Cash Incentive Scheme Research Articles

Guaranteed Cash Incentives Boosted COVID-19 Vaccinations Of Young Adults: Evidence From West Virginia.

Guaranteed small cash incentives were widely employed by policy makers during the COVID-19 vaccination campaign, but the impact of these programs has been largely understudied. We were the first to exploit a statewide natural experiment of one such program implemented in West Virginia in 2021 that provided a $100 incentive to fully vaccinated adults ages 16-35. Using individual-level data from the Census Bureau's Household Pulse Survey, we isolated the policy effect through a difference-in-discontinuities design that exploited the discontinuity in incentive eligibility at age thirty-five. We found that the $100 incentive was associated with a robust increase in the proportion of people ever vaccinated against COVID-19 and the proportion who completed or intended to complete the primary series of COVID-19 vaccines. The policy effects were also likely to be more pronounced among people with low incomes, those who were unemployed, and those with no prior COVID-19 infection. The guaranteed cash incentive program may have created more equitable access to vaccines for disadvantaged populations. Additional outreach may also be needed, especially to unvaccinated people with prior COVID-19 infections.

Keeping Girls in Schools Longer: The Kanyashree Approach in India

Regarding interventions aimed at preventing girls from prematurely dropping out of schools, this study shows that inducing economic empowerment of girls is possible with targeted policies that promote their reproductive empowerment. Using Kanyashree Prakalpa, a conditional cash transfer program implemented in West Bengal, India, that directly incentivized school attendance to delay child marriage, the study finds a strong association between program participation and successfully lowering the historically higher dropout rates post-middle school. Program-eligible girls are 12 percent (7 percent) more likely to be enrolled in or to complete secondary (higher secondary) school, respectively. Program participation is associated with approximately five more months of education. In fact, the efficacy of the program is highly correlated with the length of exposure, and the most benefits are reaped by children in the poorest households. The article discusses three policy interventions, including directly targeting girls as they transition from childhood to young adulthood. HIGHLIGHTS In West Bengal, Kanyashree Prakalpa, a unique cash incentive program, links educational empowerment with girls’ reproductive empowerment. Program participation is strongly associated with successfully lowering the historically higher dropout rates post-middle school. Policies directly targeting adolescent girls are fruitful compared to indirect influence. Policies complementing the cash transfer with other programs based on the girls’ academic achievement are useful.

The Impact of Awarding Incentives on Posyandu Cadre Performance

Background:Stunting is a condition of failure to thrive due to chronic malnutrition that occurs in toddlers. Posyandu is an intervention facility for a specific nutrition program carried out by the Ministry of Health. The role of posyandu cadres is very important in efforts to reduce the prevalence of stunting. The Government of Malang Regency implements a cash incentive program for all posyandu cadres to improve their performance.Objective:This study aims to compare the effect of giving cash incentives on the performance of cadres of Pagelaran Health Center and Gedangan Health Center, Malang Regency.Methods:This study used an observational analytic design using a proportional cluster random sampling technique on 125 Pagelaran Health Center cadres and 125 Gedangan Health Center cadres. The research results were analyzed and interpreted using the SPSS Windows release version 2.1 computer program.Results:The results of this study prove that giving incentives to posyandu cadres in the Pagelaran Health Center work area has no effect on cadre performance with a significance value of 0.98 and giving incentives to posyandu cadres in the Gedangan Health Center work area has no effect on cadre performance with a significance value of 0.657.Conclusion:It can be concluded that the provision of incentives has no direct effect on the performance of posyandu cadres in the work area of Pagelaran Health Center and Gedangan Health Center.

