Janani Shishu Suraksha Karyakram Research Articles

Assessing the Impact of the COVID-19 Pandemic on Maternal and Child Health Services: A Comprehensive Analysis of Government Initiatives in Northern India.

The coronavirus disease (COVID-19) pandemic has significantly impacted healthcare services globally, with particular challenges observed in maternal and child health (MCH) care. This study aimed to assess the impact of the pandemic on MCH services in northern India, focusing on key government programs. Data were collected from four major MCH programs in India: Janani Suraksha Yojana (JSY), Janani Shishu Suraksha Karyakram (JSSK), Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), and the Universal Immunization Program (UIP). The study compared MCH service utilization and outcomes during the pandemic period (March-September 2020) with the same period in 2019. Preliminary findings indicated a significant reduction in the utilization of MCH services during the pandemic, with a decrease observed in institutional deliveries, antenatal care visits, and immunization coverage. For instance, institutional deliveries declined by 30% compared with the previous year, with a similar decrease observed in antenatal care visits. Immunization coverage also decreased by approximately 25%, indicating a substantial decline in preventive care services. Challenges in accessing essential treatments for sick infants have also been reported, with a 40% decrease in the utilization of free treatment services under the JSSK program. The COVID-19 pandemic has substantially impacted MCH services in northern India, highlighting the vulnerability of these essential health programs during public health emergencies. Addressing the challenges identified in this study is crucial to ensuring the continuity and resilience of MCH services in similar settings.

Demand for Maternal Health Inputs in Eastern States of India

Using NFHS-4 data, this study explores the determinants of maternal health care programmes for eastern states of India, which include prenatal care and hospital delivery. To reduce unobserved heterogeneity in the analysis, we employed the Full Information Likelihood Method, also known as the Joint Estimation Technique, in conjunction with individual probit models. Like other studies, we found place of residence, wealth, caste, religion and level of education as significant contributor for demand for both services. But, unlike earlier studies, we found that women’s age increases the use of prenatal care and hospital delivery, and the child’s birth order influences getting prenatal care. To increase the utilisation of maternal health care services, we recommend investing in health infrastructure, increasing the Janani Suraksha Yojana (JSY) subsidy amount and coverage of the Janani Shishu Suraksha Karyakram (JSSK) scheme, and promoting awareness about various government programmes among women through the Accredited Social Health Activists (ASHAs). JEL Codes: I140, I150, I180, O150

A Study to Assess the Effectiveness of Orientation Programme on Knowledge and Practice Regarding Janani Suraksha Yojna (JSY) and Janani Shishu Suraksha Karyakram (JSSK) among Asha Workers in Selected Block of District Kulgam, Kashmir

Abstract: The study was conducted with an aim to improve the knowledge and Practice of ASHA WORKERS regarding JSY and JSSK , to promote maternal and child health and to encourage ASHA Workers to update their knowledge and practice regarding JSY and JSSK

ANTENATAL CARE HEALTH LITERACY AMONG RURAL AND URBAN PREGNANT WOMEN IN MAHARASHTRA – A COMPARATIVE STUDY.

Introduction : The global target to achieve a reduction in Maternal Mortality Ratio (MMR) under Sustainable Development Goal 3 (SDG) is less than 70 per 100,000 live births by 2030. To accomplish this, governments are striving for a long time. However, over a period of time, it is realised that Antenatal care (ANC) literacy is also equally crucial. Hence a comparative study was conducted in rural and urban areas of Maharashtra to assess this important aspect. Aim & objectives: To assess the Antenatal health care literacy among pregnant women in Rural and Urban areas in Maharashtra. For feasibi Methods: lity purposes, a cross-sectional study was conducted at Antenatal Care Out Patient Department located at a medical college and Rural Health Training Centre attached to it. Data was collected randomly among 100 pregnant women attending the same in both settings. The data was entered and analysed in Microsoft Excel 365, and the results were presented appropriately. All the necessary permissions were sought. The study found that 80(80%) of rural Results: participants acknowledged the need for at least four visits during pregnancy compared to 53(53%) in urban areas. Only 28(28%) of women in urban areas and 22% in rural areas were aware of the danger signs of pregnancy. ANC health literacy about early registration for pregnancy care, number of ANC visits required and haemoglobin status were signicantly higher in rural when compared to urban pregnant women ( p-value < 0.0001). Only 2 (2%) from urban and 6 (6%) from rural had information about Janani Shishu Suraksha Karyakram while 4 (4%) & 5 (5%) from urban and rural areas were knowing about Janani Suraksha Yojana respectively. There Conclusion: is a scope to improve ANC literacy with the help of innovative strategies

