The Journal of Health, Population and Nutrition
Vol. 35, No. 1, 2016, pp. 1-11
Bioline Code: hn16029
Full paper language: English
Document type: Research Article
Document available free of charge
The Journal of Health, Population and Nutrition, Vol. 35, No. 1, 2016, pp. 1-11
© Copyright 2016 - The Journal of Health, Population and Nutrition
Out-of-pocket expenditure on prenatal and natal care post Janani Suraksha Yojana: a case from Rajasthan, India|
Govil, Dipti; Purohit, Neetu; Gupta, Shiv Dutt & Mohanty, Sanjay Kumar
Background: Though Janani Suraksha Yojana (JSY) under National Rural Health Mission (NRHM) is successful in
increasing antenatal and natal care services, little is known on the cost coverage of out-of-pocket expenditure
(OOPE) on maternal care services post-NRHM period.
Methods: Using data from a community-based study of 424 recently delivered women in Rajasthan, this paper
examined the variation in OOPE in accessing maternal health services and the extent to which JSY incentives
covered the burden of cost incurred. Descriptive statistics and logistic regression analyses are used to understand
the differential and determinants of OOPE.
Results: The mean OOPE for antenatal care was US$26 at public health centres and US$64 at private health
centres. The OOPE (antenatal and natal) per delivery was US$32 if delivery was conducted at home, US$78
at public facility and US$154 at private facility. The OOPE varied by the type of delivery, delivery with complications
and place of ANC. The OOPE in public health centre was US$44 and US$145 for normal and complicated delivery,
respectively. The share of JSY was 44 % of the total cost per delivery, 77 % in case of normal delivery and 23 % for
complicated delivery. Results from the log linear model suggest that economic status, educational level and pregnancy
complications are significant predictors of OOPE.
Conclusions: Our results suggest that JSY has increased the coverage of institutional delivery and reduced financial
stress to household and families but not sufficient for complicated delivery. Provisioning of providing sonography/
other test and treating complicated cases in public health centres need to be strengthened.
OOPE; Antenatal care; Delivery care; Cash assistance scheme; India
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