Awareness and barriers in the utilisation of conditional cash transfer schemes for pregnant women: A cross-sectional study from South India.

Background: Conditional cash transfer (CCT) schemes are widely used in India to encourage the use of maternal health services and reduce out-of-pocket expenditure during pregnancy and childbirth. Although several maternity benefit schemes are available, their utilisation remains inconsistent. Objectives: To assess awareness, utilisation, barriers, and out-of-pocket expenditure related to conditional cash transfer schemes among postnatal women. Methods: A mixed-methods study was conducted from May to July 2022 at a tertiary care teaching hospital in Chengalpattu district, Tamil Nadu. A focus group discussion with six postnatal women explored barriers to using CCT schemes. Quantitative data were collected from 120 postnatal women using a pre-tested semi-structured questionnaire on socio-demographic details, awareness, utilisation of maternity benefit schemes, and out-of-pocket expenditure. Data were analyzed using descriptive statistics. Results: Most participants (91.7%) were aware of at least one maternity benefit scheme, mainly through healthcare providers. Among the participants, 73.3% were eligible for CCT schemes, and 62.5% of them had received benefits. The institutional Thirumathi Valliammai Women and Child Welfare Scheme was the most utilised. The most frequently received benefit amount ranged between Rs 6,000 and Rs 8,000. Qualitative findings showed general satisfaction with existing schemes but identified poor communication, lack of timely information, and strict eligibility criteria as key barriers. Conclusion: Despite high awareness, utilisation of maternity benefit schemes remains suboptimal. Improving counselling during antenatal care, ensuring timely information, and simplifying eligibility criteria may improve uptake and reduce financial burden among postnatal women.