EXPLORING THE LINK BETWEEN KANYASHREE PRAKALPA AND GIRL CHILD EDUCATION

In the recent times, to stimulate the educational potential as well as to stop the early marriages of female child, West Bengal Government, with the expertise of Ministry of Department of Women development and Social Welfare (DWD&SD) curated a cash incentive scheme called Kanyashree Prakalpa, launched in the year of 2013, dated 8th April. The main objective of the scheme was to promote higher education as well as stop child marriage, which will showcase a decrease in the mortality rate of both mother and child.The implementation of Kanyashree Prakalpa was done and became a success, but what is the present scenario regarding the scheme?Thepaper specifically caters the educational aspect of Kanyashree Prakalpa and from the results it was determined whether the scheme has served its purpose in the current setting.The findings of this study suggest that Kanyashree had positive impact on female admission rate in rural area and dropout rate in both rural and urban areas.

LEGAL PROTECTION OF LABOR RIGHTS DURING THE CORONAVIRUS DISEASE 2019 (COVID-19) PANDEMIC

Since the Coronavirus Disease 2019 (Covid-19) pandemic in Indonesia, which continues to grow and has an impact, not a few companies have gone bankrupt. Whether it's a small company, a medium-sized company or even a large corporation are affected by the Coronavirus Disease 2019 (Covid-19). This paper aims to find legal issues on labor right during Covid-19 pandemic in Indonesia. Using the normative legal research, this paper analyzess some of regulation and legal government act to protect labor right who terminated (Pemutusan Hubungan Kerja/PHK) during Covid-19 pandemic. In the end, this paper finds that the government issued two program to solve PHK and protect labor rights, namely Pre-Works Card and Cash Incentive Program (Bantuan Langsung Tunai/BLT). It actively helps employee to create a new job and continue their daily life.

All these worlds are yours, except india: The effectiveness of cash subsidies to export in nepal

This paper studies the impact of a ‘textbook’ ad-valorem export subsidy on firm-level export performance. The Cash Incentive Scheme for Exports (CISE) program offered by the government of Nepal offers a cash subsidy to firms exporting a select group of products to countries other than India. Using customs transactions data combined with subsidy disbursements at the firm level from 2011 to 2014, we estimate the impact of the subsidy on exports of targeted and non-target product-destination combinations and their extensive and intensive margins. We employ a range of doubly-robust matching estimators to control for the non-random selection of exporters into the scheme. We find that subsidized firms increased their exports of targeted product-destinations relative to firms in the control group and that this rise is fully accounted for by the extensive margin: a higher number of targeted products exported and foreign markets served. We do not find any significant changes along the intensive margin nor among non-targeted product-destination combinations. While our results show that the CISE scheme fomented export diversification, its limited impact on total exports and high fiscal cost call into question its effectiveness.

Cash Incentive Scheme in Nepal: Is It a Panacea to Boost Exports?

Nepal’s export performance seems unable to meet the expectation of the policy makers for a long time now, and government is trying to adopt many policies and strategies to correct the scenario. Cash incentive to export is one of such mechanisms in Nepal, which was implemented since 2012 to motivate the exporters. This paper analyses the cash incentive mechanism to exports and then investigate the association of this incentive with the export performance using the annual data for the period of 14 years from 2005-2018, in a panel structure, employing the gravity modelling approach for the exports from Nepal to its trading partners. Looking the low number of Nepal’s export data reported, we use the mirror export data as the imports are recorded more systematically than the exports. The finding from the estimations suggests that, instead motivating the exporters, the export cash incentive mechanism has a statistically significant negative association with the export performance. The reason for this may be the weakness of properly implementation of the scheme or it may have created some negligence in the firms to produce limited just for targeting the cash incentives so that exports are not really motivated. Also, not all eligible exports received the cash incentive and not all eligible firms have claimed the incentives in practice. However, from the data analysis, it seems that the cash incentive scheme has positively contributed to market diversification to some extent. This situation asks the revision of the schemes or developing the proper mechanism for implementation and on the other way to initiate other types of schemes such as credit incentives tying with production and trade infrastructure to boost the export performance in the country.

