Janani Suraksha Yojana Research Articles

SWOT analysis of Janani Suraksha Yojana among women of Western Uttar Pradesh, India

ABSTRACT Introduction: In April 2005, under the umbrella of National Rural Health Mission (NRM) in response to the slow and varied progress in improvement of maternal and neonatal health, the Government of India launched a scheme known as Janani Suraksha Yojana (ISY) Objectives: With the help of this study, we intend to understand the knowledge, source of information, awareness, and barriers to acceptance of JSY among women in Western Uttar Pradesh and conduct a SWOT analysis for the same. Material and Methods: The sample size was 300 and calculated using the prevalence of institutional delivery taken from National Family Health 2015-16 Survey (NFHS-4) in Uttar Pradesh, India, which was 67.8%. Data were analysed using appropriate statistical tests by Statistical Package for Social Sciences (SPSS) software and Microsoft excel. Results: Grassroot-level workers, namely, ASHA, ANM, AWW, and Dai, were an important source of information regarding JSY in the rural area with 68% beneficiaries saying that they got their information about JSY from them compared to only 22% in the urban area. Out of the 105 beneficiaries who delivered at home, the two most common reasons for noninstitutional delivery were the cost of the institutional delivery (51.4%) and home is convenient (47.696). Conclusion: Cash incentives help in the use of health services such as antenatal care, postnatal care, and counselling services. Less focus and ASHA coverage in urban areas as compared to rural areas.

National Programmes Related to Child Health

There are many national health programmes which are been designed for new borns as well as childrens also in India, namely, PROMOTION OF ZINC AND ORS NSSK- NAVAJAAT SHISHU SURAKSHA KARYAKRAMA ICDS - INTEGRATED CHILD DEVELOPMENT SERVICES UPI - UNIVERSAL IMMUNIZATION PROGAMME JANANI SHISHU SURAKSHA KARYAKRAMA RBSK – RASHTRIYA BALA SWASTHYA KARYAKRAMA RKSK - RASHTRIYA KISHOR SWASTHYA KARYAKRAMA MISSION INDRADHANUSH JANANI SURAKSHA YOJANA NATIONAL DEWORMING DAY, These schemes helps in promotion and safe guard the health of newborns, neonates, infants, toddlers, childrens and adolescents. These programmes also helps in uplifment of health of pregnant women and feeding mothers. If the nutrition level of the pregnant women is uplifted then there will be no severe acute malnutrition in the children. If there is no severe acute malnutrition in the children then the immunity of the children will be stable. If the immunity level is under stable then no diseases in children thus the nation will be healthy.

Impact of Janani Suraksha Yojana on Postpartum Contraception: Evidence from Two Selected Districts in Assam

Impact of Janani Suraksha Yojana on Postpartum Contraception: Evidence from Two Selected Districts in Assam

IJCM_404A: Newborn deaths in Maharashtra: A qualitative thematic analysis of newspaper articles

Background: As per statistics on infant mortality, the State of Maharashtra has done well in bringing down IMR from 33 to 16 per 1000 live births. However, in recent years many incidents come to light, especially in the case of institutional deliveries where newborns die either due to infrastructure failure or dysfunctional equipment. On a programmatic level, this has serious implications. Schemes such as Janani Suraksha Yojana promote institutional deliveries, but the institutes are unable to tend to the patient load efficiently. Analysing newspaper articles covering such incidents will throw light on actionable points for policy change. Experts from various fields tend to author such articles. Therefore it’s imperative to search every source available to bottleneck the areas for improvement. Objective: 1. To understand the perspectives of authors about newborn deaths in Maharashtra 2. To derive major areas of concern raised by such articles possibly causing newborn deaths in Maharashtra Methodology: All newspaper articles published in the last 2 years about newborn deaths in Maharashtra were identified. They were segregated according to the Name of the newspaper, author, incident, period etc. A thematic analysis was performed on 12 such articles to uncover different themes and sub themes. Results: Major themes that emerged were related to infrastructure issues and equipment failure. Another important theme was the higher patient load on secondary care due to excessive referrals from primary health facilities. The schemes promoting institutional deliveries did not anticipate the additional workload on district and subdistrict hospitals. Strengthening primary care remains the major area of concern. Conclusion: Lack of quality assurance is the major bottleneck at the infrastructure level. Strengthening primary care will reduce the excessive workload on district and subdistrict hospitals. All these are part of the same chain of events.

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.

