Context: Little is known about the impact of Janani Suraksha Yojana (JSY) in reducing
socioeconomic inequalities in the utilization of maternal health care services. The JSY
program, initiated in 2006, is intended as a safe motherhood intervention in rural India, to
reduce maternal and neo-natal mortality among pregnant women by increasing the
incidence of institutional deliveries. A conditional cash transfer program provides
incentives for hospital delivery while defraying some of the costs for prospective mothers
and is thus expected to have a greater impact on poor households.
Methods: Using data from the India Human Development Survey Wave 1 (2004-05) and
Wave 2 (2011-12), this paper examines the patterns of maternal care usage and
socioeconomic disparities in care before and after the initiation of the program among
women in rural India.
Results: The proportion of women availing full antenatal care increased by six percentage
points from 19 percent during the pre-JSY period (IHDS-I) to 25 percent during the JSY
period (IHDS-II). The number of institutional deliveries almost doubled over the period
between the two rounds, going up from 32 percent in IHDS-I to more than 60 percent in
IHDS-II. The proportion of deliveries being assisted by trained health personnel showed a
significant increase from 43 percent in IHDS-I to 65 percent in IHDS-II. The results also
indicate almost a twofold increase in the number of postnatal care check-ups over the two
periods. For each of these outcomes, the associations with household wealth and mother’s
education are weaker in IHDS-II, after JSY, than in IHDS-I, before JSY.
Conclusions: The findings indicate that the program has led to an enhancement in the
utilization of health services among all groups but especially among the poorer and
underserved sections in the rural areas, thereby reducing the prevalent disparities in
maternal care.