India’s Conditional Cash Transfer Programme (the JSY) to Promote Institutional Birth: Is There an Association between Institutional Birth Proportion and Maternal Mortality?

Randive, Bharat; Diwan, Vishal; Costa, Ayesha De

doi:10.1371/journal.pone.0067452

Cited by 212 publications

(222 citation statements)

References 14 publications

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“…Under the NRHM, there was a notable push for rural women to deliver in health facilities with skilled birth attendants. Programs such as the Janani Suraksha Yojana (JSY) program were put into place to monetarily incentivise women to do so [2,3]. As a result, institutional delivery rates in India have increased from 38.7% in 2005 to almost 80% in 2015–2016 [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…Programs such as the Janani Suraksha Yojana (JSY) program were put into place to monetarily incentivise women to do so [2,3]. As a result, institutional delivery rates in India have increased from 38.7% in 2005 to almost 80% in 2015–2016 [3,4]. Although JSY has been successful in facilitating a marked increase in institutional delivery, this increase has not been associated with a reduction in MMR as initially anticipated [3].…”

Section: Introductionmentioning

confidence: 99%

“…As a result, institutional delivery rates in India have increased from 38.7% in 2005 to almost 80% in 2015–2016 [3,4]. Although JSY has been successful in facilitating a marked increase in institutional delivery, this increase has not been associated with a reduction in MMR as initially anticipated [3]. This could be attributed to gaps in the quality of care received by women at the facilities.…”

Section: Introductionmentioning

confidence: 99%

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Do women’s perspectives of quality of care during childbirth match with those of providers? A qualitative study in Uttar Pradesh, India

Bhattacharyya

Srivastava

Saxena

et al. 2018

Global Health Action

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Background: Persistently high maternal mortality levels are a concern in developing countries. In India, monetary incentive schemes have increased institutional delivery rates appreciably, but have not been equally successful in reducing maternal mortality. Maternal outcomes are affected by quality of obstetric care and socio-cultural norms. In this light there is need to examine the quality of care provided to women delivering in institutions. Objective: This study aimed to examine pregnant women’s expectations of high-quality care in public health facilities in Uttar Pradesh, India, and to contrast this with provider’s perceptions of the same, as well as the barriers that limit their ability to provide high-quality care. Methods: A qualitative descriptive analysis was conducted on data from two studies – focus group discussions with rural women in their last trimester of pregnancy (conducted in 2014) to understand women’s experience and satisfaction with maternal care services, and in-depth interviews with care providers (conducted in 2016–17) to understand provision of person-centred care. Provider perspectives were matched with themes of women’s perspectives on quality of childbirth care in facilities. Results: Major themes of care prioritised by women included availability of doctors at the facility; availability of medicines; food; ambulance services; maintenance of cleanliness and hygiene; privacy; good and safe delivery with no complications; client-provider interaction; financial cost of care. Many women also voiced no expectation of care, indicating disillusionment from the existing system. Providers concurred with women on all themes of care except availability of doctors, as they felt that trained nurses were proficient in conducting deliveries. Conclusions: This study shows that women have clear expectations of quality care from facilities where they go to deliver. Understanding their expectations and matching them with providers’ perspectives of care is critical for efforts to improve the quality of care and thereby impact maternal outcomes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Do women’s perspectives of quality of care during childbirth match with those of providers? A qualitative study in Uttar Pradesh, India

Bhattacharyya

Srivastava

Saxena

et al. 2018

Global Health Action

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“…Powell-Jackson 2011; Mohanan et al 2014;Randive, Diwan & De Costa 2013). Attention is increasingly being turned to the supply side, as studies continue to document significant problems with care delivery, including a lack of skilled providers, suboptimal provider effort, provider absenteeism, and lack of necessary infrastructure to provide high-quality care (Barber & Gertler 2009;Das, Hammer & Leonard 2008;Harvey et al 2007;Leonard & Masatu 2010).…”

Section: Introductionmentioning

confidence: 99%

Better Obstetrics in Rural Nigeria study: evaluating the Nigerian Midwives Service Scheme

