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India’s Conditional Cash Transfer Programme (the JSY) to Promote Institutional Birth: Is There an Association between Institutional Birth Proportion and Maternal Mortality?

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  • Bharat Randive
  • Vishal Diwan
  • Ayesha De Costa

Abstract

Background: India accounts for 19% of global maternal deaths, three-quarters of which come from nine states. In 2005, India launched a conditional cash transfer (CCT) programme, Janani Suraksha Yojana (JSY), to reduce maternal mortality ratio (MMR) through promotion of institutional births. JSY is the largest CCT in the world. In the nine states with relatively lower socioeconomic levels, JSY provides a cash incentive to all women on birthing in health institution. The cash incentive is intended to reduce financial barriers to accessing institutional care for delivery. Increased institutional births are expected to reduce MMR. Thus, JSY is expected to (a) increase institutional births and (b) reduce MMR in states with high proportions of institutional births. We examine the association between (a) service uptake, i.e., institutional birth proportions and (b) health outcome, i.e., MMR. Method: Data from Sample Registration Survey of India were analysed to describe trends in proportion of institutional births before (2005) and during (2006–2010) the implementation of the JSY. Data from Annual Health Survey (2010–2011) for all 284 districts in above- mentioned nine states were analysed to assess relationship between MMR and institutional births. Results: Proportion of institutional births increased from a pre-programme average of 20% to 49% in 5 years (p

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  • Bharat Randive & Vishal Diwan & Ayesha De Costa, 2013. "India’s Conditional Cash Transfer Programme (the JSY) to Promote Institutional Birth: Is There an Association between Institutional Birth Proportion and Maternal Mortality?," PLOS ONE, Public Library of Science, vol. 8(6), pages 1-8, June.
    • Handle: RePEc:plo:pone00:0067452
    DOI: 10.1371/journal.pone.0067452
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    1. Harold Alderman, 2016. "Leveraging Social Protection Programs for Improved Nutrition," World Bank Publications - Reports 24450, The World Bank Group.
    2. 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.
    3. Haftom Gebrehiwot Weldearegay & Alemayehu Bayray Kahsay & Araya Abrha Medhanyie & Hagos Godefay & Pammla Petrucka, 2020. "Quality of and barriers to routine childbirth care signal functions in primary level facilities of Tigray, Northern Ethiopia: Mixed method study," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-22, June.
    4. Reader, Mary, 2023. "The infant health effects of starting universal child benefits in pregnancy: evidence from England and Wales," LSE Research Online Documents on Economics 118458, London School of Economics and Political Science, LSE Library.
    5. Reader, Mary, 2023. "The infant health effects of starting universal child benefits in pregnancy: Evidence from England and Wales," Journal of Health Economics, Elsevier, vol. 89(C).

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