Comparison of Janani Suraksha Yojana (JSY) and augmented Arogya Laxmi scheme (ALS) in improving maternal and child health outcomes in urban settlements of Hyderabad, South India

BackgroundIndia accounts for the largest number of global neonatal deaths with around 20 per 1000 live births. To improve the utilization of government services for institutional deliveries, Augmented Arogya Laxmi Scheme (ALS) was launched in Telangana state of southern India. This study assessed the effectiveness of the Janani Suraksha Yojana (JSY), which combines cash assistance with delivery and post-delivery care, in comparison to ALS in improving the outcomes related to antenatal, natal, and postnatal care in urban settlements of Hyderabad, Telangana, southern India.MethodsThis was a two-year cross-sectional study conducted in 14 urban settlements of Hyderabad city from September 2017- August 2019. All mothers delivered during the 18 months preceding the survey were enrolled after a written informed consent. Field investigators collected data on variables related to socio-demographic characteristics, awareness, and utilization of JSY and ALS programs. Variables related to antenatal history, antenatal care, complications during birth, delivery outcomes, newborn care, and postnatal care till 28 days were assessed. We used multivariable logistic regression model to examine the association between the different maternal, child, and socio-demographic characteristics of the two study groups.ResultsA total of 926 mothers were beneficiaries of Janani Suraksha Yojana (JSY) program while 933 mothers were beneficiaries of augmented Arogya Laxmi Scheme (ALS). Mothers in ALS group (AOR 1.71; 95% CI 1.21–2.43) were at increased odds of having more than eight antenatal care (ANC) visits compared to the mothers availing JSY. Mothers in ALS group were at decreased odds of having complications like severe pain in the abdomen (AOR 0.43; 95% CI 0.22–0.86), swelling of legs or feet (AOR 0.59; 95% CI 0.44–0.80) compared to mothers in JSY group. Children of mothers in the ALS group had increased odds of receiving breastfeeding within 30 minutes of birth (AOR 1.46; 95% CI 1.13–1.88) compared to children of mothers in JSY group.ConclusionsThe newly launched augmented ALS led to the increased utilization of the government health facilities and improved the maternal and child health outcomes.

Family and facility care variables attributing to postnatal depression among women in two tribal-dominated districts of Odisha: Log model analysis to suggest intervention.

It is a proven fact that women are affected by poor mental health predominantly in the postnatal period. This is authenticated by the use of a validated and tested Edinburg Postnatal Depression scale (EPNS), which is a simple tool to measure depression among women after delivery by posing 10 questions and this is also validated in Odia language. Odisha has made laudable progress in delivering Maternal and Child Health care to women even in tribal-dominated districts through its robust Comprehensive Obstetrics care network restricting home delivery almost to a mere 4%-5% and reducing maternal deaths by 60%-70% as per the National Family Health Survey (NFHS-5). As a part of an Indian Council of Medical Research (ICMR) extramural project to enhance contraceptive acceptance among males in districts that had a total fertility rate (TFR) higher than 3, a qualitative objective to measure mean postnatal depression in the early postpartum period (who are also the target to advocate contraceptive acceptance) was undertaken. A secondary objective was to compare family care vs. facility care as greater attributing factors for higher EPNS scores. Due to time constraints, the study was done on a fast-track mode wherein two villages each from the sampled blocks of Koraput and Boudh (with one of the highest birth rates) were selected. All women in villages who had a baby aged between 1 and 6 months, were the sampling frame and only those were selected who consented. A questionnaire was used that elicited information on familial sociodemographic details and also facility-based antenatal care (ANC) and postdelivery services that were availed for the last-born child. General Health Questionnaire-12 (GHQ-12) scores were used as an independent variable and a proxy measure of cumulative familial stress. Descriptives and log regression were used to measure the odds of family vs. facility-based services. A total of 98 women, 50 from Boudh and 48 from Koraput, participated in the study. Koraput's mean EPNS scores were 6 points higher than Boudh indicating much higher postnatal poor mental health. Log models showed that there was no difference between facility-based care in both districts as both reported 96%-97.3% institutional delivery, with out-of-pocket expenditure (OOP) being less than 520 Indian rupees on average and nearly 100% reported receipt of iron folic acid and calcium as well as streamlined Janani Suraksha Yojana (JSY) services. However, the odds of men's participation in Family planning was 2.77 times less in Koraput (SD = 2.582), fourth birth order 1.33 odds, and female gender 5.66 odds higher for the district as a result of which GHQ 12 score mean was 21.00 (CI: 19.18-22.82) hinting very high psychological stress as compared with Boudh where the mean was 17 (CI: 14.59-19.41). This clearly indicates that a robust healthcare delivery alone will not be able to address the holistic health of women in the childbearing age group. Familial stressors compound poor mental health and hence counseling of the family as a whole is necessary to achieve sound mental health in women in the postnatal period. The spousal role is emerging as a strong determinant, especially in terms of nonacceptance or casual approach to contraceptive use. Interestingly, a skewed gender bias is noted for the female child, which is also a contributor to postnatal depression (PND) in both districts, though a bigger sample would be needed to statistically prove it.