Okeke¹,

Glick²,

Abubakar³

et al. 2017

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The International Initiative for Impact Evaluation (3ie) is an international grant-making NGO promoting evidence-informed development policies and programmes. We are the global leader in funding, producing and synthesising high-quality evidence of what works, how, why and at what cost. We believe that better and policy-relevant evidence will make development more effective and improve people's lives. 3ie impact evaluations3ie-supported impact evaluations assess the difference a development intervention has made to social and economic outcomes. 3ie is committed to funding rigorous evaluations that include a theory-based design, use the most appropriate mix of methods to capture outcomes and are useful in complex development contexts. About this report SummaryLimited availability of skilled providers, particularly in rural areas, is thought to be an important constraint to increasing rates of use of maternal and child health services in low-and middle-income countries. There are, however, few well-identified studies of the relationship between the supply of skilled workers and outcomes. In this project, we studied the effects of a government program in Nigeria that sought to alleviate supply-side constraints by deploying skilled midwives to primary health facilities in rural communities, to provide round-the-clock access to skilled care.We evaluate the impact of the Midwives Service Scheme (MSS), a government program introduced in 2009 to increase access to skilled care in underserved rural areas in Nigeria. At rollout, the MSS deployed nearly 2,500 midwives to 652 primary health care centers across 36 states. To evaluate the impact of the program, we surveyed 7,104 women with a birth within the preceding five years in 386 communities across 12 states. The intervention group consisted of communities that participated in the initial rollout; the comparison group consisted of communities that would receive the program approximately three years later. To understand implementation challenges and contextualize the quantitative results, we carried out a nested qualitative study in three states, consisting of in-depth interviews and focus group discussions with policymakers, providers, childbearing women, and community stakeholder groups.Overall, we found that the program's effects were smaller than anticipated. The main effect was a 7.3-percentage-point increase in antenatal care use in program clinics (about 12 percent relative to baseline levels) and a 5-percentage-point increase in overall use of antenatal care (6 percent relative to baseline levels) within the first year of the program. We found suggestive but not conclusive evidence of a small increase in skilled birth attendance, but this was confined to the south, where there were fewer challenges with midwife retention. We did not find any significant improvements in postnatal visits or child immunizations. Given this, it is not surprising that we did not find any evidence of improvements in maternal and child health.Our data allow us to shed some light on why ...

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“…Indeed, studies have been unable to detect a significant effect of the program on maternal mortality [11,12]. One way to investigate reasons for this discordance would be to study the QoC in facilities, especially the quality of processes related to intrapartum care, which might be achieved via clinical records.…”

Section: Introductionmentioning

confidence: 99%

Assessment of the quality of clinical documentation in India's JSY cash transfer program for facility births in Madhya Pradesh

Chaturvedi

Randive

Raven

et al. 2015

Intl J Gynecology & Obste

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Objective: To gain insight into the quality of care in facilities implementing the Janani Suraksha Yojana (JSY) cash transfer program in Madhya Pradesh, India, by reviewing the level of documentation in the clinical records of women who delivered. Methods: The present retrospective, descriptive study reviewed case records of women who delivered at 73 primary, secondary, and tertiary level facilities in three districts of Madhya Pradesh between 2012 and 2013. Twenty elements of care were assessed encompassing clinical history and admission details, care during delivery and postnatal period, and discharge details. Results: A total of 1239 records were reviewed. The extent of documentation varied among the elements assessed-e.g. 24 (1.9%) records documented advice at discharge, 171 (13.8%) documented postnatal blood pressure, 437 (35.3%) documented fetal heart rate, and 1220 (98.5%) documented admission date. The extent of documentation was better at higher level facilities. Conclusion: The quality of clinical documentation in the JSY program was found to be unacceptably poor in Madhya Pradesh. Improving staff skills and practices in clinical documentation and record keeping will be required to enable clinical processes to be assessed and quality of care to be improved.

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India’s Conditional Cash Transfer Programme (the JSY) to Promote Institutional Birth: Is There an Association between Institutional Birth Proportion and Maternal Mortality?

Cited by 212 publications

References 14 publications

Do women’s perspectives of quality of care during childbirth match with those of providers? A qualitative study in Uttar Pradesh, India

Do women’s perspectives of quality of care during childbirth match with those of providers? A qualitative study in Uttar Pradesh, India

Better Obstetrics in Rural Nigeria study: evaluating the Nigerian Midwives Service Scheme

Assessment of the quality of clinical documentation in India's JSY cash transfer program for facility births in Madhya Pradesh

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