Cash transfer scheme for people with tuberculosis treated by the National TB Programme in Western India: a mixed methods study

ObjectivesThis study aimed to assess the coverage and explore enablers and challenges in implementation of direct benefit transfer (DBT) cash incentive scheme for patients with tuberculosis (TB).DesignThis is a mixed...

Why Institutional Deliveries are Low in Balrampur District Uttar Pradesh: A Cross-Sectional Quantitative and Qualitative Exploration.

The rate of institutional deliveries in India is 78.5%. Kerala and Tamil Nadu (99.8%) had the highest numbers of institutional deliveries in 2010-13, but still it is less than 60% in about 170 districts in the country. Balrampur (Uttar Pradesh) has recorded the least institutional deliveries in the country. To assess the factors associated with low utilization of healthcare institutions for delivery in rural Balrampur district, Uttar Pradesh. A community-based cross-sectional survey was conducted among mothers between the ages of 15-49 who gave birth 12months before the study in Balrampur district, Uttar Pradesh. Both qualitative and quantitative methods were used for the study. Multistage random sampling was used to select the participants for the quantitative study. Qualitative data collection was done using in-depth interview among 10 women. Mothers who were not desirous of having more children had a 2.7 times greater chance of delivering at home compared to mothers who were desirous of having more children (OR 2.705, CI 95% 1.189-6.155). Women who married before 18years of age had a greater chance of home delivery than women who married later (OR 2.381, CI 95% 1.034-5.482). Respondents living far away from home (more than 30min-1h travel) were more likely to deliver at home compared to those living close by (OR 2.385, CI 95% 2.357-8.028). Women who were unaware of complications of pregnancy were more like to deliver at home compared to their counterparts who were well aware (OR 2.355, CI 95% 1.677-3.309). Qualitative data showed that cultural beliefs, financial problems, lack of decision making power by the pregnant women were significant determinants of non-utilization of institutional deliveries. Despite the cash incentive program, strong cultural and social factors prevent women from accessing institutional deliveries in Balrampur district of UP.

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

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.

Has the Janani Suraksha Yojana (a conditional maternity benefit transfer scheme) succeeded in reducing the economic burden of maternity in rural India? Evidence from the Varanasi district of Uttar Pradesh.

BackgroundOne of the constraints in the utilisation of maternal healthcare in India is the out-of-pocket expenditure. To improve the utilisation and to reduce the out-of-pocket expenditure, India launched a cash incentive scheme, Janani Suraksha Yojana (JSY), which provides monetary incentive to the mothers delivering in public facility. However, no study has yet examined the extent to which the JSY payments reduce the maternal healthcare induced catastrophic out-of-pocket expenditure burden of the households. This paper therefore attempts to examine the extent to which the JSY reduces the catastrophic expenditure estimate household expenditure on maternity, i.e., all direct and indirect expenditure.Materials and methodsThe study used data on 396 mothers collected through a primary survey conducted in the rural areas of the Varanasi district of Uttar Pradesh state in 2013-2014. The degree and variation in the catastrophic impact of households’ maternity spending was computed as share of out-of-pocket payment in total household income in relation to specific thresholds, across socioeconomic categories. Logistic regression was used to understand the determinants of catastrophic expenditure and whether the JSY has any role in influencing the expenditure pattern.ResultsResults revealed that the JSY beneficiaries on an average spent about 8.3% of their Annual Household Consumption Expenditure on maternity care. The JSY reimbursement could reduce this share only by 2.1%. The study found that the expenditure on antenatal and postnatal care made up a significant part of the direct medical expenditure on maternity among the JSY beneficiaries. The indirect or non-medical expenditure was about four times higher than the direct expenditure on maternity services. The out-of-pocket expenditure across income quintiles was found to be regressive i.e. the poor paid a greater proportion of their income towards maternity care than the rich. Results also showed that the JSY reimbursement helped only about 8% households to escape from suffering catastrophic burden due to maternity payments.ConclusionsIt can be concluded that the JSY appeared to have achieved only a limited success in reducing the economic burden due to maternity. To reduce the catastrophic burden, policy makers should consider increasing the JSY reimbursement to cover not only antenatal and postnatal services but also non-medical expenditure due to maternity. The government should also take appropriate measures to curb non-medical or indirect expenditure in public health facilities.Significance for public healthImproving the well-being of mothers is an important public health goal for India. For improving maternal health, it is necessary that mothers utilize maternity services. However, maternity often becomes an economic burden, especially for disadvantaged and poorer groups of the society. To encourage mothers to utilize services, India launched a conditional maternity benefit transfer scheme back in 2005. This study explored whether the scheme has been able to help alleviate the burden of maternity expenditure or not. The study finds that the scheme has been successful only partially to reduce outof- pocket expenditure suggesting that maternity is a costly affair in rural India. Since the scheme is unable to save mothers from catastrophic expenditures, it is also unable to save mothers from a wide ranges of health illeffects caused by catastrophic expenditure.