Confluence of Health and Financial Policies for Development: A Study of Collaborative Governance in Maternal Health Delivery

ABSTRACT Janani Suraksha Yojana (JSY) is a public health programme in India involving multiple stakeholders across sectors with the common goal of reducing mother and infant mortality by boosting institutional deliveries. Under JSY, pregnant women receive financial assistance in the form of cash transfers into their bank accounts. Using data from the latest National Family Health Survey providing a sample of 15,968 poor women, we show that Financial inclusivity is associated with greater uptake of JSY. Our research highlights the inter-relatedness of health and financial sector policies, signifying the need to address citizen-centric development beyond the silos of schemes.

Impact of Institutionalisation of Births on Health Policies and Birth Registration in India.

Background: The Registration of Births and Deaths Act (RBD) of 1969 in India mandates continuous recording of vital events; however, after more than 50 years of its enactment, universality remains elusive. Birth registration, a fundamental right, is essential for demographic analysis and effective policy planning. Birth registration is closely linked to child development, access to healthcare, and other societal factors. Analysing its trends helps in designing targeted interventions and monitoring progress toward the Sustainable Development Goals (SDGs). Objectives: This paper aims to analyse the changes in birth registration across Indian states. This paper also examines the impact of institutionalization of births on registration and underscores its significance in policymaking. Methods: The study utilises data from the latest two rounds of National Family Health Survey (NFHS-4 & NFHS-5) to analyse birth registration trends in India. Multivariable logistic regression analysis was employed to examine the impact of place of delivery on birth registration. Findings: The comparison of NFHS-4 and NFHS-5 data demonstrates varying birth registration rates across Indian states, with notable progress in some regions and persistent challenges in others. Multivariable logistic regression analysis highlights the significant influence of place of delivery on registration likelihood. The interaction between wealth and place of delivery suggests a mitigating effect, indicating that increasing institutional births has a positive impact on birth registration, with this effect being more pronounced at different levels of household wealth. It highlights that wealthier households were more likely to register births due to the higher rate of institutional deliveries. Conclusion: India's journey towards universal birth registration under the SDGs presents progress and challenges. NFHS data shows improvements in birth registration, but disparities still persist. Socio-economic status, place of delivery, and maternal education have strong influences on birth registration. Institutional deliveries significantly increase registration likelihood, facilitated by programs like Janani Suraksha Yojana. Integrating birth registration with health services enhances health data accuracy and service delivery. By prioritising targeted interventions, addressing social barriers, and leveraging existing programs, India can ensure that every child's birth is registered, advancing towards a healthier, more equitable future.

Usage of Maternal Health Services for Fertility Regulation in India: A Retrospective Study

The use of maternal health services in India is influenced by various socioeconomic factors, with higher maternal morbidity during reproductive ages 15 to 49. The Indian government has launched programs like Maternity Safety Scheme (Janani Suraksha Yojana) and Maternity and Child Protection Programme (Janani Shishu Suraksha Karyakaram) to provide free health services to women. However, the burden of these services is disproportionately high among the poorest women, leading to high mother and newborn death rates. In the study, secondary data from the National Family Health Survey (NFHS-3) found that place of residence, exposure to mass media, education, caste, religion, and wealth were all significant predictors of maternal health care utilization. The study also found that location of residence; age, birth order, education, caste, religion, and wealth were substantially and significantly associated with the use of antenatal care, skilled attendants at birth, and postnatal care in India. Women aged 25-34 were 54.8% more likely to receive antenatal care (ANC) services than those aged 15-24. Women aged 35-49 experienced a 52.7% increase in ANC services. Rural women were 23.8% less likely to use ANC than urban women. Muslims were 43.8% less likely to seek ANC assistance compared to Hindus. Women with the highest education levels were 5 times more likely to seek ANC than those who were not educated. Schedule Tribes were 1.5 times more likely to participate in ANC than Schedule Castes. Women aged 35-49 had an 86.8% higher likelihood of seeking postnatal care than those aged 15-24 years. Media exposure had a 1.3 times higher chance of receiving this care than those who had none. Muslim women were 17.8% less likely to choose PNC services than Hindu women.