Intra-natal Care Practices in Rural Areas of Gaya District, Bihar

Context: Antenatal care (ANC) effectively reduces infant and maternal mortality rates mainly by promoting institutional deliveries. In view of this, the Government of India introduced Janani Suraksha Yojna (JSY) in 2005 and Janani Shishu Suraksha Karyakram (JSSK) in 2011. Aims: To estimate the proportion of home and institutional deliveries in the district, assess the impact of JSK and JSSY on institutional deliveries, and identify the different intranatal care providers. Settings and Design: This cross-sectional study was conducted in the Gaya district, Bihar. A total of 657 females of the reproductive age group (15-49 years) were included in the study. Methods and Material: Predesigned, pre-tested & semi-structured questionnaire was used to collect information on place of delivery, type of delivery, knowledge regarding JSY and JSSK schemes and source of information Statistical analysis used: Data was entered into excel sheets and analyzed using SPSS version 23 utilizing appropriate statistical methods. Results: Out of 519 deliveries, 63% were institutional and 37% were home deliveries. About 91 and 11.4% of respondents were aware of JSY and JSSK schemes. There was a significant association between those who opted for institutional delivery and awareness regarding JSY and JSSK services. Conclusion: Despite awareness and running of various government programs, the percentage of institutional deliveries is still less. An increase in institutional deliveries at primary care level through JSY and JSSK will not only decrease the Out of Pocket expenditure of the population but also help build faith in the government health facilities.

Effectiveness of Health Education Package of Janani Shishu Suraksha Karyakram (JSSK) Scheme by Ante-Natal and PostNatal Mothers in a District Hospital of Faridabad (Haryana)

The Government of India had launched the Janani Shishu Suraksha Karyakram (JSSK) Scheme in June 2011 to benefi t pregnant women during their ante-natal, intra-natal and post-natal period including the new-born up to age of one year. In this quasi-experimental (pre-test, post-test, control group design) study, a total of 60 mothers (30 each in experimental and control group) attending ante-natal clinic at district hospital, Faridabad were enrolled using simple random sampling (lottery method). A self-developed, pre-tested and validated tool based on knowledge and utilisation about JSSK scheme was used for data collection. Mean post-test knowledge scores of experimental group and control group were 22.4 and 12 respectively with a mean difference of 10.4. The obtained mean difference was found to be statistically signifi cant as evident from the ‘t’ value of 3.96 at 0.05 level of signifi cance. The mean post-test utilisation score of experimental group (23.57) was higher than the mean post-test utilisation scores of control group (20.6) with a mean difference of 2.97. The obtained mean difference was found to be statistically signifi cant as evident from the ‘t’ value of 3.96 at 0.05 level of signifi cance. Chi value computed between knowledge scores and utilisation scores of JSSK Scheme and selected demographic variables indicated that there was no signifi cant association. This shows that health education package was effective in enhancing the knowledge of participant mothers regarding JSSK health scheme so that they were able to utilise the scheme in a better way. There is a need of IEC activity to increase the knowledge of benefi ciaries to enhance the utilisation of JSSK health services.

