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Cash incentives for hospital births
The Janani Suraksha Yojana (JSY), a centrally funded effort to lower infant mortality rates in poorly performing states, provides pregnant women with monetary incentives to give birth in a hospital where proper care would be given.

The Indian government’s scheme of giving cash rewards to women who have their babies at health centres has lowered newborn deaths and stillbirths in the country’s 10 poorest states, says an India-US study, reported in the international journal The Lancet on June 3, 2010. 

The study evaluated the centrally-funded Janani Suraksha Yojana (JSY) and reported that the cash incentive lowered stillbirths by 4 and newborn deaths by 2 per 1,000 births. 

The country’s infant mortality rate -- newborn deaths per 1,000 live births -- was 53 in 2008, with 1 in 5 newborn deaths in the world occurring in India. 

Launched in 2005, JSY benefits 10 million women every year. It integrates cash assistance with delivery and post-delivery care for woman in 10 states with low institutional delivery rates -- Uttar Pradesh, Uttarakhand, Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Assam, Rajasthan, Orissa, and Jammu and Kashmir. 

The cash incentives given to women in these ‘low performing states’ are higher than in other states. In these states, pregnant women in rural areas get Rs 1,400 while the health workers who bring them to health centres get Rs 600. 

In urban areas, women get Rs 1,000 and health workers Rs 200. In richer states, the cash incentive for mothers is Rs 700 in rural areas and Rs 600 in urban centres. 

The study was conducted by the Public Health Foundation of India and the Seattle-based Institute for Health Metrics and Evaluation (IHME). 

“The success of JSY in this nationwide analysis, which used two rounds of district-level household surveys, is very encouraging. But more work needs to be done to reach the poorest and most disadvantaged women,” said Dr Lalit Dandona, a professor at both institutes who was part of the study. 

For instance, there were wide variations among the states both in implementation and impact. Between 2007 and 2008, some states had just 5% of all pregnant women participating while others had 44% participation. 

Dandona also suggested that instead of making all women in the 10 focus states eligible for JSY financial assistance, only those below the poverty line should be given the money. 

“JSY is the biggest programme of its kind in the world, and its success has huge implications for global health policy,” said Dr Stephen Lim, assistant professor at IHME and the study’s lead author. 

“One out of every five child deaths occurs in India. Finding ways to reduce newborn deaths in India is a critical part of achieving global goals on improving child survival.” 

 

Source: UNMC Asia Pacific