Maternal and Child Healthcare: An Analysis of Out-of-pocket Expenditure under the Janani Shishu Suraksha Karyakaram

This paper primarily focuses on the repercussions of the Janani Shishu Suraksha Karyakaram (JSSK) on the out-of-pocket expenditure incurred by beneficiaries. The paper examines the pattern of spending by beneficiaries on the various components of the JSSK at an aggregated and disaggregated level. This has been done by analysing the expenditures incurred on diet, diagnosis, transportation, and medicines separately and collectively on maternal and child health. According to the primary survey conducted across various districts of Delhi, beneficiaries are still incurring huge costs on health.The larger share of the expenditure is on diagnosis, which is mainly due to infrastructure bottlenecks followed by expenditure on medicines, which is due to lack of timely availability of drugs. While the scheme guarantees free transportation services to the beneficiaries, due to lack of ambulances and narrow inaccessible lands, beneficiaries are incurring costs on transportation, too. Diet constitutes an important part of the healthcare scheme; however, provision of raw food items like eggs, breads, etc. defeats this component of the scheme, i.e. to provide adequate nutrients to the beneficiary. This paper examines the various infrastructure and other bottlenecks that are defeating the ultimate aim of the JSSK, thereby also finding ways to reduce the out-of-pocket expenditure of beneficiaries.