IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v178y2017icp55-65.html
   My bibliography  Save this article

A qualitative study of factors impacting accessing of institutional delivery care in the context of India's cash incentive program

Author

Listed:
  • Vellakkal, Sukumar
  • Reddy, Hanimi
  • Gupta, Adyya
  • Chandran, Anil
  • Fledderjohann, Jasmine
  • Stuckler, David

Abstract

Not all eligible women use the available services under India's Janani Suraksha Yojana (JSY), which provides cash incentives to encourage pregnant women to use institutional care for childbirth; limited evidence exists on demand-side factors associated with low program uptake. This study explores the views of women and ASHAs (community health workers) on the use of the JSY and institutional delivery care facilities. In-depth qualitative interviews, carried out in September-November 2013, were completed in the local language by trained interviewers with 112 participants consisting of JSY users/non-users and ASHAs in Jharkhand, Madhya Pradesh and Uttar Pradesh. The interaction of impeding and enabling factors on the use of institutional care for delivery was explored. We found that ASHAs' support services (e.g., arrangement of transport, escort to and support at healthcare facilities) and awareness generation of the benefits of institutional healthcare emerged as major enabling factors. The JSY cash incentive played a lesser role as an enabling factor because of higher opportunity costs in the use of healthcare facilities versus home for childbirth. Trust in the skills of traditional birth-attendants and the notion of childbirth as a ‘natural event’ that requires no healthcare were the most prevalent impeding factors. The belief that a healthcare facility would be needed only in cases of birth complications was also highly prevalent. This often resulted in waiting until the last moments of childbirth to seek institutional healthcare, leading to delay/non-availability of transportation services and inability to reach a delivery facility in time. ASHAs opined that interpersonal communication for awareness generation has a greater influence on use of institutional healthcare, and complementary cash incentives further encourage use. Improving health workers' support services focused on marginalized populations along with better public healthcare facilities are likely to promote the uptake of institutional delivery care in resource-poor settings.

