Study: Ambulance not accessible to 50% of pregnant women

The Janani Suraksha Yojana (JSY), a health scheme for SC/ST and BPL families, has recorded an impressive performance by reducing maternal and neonatal mortality by promoting institutional deliveries in the State, says a study conducted by the Institute for Social and Economic Change (ISEC), Bengaluru. But it also revealed that more than 50% of pregnant women used their own means of transport to get to the health facility and return home after delivery. The free referral transport facility — the 108 ambulance service — to be used by pregnant women to reach health centres was not available 50% of the time. As a result, 50% of the women spent money from their own pockets to reach the health facility, found the study on ‘Utilisation of JSY under Maternity Benefit Scheme: An Evaluation Study in Karnataka (2017)’, conducted by C.M. Lakshmana, C. Yogananda, and Srinivasa, from the ISEC. Another positive finding was that the number of women registered under JSY rose from 5.5 lakh in 2009-10 to 8.32 lakh in 2015-16 — an increase of 33.38%. The scheme was launched in the State in 2005 under the National Rural Health Mission (NRHM) by the Ministry of Health and Family Welfare. Its objective: to reduce maternal and neonatal mortality rate and promote institutional deliveries. Overall performance The performance of JSY in terms of registration to total ante-natal care (ANC) enrolment was significant in most of the districts, and a majority of the districts showed good performance at more than 75%. The study carried out on data from the Health Management Information System portal and field visits, showed that the percentage of mothers who received incentive, paid under JSY, for delivery at a public health facility, increased from 40% in 2009-10 to 60% in 2015-16. JSY benefit received by women for home delivery to total reported home deliveries declined drastically to 6.7%. The number of mothers who got paid JSY incentive for home deliveries declined from 663 in 2010-11 to 403 for 2015-16, it said. However, none of the women received JSY incentive from the health facility at the time of discharge from the public health facility. Owing to increased awareness on JSY and Janani-Shishu Suraksha Karyakram (JSSK), a majority of women visit health facilities on their own and don’t depend on ASHA workers in rural areas. Hence, the cases where JSY incentive was paid to ASHA workers reduced from 7% in 2010-11 to 4% in 2015-16, it said. The registration for JSY benefit under NRHM was the highest in a majority of the districts in northern Karnataka, as well as in Bengaluru Urban and Dakshina Kannada. The districts of Raichur, Belagavi, Vijayapura, Dharwad, Kalaburagi, Haveri, Ballari, Gadag, Yadgir, and Koppal had shown the highest registration during the last 12 years. Kalaburagi for example recorded 100% performance to the total ANC registration. Only in two districts — Chamarajanagar and Hassan — performance was not very impressive.