Improving maternal nutrition in public health facilities by strengthening the dietary component of Janani Shishu Suraksha Karyakram – A government of India programme

Introduction: The Janani Shishu Suraksha Karyakram (JSSK) is a government of India initiative for all pregnant women visiting public health facilities, with many free entitlements – free diet being one. After an in-depth study of existing dietary provisions in all community health centres, an elaborate cyclic-weekly nutritious menu was designed taking into consideration the latest recommendations (2019) by the Ministry of Family and Child Welfare, India to improve maternal health nutrition. Methods: The health functionaries from all ten community health centres of rural Vadodara were chosen for an in-depth estimation of the different meals served in the facilities. Standard measuring cups and spoons were used to measure the exact serving sizes for each person. Each meal served was supervised, checked and quantified in triplicate, while macro- and micronutrients were calculated using the Indian Food Composition Tables 2017 (Longvah et al. 2017). To bridge the gap in service delivery, two new models of cyclic-weekly menu were developed, keeping in mind the amount per mother per day as one hundred Indian rupees. Results: On average the foods served in the community health centres provided 69% of recommended energy intake, while mean recommended dietary allowance met for protein was 51%, calcium 18%, iron 50%, and fat 267%. Conclusion: The recommendations specified in this paper would improve the nutritional status of all pregnant and lactating women availing the services in rural health facilities, which would go a long way in ensuring safe and healthy motherhood.

Assess the Knowledge Regarding Janani Shishu Suraksha Karyakram among Antenatal Mothers Attending Antenatal Clinic at Selected PHC, Tamil Nadu

Aim: to assess the knowledge regarding Janani Shishu Suraksha Karyakram among antenatal mothers attending antenatal clinic at selected PHC in a view to develop an information booklet regarding Janani Shishu Suraksha Karyakram. Objectives: (i) To assess the level of knowledge regarding Janani Shishu Suraksha Karyakaram among antenatal mothers. (ii) To associate the significant between the level of knowledge regarding Janani Shishu Suraksha Karyakaram among antenatal mothers with selected demographic variables. Methods & Material: A quantitative research approach .descriptive survey design with one group pretest design was adopted 50 samples were selected for the study by using non probability convenient sampling techniques. Result: The finding shows that the level of knowledge majority of mother 37 [74%] had moderate knowledge & 6 [12%] had adequate knowledge and 7 [14%] had inadequate knowledge; there is association between level of Knowledge with the Demographic Variables like Religion and Education of Mothers and the is no association in Age, Occupation, Type of Family, family Income Per Month and No. of Gravida. Conclusion: The findings of the study show that in level of knowledge, the mean value was 10.66 with the standard of 3.8859. The study concluded that most of the antenatal mother are having moderate knowledge regarding Janani Shishu Suraksha Karyakram among antenatal mother. Keywords: Antenatal Mothers, Janani Shishu Suraksha Karyakram.

Awareness and utilization of maternal benefit schemes among mothers in urban area

Background: Motherhood is the most important stage of a woman’s life but can be a life-threatening condition too. During pregnancy, any woman can develop life-threatening complications that require immediate medical care. Maternal mortality is unacceptably high. About 830 women die from pregnancy or childbirth-related complications around the world every day. Maternal health care services are the measures to ensure safe motherhood through promotive, preventive, curative, and rehabilitative health-care system. In view of the difficulty being faced by the pregnant women along with high expenditure on delivery, Ministry of Health and Family Welfare and state governments have launched many schemes to ensure better facilities for women during pregnancy and delivery. However, the success of these schemes depends on their utilization by antenatal and postnatal mothers. Aim and Objective: This study was planned to estimate the level of awareness about the various government maternal benefit schemes among and also to assess the utilization of maternal benefit schemes among those mothers. Materials and Methods: This was a community-based cross-sectional study. All the mothers who had delivered before 1 year from the start of the study were included in the study. The mothers were identified with the help of Accredited Social Health Activist worker and Anganwadi worker by door-to-door enumeration. A sample of 150 was studied. Non-probability convenience sampling was followed to select study participants. A structured interview method was used. Results: In the present study, most of the mothers (89.3%) were in the age group of 20–30 years with mean age of 24.3 years (± 3.4 years). The participant was considered as aware of the government scheme, if she had heard about the scheme and knows about certain key points of the scheme. Health care workers were the major source of information for mothers (62.5%) in our study area followed by friends and family for 17.5–9.2%, respectively. Majority of the mothers (65%) had utilized Anganwadi Nutrition Supplementation followed by Bhagyalakshmi Scheme and Janani Suraksha Yojana. Conclusion: Overall awareness regarding government maternity benefits scheme ranges from 6.3% (Madilu kit) to 77.6% (Integrated Child Development Services). The awareness about important Government Maternity Benefit Schemes specifically targeted to reduce maternal and neonatal mortality such as Thayi Bhagya scheme and Janani Shishu Suraksha Karyakram was low.