Suggested Citation

  • Vellakkal, Sukumar & Reddy, Hanimi & Gupta, Adyya & Chandran, Anil & Fledderjohann, Jasmine & Stuckler, David, 2017. "A qualitative study of factors impacting accessing of institutional delivery care in the context of India's cash incentive program," Social Science & Medicine, Elsevier, vol. 178(C), pages 55-65.
    • Handle: RePEc:eee:socmed:v:178:y:2017:i:c:p:55-65
    DOI: 10.1016/j.socscimed.2017.01.059
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953617300734
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2017.01.059?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Randive, Bharat & San Sebastian, Miguel & De Costa, Ayesha & Lindholm, Lars, 2014. "Inequalities in institutional delivery uptake and maternal mortality reduction in the context of cash incentive program, Janani Suraksha Yojana: Results from nine states in India," Social Science & Medicine, Elsevier, vol. 123(C), pages 1-6.
    2. Tinoco-Ojanguren, Rolando & Glantz, Namino M. & Martinez-Hernandez, Imelda & Ovando-Meza, Ismael, 2008. "Risk screening, emergency care, and lay concepts of complications during pregnancy in Chiapas, Mexico," Social Science & Medicine, Elsevier, vol. 66(5), pages 1057-1069, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Rajesh Kamath & Helmut Brand & Nisha Nayak & Vani Lakshmi & Reena Verma & Prajwal Salins, 2023. "District-Level Patterns of Health Insurance Coverage and Out-of-Pocket Expenditure on Caesarean Section Deliveries in Public Health Facilities in India," Sustainability, MDPI, vol. 15(5), pages 1-17, March.
    2. Anita Makins & Jochen Ehmer & Alexandra Piprek & Francisco Mbofana & Amanda Ross & Michael André Hobbins, 2019. "Demand-side financing in the form of baby packages in Northern Mozambique: Results from an observational study," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-12, May.
    3. Prabal K. De & Laxman Timilsina, 2020. "Cash‐based maternal health interventions can improve childhood vaccination—Evidence from India," Health Economics, John Wiley & Sons, Ltd., vol. 29(10), pages 1202-1219, October.
    4. Vandita Dar & Madhvi Sethi & Saina Baby, 2023. "Direct Cash Transfers in Emerging Economies: The Case of India," Business Perspectives and Research, , vol. 11(2), pages 287-308, May.
    5. Tulasi Malini Maharatha & Sumirtha Gandhi & Umakant Dash, 2021. "Has the Demand and Supply-side Components of Janani Suraksha Yojana Augmented the Uptake of Maternal Health Care Services among Poor Women in India ? : An Application of Hybrid Matching Technique," BASE University Working Papers 08/2021, BASE University, Bengaluru, India.
    6. Jayanta Kumar Bora & Rajesh Raushan & Wolfgang Lutz, 2019. "The persistent influence of caste on under-five mortality: Factors that explain the caste-based gap in high focus Indian states," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-20, August.
    7. Ravi Durga Prasad & Somya Arora & Pradeep S. Salve & Srinivas Goli & K. S. James & Saseendran Pallikadavath & Udaya S. Mishra & Irudaya S. Rajan, 2022. "Why there is underutilization of four and more antenatal care services despite the colossal rise in institutional deliveries in Bihar, India," Journal of Social and Economic Development, Springer;Institute for Social and Economic Change, vol. 24(2), pages 355-378, December.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Itismita Mohanty & Tesfaye Alemayehu Gebremedhin, 2018. "Maternal autonomy and birth registration in India: Who gets counted?," PLOS ONE, Public Library of Science, vol. 13(3), pages 1-19, March.
    2. Verma, Asmita & Pandey, Ekta & Ramanathan, Ahalya & Saluja, Nitin, 2015. "Impact of Janani SurakshaYojana (JSY): A study across two Delhi hospitals," MPRA Paper 109995, University Library of Munich, Germany, revised 15 Oct 2017.
    3. Aizawa, T.;, 2019. "Reviewing the Existing Evidence of the Conditional Cash Transfer in India through the Partial Identification Approach," Health, Econometrics and Data Group (HEDG) Working Papers 19/24, HEDG, c/o Department of Economics, University of York.
    4. Pal, Sarmistha, 2015. "Impact of hospital delivery on child mortality: An analysis of adolescent mothers in Bangladesh," Social Science & Medicine, Elsevier, vol. 143(C), pages 194-203.
    5. Pourette, Dolorès & Pierlovisi, Carole & Randriantsara, Ranjatiana & Rakotomanana, Elliot & Mattern, Chiarella, 2018. "Avoiding a "big" baby: Local perceptions and social responses toward childbirth-related complications in Menabe, Madagascar," Social Science & Medicine, Elsevier, vol. 218(C), pages 52-61.
    6. Susmita Baulia, 2020. "Cash incentives to mothers or to community health workers - what contributes better to the health of the mother and the newborn? Evidence from India," Discussion Papers 133, Aboa Centre for Economics.
    7. Mohamad A. Khaled & Paul Makdissi & Rami V. Tabri & Myra Yazbeck, 2018. "A framework for testing the equality between the health concentration curve and the 45‐degree line," Health Economics, John Wiley & Sons, Ltd., vol. 27(5), pages 887-896, May.
    8. Izugbara, Chimaraoke O. & Egesa, Carolyne & Okelo, Rispah, 2015. "‘High profile health facilities can add to your trouble’: Women, stigma and un/safe abortion in Kenya," Social Science & Medicine, Elsevier, vol. 141(C), pages 9-18.
    9. Naresh Kumar & Ritu Rani, 2020. "Extent of Social Change in Family Quality of Life Index: Empirical Evidence from Selected States of India," South Asian Survey, , vol. 27(1), pages 62-80, March.
    10. Zafer Çalışkan & Dilek Kılıç & Selcen Öztürk & Emre Atılgan, 2015. "Equity in maternal health care service utilization: a systematic review for developing countries," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 60(7), pages 815-825, November.
    11. Barnish, Maxwell S. & Tan, Si Ying & Robinson, Sophie & Taeihagh, Araz & Melendez-Torres, G.J., 2023. "A realist synthesis to develop an explanatory model of how policy instruments impact child and maternal health outcomes," Social Science & Medicine, Elsevier, vol. 339(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:178:y:2017:i:c:p:55-65. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.