Modeling heaped duration data: An application to neonatal mortality

In 2005, the Indian Government launched a conditional cash-incentive program to encourage institutional delivery. This paper studies the effects of the program on neonatal mortality using district-level household survey data. We model mortality using survival analysis, paying special attention to substantial heaping, a form of measurement error, present in the data. The main objective of this paper is to provide a set of sufficient conditions for identification and consistent estimation of the (discretized) baseline hazard accounting for heaping and unobserved heterogeneity. Our identification strategy requires neither administrative data nor multiple measurements, but a correctly reported duration point and the presence of some flat segment(s) in the baseline hazard. We establish the asymptotic properties of the maximum likelihood estimator and derive a set of specification tests that allow, among other things, to test for the presence of heaping and to compare different heaping mechanisms. Our empirical findings do not suggest a significant reduction of mortality in treated districts. However, they do indicate that accounting for heaping matters for the estimation of the hazard parameters.

A qualitative study of factors impacting accessing of institutional delivery care in the context of India's cash incentive program

Not all eligible women use the available services under India's Janani Suraksha Yojana (JSY), which provides cash incentives to encourage pregnant women to use institutional care for childbirth; limited evidence exists on demand-side factors associated with low program uptake. This study explores the views of women and ASHAs (community health workers) on the use of the JSY and institutional delivery care facilities. In-depth qualitative interviews, carried out in September-November 2013, were completed in the local language by trained interviewers with 112 participants consisting of JSY users/non-users and ASHAs in Jharkhand, Madhya Pradesh and Uttar Pradesh. The interaction of impeding and enabling factors on the use of institutional care for delivery was explored. We found that ASHAs' support services (e.g., arrangement of transport, escort to and support at healthcare facilities) and awareness generation of the benefits of institutional healthcare emerged as major enabling factors. The JSY cash incentive played a lesser role as an enabling factor because of higher opportunity costs in the use of healthcare facilities versus home for childbirth. Trust in the skills of traditional birth-attendants and the notion of childbirth as a ‘natural event’ that requires no healthcare were the most prevalent impeding factors. The belief that a healthcare facility would be needed only in cases of birth complications was also highly prevalent. This often resulted in waiting until the last moments of childbirth to seek institutional healthcare, leading to delay/non-availability of transportation services and inability to reach a delivery facility in time. ASHAs opined that interpersonal communication for awareness generation has a greater influence on use of institutional healthcare, and complementary cash incentives further encourage use. Improving health workers' support services focused on marginalized populations along with better public healthcare facilities are likely to promote the uptake of institutional delivery care in resource-poor settings.

