Utilization of janani suraksha yojana by eligible pregnant women in rural South India: A qualitative study

Abstract

Context: In India, the Janani Suraksha Yojana (JSY) scheme, translated as “safe motherhood scheme,” has been implemented to tackle this financial insecurity by giving cash incentives to women who give birth in public health facilities and accredited private health facilities. Although there is a reported increase in the number of institutional deliveries, there has not been much improvement in maternal or neonatal mortality rates. Objective: To explore the utilization of and barriers toward the use of JSY scheme by eligible rural pregnant women. Design: Qualitative research method in the form of in-depth interview was used for data collection and analysis. Methodology: The study was conducted in seven villages of Bellary district in Karnataka, South India. In depth interview was conducted for the study participants included twenty women who had delivered over the last 1 year and were selected by purposive sampling from antenatal registers which were available from the primary and community health centers in the district. Results: About 80% had delivered at public sector health facilities. To pay for the financial deficit to meet the pregnancy-related expenses, a large number of participants expressed to have raised money from loans, mortgage of land and house, and selling of jewelry and livestock. Many narrated their experiences with the poor quality of care at the public sector health centers. Several participants faced problems ranging from those related to opening a bank account to cumbersome procedures and logistical issues for money encashment. Conclusion: The incentive which is given under JSY does not seem adequate as, despite its availability, the family still needs to incur lofty medical expenditure. Furthermore, lack of quality care at public health facilities results in excessive out of pocket expenditure incurred at private health centers. The encashment procedure is also fraught with cumbersome procedures once again leads to loss of work time and additional economic losses.