Unpacking the implementation blackbox using 'actor interface analysis': how did actor relations and practices of power influence delivery of a free entitlement health policy in India?

Exploring the implementation blackbox from a perspective that considers embedded practices of power is critical to understand the policy process. However, the literature is scarce on this subject. To address the paucity of explicit analyses of everyday politics and power in health policy implementation, this article presents the experience of implementing a flagship health policy in India. Janani Shishu Suraksha Karyakram (JSSK), launched in the year 2011, has not been able to fully deliver its promises of providing free maternal and child health services in public hospitals. To examine how power practices, influence implementation, we undertook a qualitative analysis of JSSK implementation in one state of India. We drew on an actor-oriented perspective of development and used ‘actor interface analysis’ to guide the study design and analysis. Data collection included in-depth interviews of implementing actors and JSSK service recipients, document review and observations of actor interactions. A framework analysis method was used for analysing data, and the framework used was founded on the constructs of actor lifeworlds, which help understand the often neglected and lived realities of policy actors. The findings illustrate that implementation was both strengthened and constrained by practices of power at various interface encounters. The implementation decisions and actions were influenced by power struggles such as domination, control, resistance, contestation, facilitation and collaboration. Such practices were rooted in: Social and organizational power relationships like organizational hierarchies and social positions; personal concerns or characteristics like interests, attitudes and previous experiences and the worldviews of actors constructed by social and ideological paradigms like their values and beliefs. Application of ‘actor interface analysis’ and further nuancing of the concept of ‘actor lifeworlds’ to understand the origin of practices of power can be useful for understanding the influence of everyday power and politics on the policy process.

Informal Payments for Maternal and Neonatal Health Services in Public Hospitals in Central India

Background: Informal payments are unauthorised ‘unregistered’ out-of-pocket payments, outside the official payment system, for purchase or service meant to be covered/provided by the healthcare system. This study attempts to measure and report the extent and magnitude of informal payments based on the entitlements in Janani-Shishu Suraksha Karyakram (JSSK) in the Indian context. Methods: A cross-sectional study using convenience sampling and a semi-structured interview schedule was conducted among 281 participants in 2016 in 26 JSSK-notifying health facilities from all five divisions of Chhattisgarh. Pregnant women and women who delivered in the previous year, and provided informed consent, were included. After reviewing various definitions, informal payment was operationally defined in the context of JSSK for India as ‘payments made in cash or kind, unregistered or non-reimbursed, made by/on behalf of the beneficiary or someone related thereof, for free and cashless entitlements in a JSSK-listed health facility, to an individual or institutional healthcare provider/staff who provides/arranges for provision of the service’. Results: Of 281 participants, 91.8 per cent reported informal payments across all JSSK entitlements categories. A relative majority of these payments was made at the district hospital (37%), ranging from ₹2 to ₹6,500 (US$0.03–101). Investigations incurred the greatest median amount of informal payments, at, ₹455 (US$7). Informal payments ranged between three and seven times higher than the JSSK price cap in Chhattisgarh. No significant association was found between participant characteristics and informal payments. Conclusion: Further research is required to understand the magnitude and motivation of informal payments made in programmes like JSSK.