All These Worlds are Yours, Except India: The Effectiveness of Export Subsidies in Nepal

This paper evaluates the effect on firm-level export outcomes of the Cash Incentive Scheme for Exports program provided by the Government of Nepal. The analysis utilizes customs-level data for 2011-14, combined with information on the subsidy payments made to individual firms provided by the Central Bank of Nepal. The Cash Incentive Scheme for Exports cash subsidy is available to firms exporting a select group of products, and requires firms to export to countries other than India. Overall, the subsidy has not produced a significant impact on firm-level export values, prices, quantities, or their growth rates. However, the study finds a small positive effect on the number of eligible products exported to countries other than India and the number of destination markets reached among firms that receive the subsidy. These results are consistent with the fact that the subsidy was granted primarily to large exporters that were already shipping eligible products to countries other than India. The findings suggest that although the cash subsidy has not produced a significant increase in exports, it has achieved a positive impact on export diversification for firms that were already satisfying the scheme’s eligibility criteria.

Out of pocket expenditure to deliver at public health facilities in India: a cross sectional analysis.

BackgroundTo expand access to safe deliveries, some developing countries have initiated demand-side financing schemes promoting institutional delivery. In the context of conditional cash incentive scheme and free maternity care in public health facilities in India, studies have highlighted high out of pocket expenditure (OOPE) of Indian families for delivery and maternity care. In this context the study assesses the components of OOPE that women incurred while accessing maternity care in public health facilities in Uttar Pradesh, India. It also assesses the determinants of OOPE and the level of maternal satisfaction while accessing care from these facilities.MethodIt is a cross-sectional analysis of 558 recently delivered women who have delivered at four public health facilities in Uttar Pradesh, India. All OOPE related information was collected through interviews using structured pre-tested questionnaires. Frequencies, Mann-Whitney test and categorical regression were used for data reduction.ResultsThe analysis showed that the median OOPE was INR 700 (US$ 11.48) which varied between INR 680 (US$ 11.15) for normal delivery and INR 970 (US$ 15.9) for complicated cases. Tips for getting services (consisting of gifts and tips for services) with a median value of INR 320 (US$ 5.25) contributed to the major share in OOPE. Women from households with income more than INR 4000 (US$ 65.57) per month, general castes, primi-gravida, complicated delivery and those not accompanied by community health workers incurred higher OOPE. The significant predictors for high OOPE were caste (General Vs. OBC, SC/ST), type of delivery (Complicated Vs. Normal), and presence of ASHA (No Vs. Yes). OOPE while accessing care for delivery was one among the least satisfactory items and 76 % women expressed their dissatisfaction.ConclusionEven though services at the public health facilities in India are supposed to be provided free of cost, it is actually not free, and the women in this study paid almost half of their mandated cash incentives to obtain delivery care.

Factors influencing women's preference for health facility deliveries in Jharkhand state, India: a cross sectional analysis.

BackgroundExpanding institutional deliveries is a policy priority to achieve MDG5. India adopted a policy to encourage facility births through a conditional cash incentive scheme, yet 28 % of deliveries still occur at home. In this context, it is important to understand the care experience of women who have delivered at home, and also at health facilities, analyzing any differences, so that services can be improved to promote facility births. This study aims to understand women’s experience of delivery care during home and facility births, and the factors that influence women’s decisions regarding their next place of delivery.MethodA community-based cross-sectional survey was undertaken in a district of Jharkhand state in India. Interviews with 500 recently delivered women (210 delivered at facility and 290 delivered at home) included socio-demographic characteristics, experience of their recent delivery, and preference of future delivery site. Data analysis included frequencies, binary and multiple logistic regressions.ResultsThere is no major difference in the experience of care between home and facility births, the only difference in care being with regard to pain relief through massage, injection and low cost of delivery for those having home births. 75 % women wanted to deliver their next child at a facility, main reasons being availability of medicine (29.4 %) and perceived health benefits for mother and baby (15 %). Women with higher education (AOR = 1.67, 95 % CI = 1.04–3.07), women who were above 25 years (AOR = 2.14, 95 % CI = 1.26–3.64), who currently delivered at facility (AOR = 5.19, 95 % CI = 2.97–9.08) and had health problem post-delivery (AOR = 1.85, 95 % CI = 1.08–3.19) were significant predictors of future facility-based delivery.ConclusionThe predictors for facility deliveries include, availability of medicines and supplies, potential health benefits for the mother and newborn and the perception of good care from the providers. There is a growing preference for facility delivery particularly among women with higher age group, education, income and those who had antennal checkup. In order to uptake facility births, the quality improvement initiatives should regularly assess and address women’s experiences of care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-0839-6) contains supplementary material, which is available to authorized users.

