Maternal mortality and infant mortality are among the key health indicators of any civilized society. They are the touchstone for a public health delivery system. Among the various tools of achieving the goal of low maternal mortality and infant mortality, the most important is ensuring an institutional i.e. a medically supervised environment at the time of childbirth. The Government has made it crucial part of its health delivery effort.
Under the overall umbrella of National Rural Health Mission (NRHM) the Reproductive and Child Health programme Phase II (RCH-II) was launched in the year 2005. RCH-II aims to improve access for rural people, especially from the under privileged section to equitable, affordable, accountable and effective primary health care. The corner stone of this ambitious programme has been the Janani Suraksha Yojana (JSY).
JSY is a cash benefit scheme under RCH-II to promote institutional delivery with the special focus on below poverty line and SC/ST pregnant women. Promoting Institutional Delivery Janani Suraksha Yojana is a safe motherhood intervention under the National Rural Health Mission was launched on 12th April 2005 to promote institutional delivery among the poor pregnant women. The Yojana is being implemented in all States and Union Territories. JSY is a 100% centrally sponsored scheme.
The scheme focuses on the poor pregnant woman with special dispensation for States having low institutional delivery rate namely, the States of Uttar Pradesh, Uttrakhand, Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Assam, Orissa, Rajasthan and Jammu & Kashmir. Besides the maternal care, the scheme provides cash assistance to all eligible mothers for delivery care.
The Yojana has identified the Accredited Social Health Activist (ASHA), as an effective link between the Government and the poor pregnant women in the ten low performing States. Her main role is to facilitate pregnant women to avail services of maternal care and arrange referral transport. Built-in Incentives Janani Suraksha Yojana has built in incentives for both ASHA and the mother. Mother’s package in the target states is Rs. 1400/- and ASHA gets Rs. 600/- for various services in promoting institutional delivery. The Yojana subsidized the cost of Caesarean Section or for the management of Obstetric complications, upto Rs. 1500/- per delivery to the Government Institutions, where Government specialists are not in position. LPS and HPS States, all such BPL pregnant women, aged 19 years and above, preferring to deliver at home are entitled to cash assistance of Rs. 500/- per delivery, upto two live births.
There are other measures for improving IMR and MMR such as 24 hour delivery services at Primary Health Centres, post natal care, skilled attendance at birth, blood storage centres, training of MBBS doctors for life saving anesthetic skills for emergency obstetric care. More than a Crore Beneficiaries Janani Suraksha Yojana has benefited more than one crore women. JSY scores with using the incentives mechanism effectively and using the community support structures effectively. The scheme has great instrumental value as by ensuring institutional delivery other health services can be provided to the mother and the newborn in a controlled and monitored environment.
Janani Suraksha Yojana has proved to be very popular and is fast emerging as a measure tools for achieving Millennium Development Goals for universal health.