Improving Reproductive and Maternal Healthcare Uptake in India: An Evaluation of Project Ujjwal Public-Private Partnership Program

Abstract

Background and Objective: Project Ujjwall was a public private partnership established to improve maternal and child health (MCH) outcomes in Bihar and Odisha in India. This paper examines whether Project Ujjwal meaningfully increased the usage of family planning methods and maternal health services to determine whether the Ujjwall program model should be expanded in India. This is the first attempt to establish the causal impact of Project Ujjwal on access to reproductive healthcare in India. Methods: Data were obtained from the National Family Health Survey of India. A difference-in-differences strategy and linear probability models were used to estimate the likelihood of ever having encountered family planning information or ever having used contraceptives, antenatal care, etc. Results: The sample size for Odisha was 4,540; the sample size for Bihar was 3,818; the total sample size for all states in the control group was 24,922. Within Odisha and Bihar, Project Ujjwal increased the likelihood of ever having used any contraceptive by 8.9%, increased the likelihood of having ever accessed antenatal care from a licensed doctor or nurse by 2.5% and increased the likelihood of having ever encountered family planning media by 5.1%. However, most results seem differentially driven by the success of the program in either Odisha or Bihar: among all results, only the odds that a woman received delivery assistance (2.8%) and the odds that a woman will have used oral contraceptives by (9.3%) increased statistically significant in both states. Conclusion and Implications for Translation: These results are promising and show Project Ujjwal may have been more effective than existing government programs. Limitations of this analysis include a lack of information about the demand generation tactics and an inability to include state-level fixed effects due to over-specification concerns. Disparities in the impact of Project Ujjwal on Bihar and Odisha and the lack of specific information about latent demand both suggest the need for further investigation. Copyright © 2023 Lokhande. Published by Global Health and Education Projects, Inc.This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.