Inequalities in institutional delivery uptake and maternal mortality reduction in the context of cash incentive program, Janani Suraksha Yojana: Results from nine states in India

Proportion of women giving birth in health institutions has increased sharply in India since the introduction of cash incentive program, Janani Suraksha Yojana (JSY) in 2005. JSY was intended to benefit disadvantaged population who had poor access to institutional care for childbirth and who bore the brunt of maternal deaths. Increase in institutional deliveries following the implementation of JSY needs to be analysed from an equity perspective. We analysed data from nine Indian states to examine the change in socioeconomic inequality in institutional deliveries five years after the implementation of JSY using the concentration curve and concentration index (CI). The CI was then decomposed in order to understand pathways through which observed inequalities occurred. Disparities in access to emergency obstetric care (EmOC) and in maternal mortality reduction among different socioeconomic groups were also assessed. Slope and relative index of inequality were used to estimate absolute and relative inequalities in maternal mortality ratio (MMR).Results shows that although inequality in access to institutional delivery care persists, it has reduced since the introduction of JSY. Nearly 70% of the present inequality was explained by differences in male literacy, EmOC availability in public facilities and poverty. EmOC in public facilities was grossly unavailable. Compared to richest division in nine states, poorest division has 135 more maternal deaths per 100,000 live births in 2010. While MMR has decreased in all areas since JSY, it has declined four times faster in richest areas compared to the poorest, resulting in increased inequalities.These findings suggest that in order for the cash incentive to succeed in reducing the inequalities in maternal health outcomes, it needs to be supported by the provision of quality health care services including EmOC. Improved targeting of disadvantaged populations for the cash incentive program could be considered.

Modelling Heaped Duration Data: An Application to Neonatal Mortality

In 2005, the Indian Government launched a conditional cash-incentive program to encourage institutional delivery. This paper studies the effects of the program on neonatal mortality using district-level household survey data. We model mortality using survival analysis, paying special attention to substantial heaping, a form of measurement error, present in the data. The main objective of this paper is to provide a set of sufficient conditions for identification and consistent estimation of the (discretized) baseline hazard accounting for heaping and unobserved heterogeneity. Our identification strategy requires neither administrative data nor multiple measurements, but a correctly reported duration point and the presence of some flat segment(s) in the baseline hazard. We establish the asymptotic properties of the maximum likelihood estimator and derive a set of specification tests that allow, among other things, to test for the presence of heaping and to compare different heaping mechanisms. Our empirical findings do not suggest a significant reduction of mortality in treated districts. However, they do indicate that accounting for heaping matters for the estimation of the hazard parameters.

Modelling Heaped Duration Data: An Application to Neonatal Mortality

In 2005, the Indian Government launched a conditional cash-incentive program to encourage institutional delivery. This paper studies the effects of the program on neonatal mortality using district-level household survey data. We model mortality using survival analysis, paying special attention to the substantial heaping present in the data. The main objective of this paper is to provide a set of sufficient conditions for identification and consistent estimation of the baseline hazard accounting for heaping and unobserved heterogeneity. Our identification strategy requires neither administrative data nor multiple measurements, but a correctly reported duration and the presence of some flat segments in the baseline hazard which includes this correctly reported duration point. We establish the asymptotic properties of the maximum likelihood estimator and provide a simple procedure to test whether the policy had (uniformly) reduced mortality. While our empirical findings do not confirm the latter, they do indicate that accounting for heaping matters for the estimation of the baseline hazard.

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

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 (2003-2005) and compared with two years following implementation of JSY (2005-2007). 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.