Awareness and Uptake of Maternal and Child Health Benefit Schemes Among the Women Attending a District Hospital in Coastal South India

Introduction: Maternal and child health (MCH) benefit schemes were introduced to increase institutional deliveries, to reduce out of pocket expenditure, to provide quality care and nutrition to mother and baby and thereby reduce maternal mortality rate and infant mortality rate. Objective: To assess the awareness and estimate the uptake of benefits regarding various MCH benefit schemes among study participants. Methodology: A cross-sectional study was conducted at district hospital, Mangaluru, Karnataka, India, among 250 antenatal women and postnatal mothers. They were interviewed using a semi-structured–validated questionnaire. Data were analysed using Statistical Package for Social Science version 11.5. Result: Awareness for scheme varied, ranging from 94 per cent for Integrated Child Development Service and 0.8 per cent for Rashtriya Bal Swasthya Karyakram. Major source of information being accredited social health activist (40.41%), most of the study participants had a favourable opinion regarding the benefits of MCH schemes. Maximum uptake was seen for Janani Shishu Suraksha Karyakram (100%); however, none of them availed Prasoothi Araike. Conclusion: Our study showed that the awareness and uptake for different MCH-related schemes varied. Most of the study participants had a favourable opinion about the benefits of MCH schemes. Since awareness for some schemes were low, efforts should be made to increase awareness regarding all schemes by displaying the information. Uptake can be increased by proper channelising the resources.

Assessment of knowledge and awareness about utilization of Janani Shishu Suraksha Karyakram: A community-based study in a rural block of Himachal Pradesh

INTRODUCTION: In view of the difficulty being faced by the pregnant women and parents of sick newborn along with high expenditure on delivery and treatment of sick newborn, the Ministry of Health and Family Welfare has taken a major initiative to ensure better facilities for women and child health services through the Janani Shishu Suraksha Karyakram (JSSK) on June 1 2011. It is an initiative to provide completely free and cashless services to pregnant women. OBJECTIVES: The objective of this study was (1) to find out the awareness level about JSSK among pregnant women and lactating mothers and to determine the sources of awareness and knowledge about the components of JSSK and (2) to find out the association between demographic factors and benefits and satisfaction level about JSSK among the rural women of Kangra district. MATERIALS AND METHODS: A descriptive cross-sectional study was carried out among 106 pregnant women and lactating mothers selected by convenient sampling technique with the help of structured questionnaire from December 2016 to February 2017. The data were analyzed using SPSS version 22. RESULTS: It was observed that among 106 women, good awareness was found only in 84.9% of them, maximum awareness (56.6%) was created through anganwadi workers, 49.1% of the women heard about it before pregnancy, 44.3% heard about it during pregnancy, and 15.1% of the women had no knowledge about the program. The study showed that educational status (P = 0.001) was significant with receiving the benefits of JSSK. However, it revealed that both educational status (P = 0.001) and occupation (P = 0.03) of the women were significantly associated with the satisfaction with JSSK. CONCLUSION: The level of awareness regarding JSSK in pregnant women and lactating mothers was found to be good, but it was found that despite having good knowledge of the program, the women are not taking much concern about the ongoing program. The women need to be encouraged for more utilization of the services which are comprehensively built for them.

Knowledge of women about the Janani Shishu Suraksha Karyakram cash incentive and its association with institutional delivery

Maternal and infant deaths can be reduced by ensuring timely access to public health facilities. Janani Shishu Suraksha Karyakram (JSSK) scheme has made health for all a reality. This study was done to assess the knowledge about JSSK scheme, its benefits and cash incentives under it and to assess the relation of knowledge of JSSK with institutional delivery. Good knowledge about JSSK was noted among 69% of women. Out of these, almost 99% percent had institutional delivery. A higher literacy level was also associated with institutional delivery. Mouth to mouth publicity and media were the commonest source followed by information from media. To conclude, a combined effort of the government, health care providers and the public itself in raising the literacy level of the population and spreading awareness of JSSK may help in achieving the objective of programme.

Utilization of Janani Shishu Suraksha Karyakram and estimation of out of pocket expenditure: A prospective follow-up study among mothers and newborns in Chittoor.

