How much do conditional cash transfers increase the utilization of maternal and child health care services? New evidence from Janani Suraksha Yojana in India

Janani Suraksha Yojana (safe motherhood scheme, or JSY) provides cash incentives to marginal pregnant women in India conditional on having mainly institutional delivery. Using the fourth round of district level household survey (DLHS-4), we have estimated its effects on both intended and unintended outcomes. Our estimates of average treatment effect on the treated (ATT) from propensity score matching are remarkably higher than those found in previous prominent studies using the second and third rounds of the survey (DLHS-2 and DLHS-3). When we apply fuzzy regression discontinuity design exploiting the second birth order, our estimates of local average treatment effect (LATE) are much higher than that of ATT. For example, due to JSY, institutional delivery increases by around 16 percentage points according to ATT estimate but about 23 percentage points according to LATE estimate

Do the User of Nutrition Information System (SISFORNUTRIMIL) Application Have an Impact on Maternal Eating Behaviour and Pregnancy Outcomes?

Background: In several studies have reported that complications of pregnancy could be indicated by inadequate nutrition during pregnancy. In this regard, some of the pregnant women are limited-time engagement with health professionals, lack resources and education of nutrition, and consume unhealthy food. Often found that pregnant women and family are difficult to estimate nutrient intake in line with dietary targets and guidelines and nutrient reference value.TheNutritionalInformation System (SISFORNUTRIMIL) is an application which helps the pregnant women to estimate nutrient intake and record their food intake. Objectives: The study aims to determine the maternal eating behaviour and pregnancy outcomes measurements. Methods: This study involved two phases. Phase one: Conducting a literature search required engaging in an extensive and systematic search strategy to be able to identify articles related to this study. Step two: this study will randomized control trial (RCT) and allocate participants 1:1 to the SISFORNUTRIMIL application user and non-user application. The Minimum Dietary Diversity for Women of reproductive age (MDD-W) indicators and Adult Behaviour Eating Questionnaire (ABEQ) will be used to identify maternal eating behaviour. In additional, maternal weight gain, blood sample test, and birth weight examination used to measure pregnancy experience and pregnancy outcome. Discussion: Nutrition intervention during pregnancy is an important strategy to improve health pregnancy in reduced the healthcare and health promotion issue. The SISFORNUTRIMIL application for individual preferences for nutrition intervention and optimal pregnancy outcomes, suggesting a need for food intake guidelines that facilitate pregnant women involvement in eating properly. Furthermore, this research as a proper foundation to contribute to decreasing the morbidity and mortality rate

Human resource inequalities at the base of India's public health care system

This paper examines the extent of inequalities in human resource provision at India's Heath Sub-Centres (HSC) - first level of service provision in the public health system. ‘Within state' inequality explained about 71% and ‘between state’ inequality explained the remaining 29% of the overall inter-HSC inequality. The Northern states had a lower health worker share relative to the extent of their HSC provision. Contextual factors that contributed to ‘between’ and ‘within’ district inequalities were the percentages of villages connected with all-weather roads and having primary schools. Analysis demonstrates a policy and programming need to address ‘within State’ inequalities as a priority

Maternal tetanus toxoid vaccination and neonatal mortality in rural North India

Objectives: Preventable neonatal mortality due to tetanus infection remains common. We aimed to examine antenatal vaccination impact in a context of continuing high neonatal mortality in rural northern India. Methods and Findings: Using the third round of the Indian National Family Health Survey (NFHS) 2005-06, mortality of most recent singleton births was analysed in discrete-time logistic model with maternal tetanus vaccination, together with antenatal care utilisation and supplementation with iron and folic acid. 59% of mothers reported receiving antenatal care, 48% reported receiving iron and folic acid supplementation and 68% reported receiving two or more doses of tetanus toxoid (TT) vaccination. The odds of all-cause neonatal death were reduced following one or more antenatal dose of TT with odds ratios (OR) of 0.46 (95% CI 0.26 to 0.78) after one dose and 0.45 (95% CI 0.31 to 0.66) after two or more doses. Reported utilisation of antenatal care and iron-folic acid supplementation did not influence neonatal mortality. In the statistical model, 16% (95% CI 5% to 27%) of neonatal deaths could be attributed to a lack of at least two doses of TT vaccination during pregnancy, representing an estimated 78,632 neonatal deaths in absolute terms. Conclusions: Substantial gains in newborn survival could be achieved in rural North India through increased coverage of antenatal TT vaccination. The apparent substantial protective effect of a single antenatal dose of TT requires further study. It may reflect greater population vaccination coverage and indicates that health programming should prioritise universal antenatal coverage with at least one dose

Human resource inequalities at the base of India\u27s public health care system

This paper examines the extent of inequalities in human resource provision at India\u27s Heath Sub-Centres (HSC)—first level of service provision in the public health system. ‘Within state’ inequality explained about 71% and ‘between state’ inequality explained the remaining 29% of the overall inter-HSC inequality. The Northern states had a lower health worker share relative to the extent of their HSC provision. Contextual factors that contributed to ‘between’ and ‘within’ district inequalities were the percentages of villages connected with all-weather roads and having primary schools. Analysis demonstrates a policy and programming need to address ‘within State’ inequalities as a priority

Maternal and child health care services' utilization data from the fourth round of district level household survey in India

In this article, we briefly discuss the data used in the article entitled “How Much Do Conditional Cash Transfers Increase the Utilization of Maternal and Child Health Care Services? New Evidence from Janani Suraksha Yojana in India” (Rahman and Pallikadavath, 2018), which has estimated the effects of demand-side financing program named as Janani Suraksha Yojana (JSY) on the utilization of maternal and child health care services in India, using the fourth round of District Level Household Survey (DLHS-4) surveyed on 76,847 Indian women in 2013–14. This survey contains the detailed information on the women's utilization of maternal and child care services, demographic characteristics, and socio-economic status

Direct and indirect effects of Janani Suraksha Yojana on antenatal care and institutional delivery

Janani Suraksha Yojana (JSY) provides conditional cash incentives to eligible pregnant women in India so that they can take at least three antenatal care services including tetanus injection and iron-folic acid, to deliver their babies in health institutions, and to take at least one postnatal service for them and their neonatal babies. We examine its effects on antenatal care and the institutional delivery. We also decompose effects into direct and indirect categories, deriving parameters from the theoretical model, then estimating them using several regression methods including the propensity score matching. We use the fourth round of the District Level Household Survey (DLHS), which has an advantage over the previous waves of DLHS