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 knowledge regarding Janani Suraksha Yojana among Antenatal mothers in selected rural area

Janani Suraksha Yojana, under the overall umbrella of National Rural Health Mission (NRHM), has been proposed by a way of modifying the National Maternity Benefit Scheme (NMBS). To assess knowledge regarding JSY among antenatal mothers in selected area. To find out an association between knowledge regarding JSY among antenatal mothers with selected demographic variables. Method: Descriptive design was used for the study. 100 antenatal mothers were selected as sample for study by using simple random sampling technique. The data was collected by using structured knowledge questionnaires to assess the knowledge. For the assessment of the level of knowledge regarding basic concepts of JSY among antenatal mothers who attend antenatal visit at selected PHC score was divided in to three groups poor (0-2 score), average (3-4 score) and good (5-6 score). The assessment of level of level of knowledge regarding basic concepts of JSY among antenatal mothers showed that, 5% of mothers had poor knowledge, 64% had average knowledge and 31% had good knowledge level. The average knowledge score was 4.04 with standard deviation of 1.00. The minimum score was 0 with the maximum score 6. The assessment of level of knowledge regarding of Janani Suraksha Yojana among antenatal mothers showed that, 1% of mothers had poor knowledge, 85% had average knowledge and 14% had good knowledge level. The average knowledge mean score was 14-98 with standard deviation of 1.87. The minimum score was 8 with the maximum score 20. Conclusion There was significant association of these demographic variables with the level of knowledge.

Performance of ‘Janani Suraksha Yojana (JSY)’ in Udaipur District of Rajasthan

Maternal health is crucial for a healthy family, a healthy society and a healthy nation. Poor maternal health has been a major issue of concern both at the global and national levels and many initiatives have been taken to improve it. It was one of the targets of the Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs). ‘Janani Suraksha Yojana (JSY) was launched in India in 2005 to reduce the maternal mortality ratio (MMR) by increasing institutional deliveries so that women can have better ante-natal and post-natal care with cash incentives. It is necessary to assess how this scheme has contributed to improvising maternal health parameters, especially in the low-performing areas at the time of its implementation. Thus, this paper tries to analyse the performance of JSY in the Udaipur district of Rajasthan which is majorly a tribal area and poor performing district of the poorly performing state in this regard and compare it with the state performance. For this purpose, the achievements of the five parameters related to maternal health and JSY, i.e., antenatal registration within 12 weeks, at least three antenatal check-ups, institutional deliveries, JSY beneficiaries and immunization were analysed for Udaipur and Rajasthan with the help of secondary data collected from Directorate of Medical, Health & Family Welfare Services, Jaipur from the year 2008-09 to 2018-19. The composite performance index of JSY was also computed and compared to summarise its performance at both levels. It is concluded that the performance of JSY has improved in Udaipur and Rajasthan during the study period. Still, both are far from achieving the targets of JSY, especially of 100 per cent institutional delivery, and have to put in extra efforts to achieve them.

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

A Study on Birth Preparedness and Complication Readiness among Women Attending Antenatal Clinics in a Rural Area of Hooghly District, West Bengal

ABSTRACT Background: Globally, more than 40% of pregnant women experience acute obstetric problems and a large burden of it is shared by India. Birth Preparedness and Complication Readiness (BPCR) strategy is used to addresses these problems by encouraging women and communities to effectively plan for births, deal with birth emergencies. Objective: This study was conducted to assess the status of birth preparedness and complication readiness and to find out the factors associated with inadequate BPCR among pregnant woman in a rural area of West Bengal. Methodology: Institution based, observational study with cross-sectional design was conducted from January 2019 to September 2020 among pregnant women, attending antenatal care clinics in Singur block, Hooghly district West Bengal. Sample size was 272. Participants were chosen by systematic random sampling. Response rate was 94.5% (257). Data were collected using a predesigned pretested schedule and analyzed using Microsoft Excel version 2016 and SPSS version 16.0. Results: Overall, 60.3% mothers had inadequate BPCR. 66.1% mothers had poor BPCR knowledge and 72.8% mothers had poor BPCR practice. In multivariable logistic regression model, the odds of maternal morbidity [AOR = 2.03 (1.14 –3.62), P value = 0.16], ≤4 No. of ANC visits [AOR = 10.96 (4.82–22.9), P value = 0.001], first trimester USG [OR = 12.53 (5.8–24.5), P value = 0.001] showed significance with inadequate BPCR. Conclusion: Glimpse of BPCR is seen in government programmes like Janani Suraksha Yojana (JSY) and Janani Shishu Suraksha Karyakaram (JSSK). Yet a big void exists among Indian pregnant women’s knowledge and practice of BPCR. Thus, there is a need to include BPCR in health care system to improve outcomes for pregnant women.