Introduction:Janani Sishu Suraksha Karyakram (JSSK) is a flagship program of India to reduce out of pocket expenditure (OOPE) of the families during childbirth and neonatal sicknesses.Objectives:To assess the utilization of JSSK while availing services for childbirth and newborn care in a secondary care hospital in Southern India; estimate the OOPE in services covered by JSSK and identify the associated factors with OOPE.Methods:228 mothers who delivered in the previous 2 days, were recruited from a secondary-level government hospital in Chittoor. Expenditure incurred under various components of JSSK was asked during the recruitment and subsequently through telephonic interviews.Results:All components of JJSK, except transport, were fully utilized by the families. 138 mothers (60.5%, 95% CI: 54.0, 67.0), and all sick children (n = 138, 100%) who visited government hospital, incurred OOPE in the form of transport cost. The median expenditure of transport (from home to hospital and hospital to home) of the mothers was 250 INR (IQR: 100-513 INR). Transport expenditure was greater for the rural families (300 INR) than the urban families (100 INR) (p < 0.05). In multiple logistic regression, nuclear families were associated with high OOPE (AOR- 2.0, 95% CI: 1.1- 3.7). Though education of the mother showed high association (AOR- 2.7, 95% CI: 1.0- 7.8), it was not statistically significant (p = 0.05).Conclusion:The families utilize most of the components of JSSK, except transport. Family-centric counselling of the beneficiaries during antenatal check-ups and home visits by the healthcare workers can reduce transport-related OOPE.

Regular Antenatal Care Visits Predict Good Knowledge Among Post-natal Mothers Regarding Entitlements of Health Programs in Western India.

Janani-Shishu Suraksha Karyakram (JSSK) and Janani Suraksha Yojana (JSY) were launched with the objective of increasing institutional deliveries. But, its knowledge among the post-natal mothers is not known. This research evaluated the knowledge of two national health programs among post-natal mothers and found out the predictors of good knowledge about the entitlements of these programs. A cross-sectional study was conducted on a sample of consecutively recruited 339 post-natal mothers who had delivered in a tertiary care hospital of western India. Data were collected from November 2016 to February 2017 by interview method using a questionnaire with questions about knowledge regarding the entitlements of JSSK and JSY. Multivariable analysis was carried out for predictors of good knowledge. Among the 339 post-natal mothers, 30% had a good knowledge regarding JSSK. Only 24% had heard about JSSK; 54% knew regarding free transport to the place of delivery; only 22% and 13%, respectively knew about free inter-facility transport in case of complications for pregnant women and sick infants, while 96% knew regarding free drop-back facility. Only one-fourth of the mothers knew regarding monetary benefit under JSY, while 28% of them had actually received the benefit. The number of antenatal care visits, having an occupation and belonging to Hindu religion significantly predicts good knowledge among postnatal mothers regarding JSSK. Knowledge among the post-natal mothers regarding the entitlements of JSSK and JSY is less while comparing with published literature and needs improvement. Regular ante-natal care (ANC) visits might improve their knowledge of these programs. There is a need to create awareness among hospital staff for the provision of reimbursement of costs incurred by post-natal mothers. There is also a need to carry out demand generation activities among mothers regarding the entitlements of JSSK and JSY.

Implementation status of Janani Shishu Suraksha Karyakram in Ahmedabad district

Background: The government has launched various schemes for reduction in maternal mortality rate and neonatal mortality rate. The Janani Shishu Suraksha Karyakram (JSSK) was launched to increase the institutional delivery by providing the entitlements for mother and infants by government. Objectives: The objectives of the study were to assess the implementation status of JSSK and to identify the beneficiaries and provider perspective. Materials and Methods: The cross-sectional study was carried out during January 2014-December 2015. A total of 19 primary health centers (PHCs) and 10 community health centers (CHCs) were selected to study the implementation status of JSSK in Ahmedabad district. Results: All the PHCs and CHCs had basic infrastructure facilities. In 50% PHCs and the entire CHCs provider perceived that there was overload in the work after the implementation of scheme. Provider perceives that there was lack of awareness of entitlements among beneficiaries. Conclusion: All the PHCs and CHCs have the required infrastructure facilities to provide maternal and child health services. The laboratory services were available in all health centers, but it was inadequate.

