ArticleInternational journal for equity in health2016
Out-of-pocket expenditures for childbirth in the context of the Janani Suraksha Yojana (JSY) cash transfer program to promote facility births: who pays and how much? Studies from Madhya Pradesh, India.
Article in International journal for equity in health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed.
- Awareness and barriers in the utilisation of conditional cash transfer schemes for pregnant women: A cross-sectional study from South India.Journal of family medicine and primary care · 2026Article
- ARIMA based projection of infant mortality rate by the year 2030: a comparative analysis of India and Madhya Pradesh.BMC public health · 2025Article
- 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.BMC pregnancy and childbirth · 2024Article
- Towards renewed commitment to prevent maternal mortality and morbidity: learning from 30 years of maternal health priorities.Sexual and reproductive health matters · 2023Article
- Experiences of conditional and unconditional cash transfers intended for improving health outcomes and health service use: a qualitative evidence synthesis.The Cochrane database of systematic reviews · 2023Review
- Evaluating a Conditional Cash Transfer Scheme in a Maternal Health Care Utilization Program Among Rural Pregnant Women in Mysore District, India.Women's health reports (New Rochelle, N.Y.) · 2020Article
- Has the Public Health System Provided Adequate Financial Risk Protection for Child Birth Conditions - Evidences From an Eastern Indian State.International journal of health policy and management · 2019Article
- Observational
- Women's knowledge about the conditional cash incentive program and its association with institutional delivery in Nepal.PloS one · 2018Article
- The operations of the free maternal care policy and out of pocket payments during childbirth in rural Northern Ghana.Health economics review · 2017Article
- Effect of previous utilization and out-of-pocket expenditure on subsequent utilization of a state led public-private partnership scheme "Chiranjeevi Yojana" to promote facility births in Gujarat, India.BMC health services research · 2017Article
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6 authors.
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Abstract
backgroundHigh out-of-pocket expenditures (OOPE) make delivery care difficult to access for a large proportion of India's population. Given that home deliveries increase the risk of maternal mortality, in 2005 the Indian Government implemented the Janani Suraksha Yojana (JSY) program to incentivize poor women to deliver in public health facilities by providing a cash transfer upon discharge. We study the OOPE among JSY beneficiaries and women who deliver at home, and predictors of OOPE in two districts of Madhya Pradesh.
methodsSeptember 2013 to April 2015 a cross-sectional community-based survey was performed. All recently delivered women were interviewed to elicit delivery costs, socio-demographic characteristics and delivery related information.
resultsMost women (n = 1995, 84 %) delivered in JSY public health facility, the remaining 16 % (n = 386) delivered at home. Women who delivered under JSY program had a higher median, IQR OOPE ($8, 3-18) compared to home ($6, 2-13). Among JSY beneficiaries, poorest women had twice net gain ($20) versus wealthiest ($10) post cash transfer. Informal payments (64 %) and food/baby items (77 %) were the two most common sources of OOPE. OOPE made among JSY beneficiaries was pro-poor: poorer women made proportionally less expenditures compared to wealthier women. In an adjusted model, delivering in a JSY public facility increased odds of incurring expenditures (OR: 1.58, 95 % CI: 1.11-2.25) but at the same time to a 16 % (95 % CI: 0.73-0.96) decrease in the amount paid compared to home deliveries.
conclusionsOOPE is prevalent among JSY beneficiaries as well in home deliveries. In JSY, OOPE varies by income quintile: wealthier quintiles pay more OOPE. However the cash incentive is adequate enough to provide a net gain for all quintiles. OOPE was largely due to indirect costs and not direct medical payments. The program seems to be effective in providing financial protection for the most vulnerable groups.
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