Study on utilization of healthcare and social security schemes among street vendors in an urban area of Bengaluru

Background: Access to healthcare may vary across countries, groups, and individuals, largely influenced by social and economic conditions as well as the health policies in place. In the Indian scenario, most health-care expenses are paid out-of-pocket by patients and their families, rather than through insurance or social security schemes. Health-seeking behavior denotes visiting the health-care facility for need of care during diseases, injury and health related events which includes public hospitals, clinics or privately owned hospitals. There is a lack of inadequate information on health-care utilization and social security benefits availed by street vendors in India. Hence, the study was planned to look into issues of health-care utilization and related issues. Aims and Objectives: To assess the utilization of health care and social security schemes among the street vendors of urban area of Bengaluru and to find the determinants of health-care utilization among them. Materials and Methods: A community-based, cross-sectional, descriptive, and explorative study was undertaken for 2 months from May to June 2021 among 160 street vendors in urban area of Bengaluru. Data on socio-demographic factors, vending type and nature, social security benefits, health insurance, and health-care utilization were collected from each vendor. The prevalence of utilization of healthcare and social security schemes among street vendors were estimated. Results: Majority of the vendors (77% males and 82.4% females) visit health-care center only when the illness was severe and only 18.8% of the vendors seek healthcare for all types of illnesses. Over-the-counter medicines were preferred than visiting a health-care facilities by 71.3% of the street vendors and majority of them were males (76.3%). The part time vendors (38.5%) used more than one health facility, i.e., government, polyclinic, and medical college facilities, whereas (27.2%) of full time vendors were dependent on government health-care facilities. The fixed place vendors (23.8%) and mobile cart vendors (32.7%) used government health-care facilities. Majority of the fruit vendors used government facilities. There were 20% of the street vendors who were aware of only Indira Gandhi National Old Age Pension Scheme (IGNOAPS), 18.8% aware of only Janani Suraksha Yojana (JSY) Scheme, 28% aware of Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), 8% were aware of Pradhan Mantra Shram Yogi Maandhan Yojana (PM-SYM), and 9.4% aware of all the above schemes as applicable. Almost two third of the study population (69% of males and 61.8% of females) were not availing any of the social security schemes. 71.4% of males above 60 years of age were availing IGNOAPS, 31% of females in the reproductive age group availed JSY as applicable, 12% availed AB-PMJAY, 67.6% of the fixed place vendors, and 67.3% of the mobile cart vendors did not avail any social security scheme. None of the vendors had any type of medical health insurance and only 59.4% of the vendors were below poverty line card holders. Conclusion: Most of the vendors and their family members used government facilities (26.9%) and only 44.4% were availing the social security schemes. Timing of vending (part/full time), time of visit of different health-care facilities, and financial status were the important determinants of utilizing healthcare. Therefore, government run health-care centers should be made more accessible and available to the unorganized working class.

Factors Influencing Institutional Delivery and Its Associates among Antenatal Women in Surat city: A Cross Sectional Study

Background: India has focused to incentivize institutional delivery. Skilled care is key for reducing maternaland neonatal mortality. We examined the determinants influencing institutional delivery, its associates amongantenatal women and birth preparedness among 310 pregnant women attending an urban health centre.Methods: A facility based cross-sectional study conducted among 310 antenatal women at Urban Health TrainingCentre attached to Government Medical College, Surat, Gujarat. Predesigned, semi- structured, pretestedquestionnaire was used for data collection after informed written consent.Results: This study was conducted among 310 pregnant women attending an urban health centre. Mean age ofparticipants was 22.9+3.6 years. Highest educational level for most of participants (38.4%) was higher secondary.Around three-fourth 238 (76.7%) of participants were satisfied with institutional delivery whereas one-tenth(9.7%) participants were not ready for institutional delivery out of 72 (23.2%) unsatisfied participants. Majority196 (63.2%) participants were aware about Janani Suraksha Yojana. Time required to reach health facility wassignificantly associated with birth preparedness.Conclusion: Study results shows that 23.2% participants were unsatisfied with institutional delivery and some9.7% were opting for home delivery. Institutional delivery can be increased by promoting awareness aboutgovernment schemes and fulfilling the need of participants.