The perceptions, health-seeking behaviours and access of Scheduled Caste women to maternal health services in Bihar, India

The caste system is a complex social stratification system which has been abolished, but remains deeply ingrained in India. Scheduled Caste (SC) women are one of the historically deprived groups, as reflected in poor maternal health outcomes and low utilisation of maternal healthcare services. Key government schemes introduced in 2005 mean healthcare-associated costs should now be far less of a deterrent. This paper examines the factors contributing to this low use of maternal health services by investigating the perceptions, health-seeking behaviours and access of SC women to maternal healthcare services in Bihar, India. Eighteen in-depth, semi-structured interviews were conducted with SC women in Bihar. Data were analysed using Framework Analysis and presented using the AAAQ Toolbox. Main facilitating factors included the introduction of accredited social health activists (ASHAs), free maternal health services, the Janani Shishu Suraksha Karyakram (JSSK), and changes in the cultural acceptability of institutional delivery. Main barriers included inadequate ASHA coverage, poor information access, transport costs and unauthorised charges to SC women from healthcare staff. SC women in Bihar may be inequitably served by maternal health services, and in some cases may face specific discrimination. Recommendations to improve SC service utilisation include research into the improvement of postnatal care, reducing unauthorised payments to healthcare staff and improvements to the ASHA programme.

Janani Shishu Suraksha Karyakram services utilization among rural mothers: community perspective from southern areas of West Bengal

Background: Janani Shishu Suraksha Karyakram (JSSK) was launched to increase accessibility of healthcare services for expectant mothers and children. The present study was conducted to understand the utilization pattern of JSSK services among recently-delivered women of southern West Bengal.Methods: A community based cross-sectional study was conducted in the rural areas of South 24-Parganas district of West Bengal. By multistage sampling 340 mothers were selected. Data regarding child-bearing experiences, different services related to maternal health and the utilization of JSSK services were collected through interview.Results: The mean age of the mothers was 23.58 years (±4.36 years). Majority of the respondents had education up to primary level with majority having two living children or less. During ante-natal period 74.6% of the respondents in delta regions did not undergo any diagnostic tests. In Kolkata-nearing non-delta regions, majority of the respondents (92.8%) utilized exclusively government hospital for diagnostic tests. In delta regions most of the deliveries (78.8%) happened at home. After delivery in government/accredited facility, majority of women did not get the free drop-back facility. While 18.4% of the respondents from delta region utilized free diagnostic services, 16.9% utilized the free delivery services. A marginally higher utilization of free transportation among the respondents of non-delta region was observed for transport back to home.Conclusions: Delta blocks need to be given special attention especially regarding institutional delivery. Along with promotion of the services generation of awareness, acceptance and also implementation of methods to reach out to people should be focused more.

Availing entitlements under Janani Shishu Suraksha Karyakram in Tamil Nadu: a reality

Background: Janani Shishu Suraksha Karyakram (JSSK) was launched in India to improve maternal and child healthcare, and to alleviate out of pocket expenditure on healthcare. The objective was to analyze the awareness and utilization of the JSSK entitlements among residents in Kancheepuram district of Tamil Nadu.Methods: This cross sectional study was conducted in Thriuporur block, which was selected randomly from 13 blocks of Kancheepuram district. Two primary health care centers - Ezhichur and Thiruporur of Thriuporur block, were selected based on population proportion to size. A total of 80 mothers who had recently delivered a live child were selected randomly from these two PHCS. The data was collected through house to house visits by trained interviewers using a pretested, validated, structured questionnaire.Results: Mean age of the participants was 24.58 (±3.32) years. Around fifty two participants were aware about the scheme. Better awareness was seen with higher literacy and higher socioeconomic status (p=-0.043, 0,032). Cashless deliveries (100%) and free drugs (100%) were availed by all participants and among the neonates, free diagnostics (100%) and blood transfusions (100%) were availed by all. Transportation services to and from health institutions were utilized by 1.2% of the participants. Majority of the participants (98%) spent on conveyance to and from hospital.Conclusions: Though the study revealed good awareness of the scheme among the participants, it showed insight into the existing gaps in utilization of these services. Further effort is required in providing additional information on JSSK and its services within institutions and at the community level.