Evaluation of Janani Shishu Suraksha Karyakram scheme and out of pocket expenditure in a rural area of Northern India.

Abstract

The stagnant performance of countries with regard to maternal and child health is linked to low investment in health and out of pocket expenditure (OOP). To address issue of OOP expenses related to maternal and newborn care, Janani Shishu SUraksha Karyakram (JSSK) was launched in the year 2011 in Mewat district of Haryana with the objective to eliminate OOP expenses of obstetric women and sick infants. A community based cross-sectional study was undertaken in rural area of Haryana to know the utilization of JSSK scheme and OOP expenditure. A total of 200 delivered mothers were included as study subjects. The study was conducted from July 20113 to September 2014. Out of 200, 134 subjects delivered in government institutions and hence were eligible for benefits of JSSK scheme. Twenty nine percent of deliveries occurred in private facilities and 17% newborns were sick within 30 days of birth. OOP expenditure was done by 83.5% subjects with median amount Rs. 1100. Most common suggestions given by subjects were the availability of ultrasound facility, cooperative staff and crowd management in hospitals. For reducing OOP expenses, up-gradation and constant supervision is required to maintain the adequacy of services. More evaluation studies need to be conducted to know the utilization pattern of JSSK so as to improve the coverage and removing the bottlenecks to further increase the utilization of JSSK scheme.