Utilisation of Janani Shishu Suraksha Karyakaram Services in the State of Telangana: A Rural–Urban Comparison

Background: Maternal and infant mortality remains one of the concerns in India, even in high-performing states like Telangana. However, the urban–rural divide in the maternal and child health service provided and utilisation by the population is more concerning. The Government of India launched schemes like Janani Suraksha Yojana (JSY) and Janani Shishu Suraksha Karyakaram (JSSK) to improve institutional delivery and reduce the out-of-pocket expenditure of users seeking service at public institutions and private institutions facilities. This study aims to study the utilisation of one such service, that is, JSSK, and compare it in urban and rural areas of Telangana state. Methodology: A cross-sectional study was conducted in Warangal and Ranga Reddy districts in the state of Telangana with an interview schedule administered to mothers who had at least one child at the time of the interview and were beneficiaries of JSY and JSSK from the previous delivery. A multistage cluster random sampling was used to select the study area, and a total of 408 respondents were chosen to participate in the study. Results: The study found that most facility characteristics related to maternal and child health, JSSK service availability and JSSK service satisfaction and awareness were significantly different across the urban and rural areas. Conclusion: The study found that crucial factors affecting respondents’ services utilisation differed across urban and rural areas. This study shows there is still a margin of improvement in services provided under the JSY and JSSK, especially in service availability and awareness of the population on their entitlements under these schemes.

An Analysis of Utilization of Maternal Health Services with Respect to Information Received and Impact of Demographics in Punjab, India

The value information leads to effective utilisation of services. The study identifies the gap in information about maternal health services and their utilisation. The information which has led to utilisation of services can be assiduously labelled as value information or value awareness. The relationship has been explored between awareness about maternal health services and service utilisation among Janani Suraksha Yojana (JSY) beneficiaries in Punjab, a high-performing state in India as per NRHM. Further, an assessment of impact of demographics on beneficiaries with information and those who utilised the services has been explored. Information received and utilisation of ante-natal checkups (ANC), delivery care and post-natal checkups (PNC) services have been studied for two districts in the state of Punjab, India. Chi-square test has been applied to know the association between the maternal health services and the select districts with respect to information and services utilised. Impact of demographic variables such as age, education, income and caste have been evaluated for information and utilisation of maternal health services. The dispersed information that has not triggered in utilisation of services by JSY beneficiaries have been used as an ingredient to explore and understand the deterring factors in non-utilisation of maternal care services in the rural areas of developing country like India. Results highlight that a significant association exists between the utilisation of maternal health services among the select districts in the state of Punjab ( χ2 = 8.73, p-value = 0.0127); however, there is no association between the informed beneficiaries and the districts for the maternal health services. No impact of demographic variables has been found on the beneficiaries with information about maternal health services and those who utilised the services. The gap in awareness and utilisation of services throws light on the lurking concerns of unrecognised benefits, uncaring attitude towards health, prejudices about institutional delivery and PNC being considered an unimportant service among the beneficiaries.

Adoption of safe motherhood practices and the moderating role of facilitating conditions

PurposeThe purpose of the study is to investigate the factors responsible for the utilisation of safe motherhood practices under the Government of India (GOI)-run maternal health programme Janani Suraksha Yojana (JSY).Design/methodology/approachData for the survey were collected from 435 expectant mothers registered under JSY from seven districts of western Uttar Pradesh, India. Based on the existing theories of behaviour change and the social marketing framework, a model of antecedents of adoption of safe motherhood practices was tested out empirically.FindingsThe results suggested that controlling for demographic variables such as age, education, number of children, intention to follow safe motherhood practices, maternal health self-efficacy, attitude towards safe motherhood, life satisfaction and facilitating conditions all contributed towards the adoption of safe motherhood practices. However, facilitating conditions moderated the relationship between intention to follow safe motherhood practices and adoption of safe motherhood practices.Research limitations/implicationsThe study focused only on maternal health, excluding child health under JSY.Practical implicationsThe study findings suggest that social marketers should focus on the individual (micro)- as well as programme (macro)-level factors to bring about systemic behaviour change.Social implicationsThe adoption of safe motherhood practices will result in a reduction of the maternal mortality rate. This will improve the overall health of mother and child.Originality/valueThe JSY programme is targeted at promoting safe motherhood practices among poor women in the reproductive age group from India. The adoption of safe motherhood practices will result in less maternal mortality and contribute to the well-being of the family.