 2014). Across region variation in culture, tradition, education level, and marriage practices even within the district has been observed (Ota and Mohanty 2010), which could be the main source and cause for differences in genetic epidemiology.…”

Impact of Janani Suraksha Yojana on institutional delivery in Empowered Action Group States, India

“…[18][19][20][21][22][23][24] The present paper also seeks the changing pattern of behaviour across the socioeconomic classes on institutional delivery in EAG states. EAG states are defined as with high fertility rates and weak on socio-economic indicators by Ministry of Health and family Welfare in India.…”

Impact of Janani Suraksha Yojana on institutional delivery rate, incidence of rupture uterus and feto-maternal outcome related to uterine rupture

“…International Journal of Reproduction, Contraception, Obstetrics and Gynecology Volume 5 · Issue 9 Page 2958 [4][5][6] There was significant decrease in the incidence of rupture uterus in post JSY period. JSY has motivated patients to conduct institutional deliveries, thereby avoided prolong trial of labour by untrained personnel leading to rupture uterus.…”