Janani Suraksha Yojana

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Janani Suraksha Yojana (JSY): 

Janani Suraksha Yojana (JSY) State Institute of Health & Family Welfare, Jaipur SIHFW: an ISO9001: 2008 certified institution 1

Janani Suraksha Yojana: 

Janani Suraksha Yojana JSY scheme-2005. A safe motherhood intervention Replaces "National Maternity Benefit Scheme”. 100 % centrally sponsored, largest cash- subsidy scheme Integrates cash assistance with delivery & post-delivery care. Pay- for performance Source:- Paying for Performance: The Janani Suraksha Program in India SIHFW: an ISO9001: 2008 certified institution 2

Pay - for- Performance: 

Pay - for- Performance Pay – for –performance (P4P) is a strategy that links payment to results. It is an important complement to strengthen health systems and achieve Millennium Development Goals(MDG) and other targets that represent better health status for people . Source:- Paying for Performance:The Janani Suraksha Progran in India SIHFW: an ISO9001: 2008 certified institution 3

Goals: 

Goals To reduce maternal and infant mortality through increasing institutional delivery, Access to quality antenatal and postpartum health care The program provides a continuum of care package that includes ANC, institutional delivery, postpartum care, and family planning coordinated by the ASHA SIHFW: an ISO9001: 2008 certified institution 4

Janani Suraksha Yojna: 

Janani Suraksha Yojna Vision To promote Institutional Deliveries To reduce overall Maternal Mortality Ratio and Infant Mortality Rate. SIHFW: an ISO9001: 2008 certified institution 5

Beneficiaries: 

Beneficiaries Pregnant women of all section of the society. No age bar. Irrespective of birth order. In rural & urban areas. SIHFW: an ISO9001: 2008 certified institution 6

JSY: Strategy: 

JSY: Strategy Early registration Identification of complicated cases 3 ANC & PNC visits Organizing referral services and transport Convergence with ICDS - involving AWW Transparent & timely disbursement of cash 24 X 7 delivery services at PHC Making FRUs functional Building partnership SIHFW: an ISO9001: 2008 certified institution 7

JSY: Implementation: 

JSY: Implementation States/UTs classified as: Low performance States (LPS) States covered- 10 8 EAG states Assam J& K High Performance States (HPS)-18 Cash assistance linked to ID Incentive to ASHA Source:- Paying for Performance: The Janani Suraksha Program in India SIHFW: an ISO9001: 2008 certified institution 8

JSY: Key features: 

JSY: Key features Early registration and identification of complicated cases; Referral and referral transport when necessary Micro-birth plans Institutional birth ANC visits and postpartum visits SIHFW: an ISO9001: 2008 certified institution 9

JSY: Key features: 

JSY: Key features Assistance for Caesarean Section – Rs.1500/- Compensation payment for Tubectomy /Laparoscopy Disbursement of cash assistance Partnership with private sector Provision to meet administrative expenses SIHFW: an ISO9001: 2008 certified institution 10

Cash Assistance : 

Cash Assistance JSY program go to two types of recipient: Women receive demand-side payment for accessing a continuum of maternal and newborn health services at Gov.& accredited private institutions Individual community health workers receive supply side payment Source:- Paying for Performance: The Janani Suraksha Program in India SIHFW: an ISO9001: 2008 certified institution 11

PowerPoint Presentation: 

Cash assistance also given for deliveries at accredited pvt . Institutions, but the beneficiary has to pay the total cost No incentive for ASHA for accompanying to pvt . Institution Cash Assistance SIHFW: an ISO9001: 2008 certified institution 12

JSY: Eligibility for cash assistance for Demand Side: 

JSY: Eligibility for cash assistance for Demand Side L ow Performance States All pregnant women delivering in Government health centers like Sub-centre, PHC/CHC/ FRU / general wards of District and state Hospitals or accredited private institutions High Performance States Schedule caste, schedule tribe and BPL pregnant women , aged 19 years and above LPS & HPS All SC and ST women delivering in a government health centre like Sub-centre, PHC/CHC/ FRU / general ward of District and state Hospitals or accredited private institutions SIHFW: an ISO9001: 2008 certified institution 13

Role of ASHA: 

Role of ASHA Duties of ASHA - Sahyogini : Registration of eligible beneficiary. Antenatal checkup (3 times) Arrange referral transport, Escort her to health facility & facilitate cash assistance from PHC/CHC/DH. Post natal checkup (2 times). Source: DM&HS SIHFW: an ISO9001: 2008 certified institution 14

JSY: Eligibility for Cash Assistance for Supply Side: 

JSY: Eligibility for Cash Assistance for Supply Side Payment is made only if the ASHA escorts the pregnant woman to the delivery facility and stay with her until the delivery is completed To receive the JSY payment the women must present documents-JSY card, BPL certificates SIHFW: an ISO9001: 2008 certified institution 15

Scale of assistance for ID: 

Scale of assistance for ID Category Rural Area Total Urban Area Total Mother’s Package ASHA’s Package Rs. Mother’s Package ASHA’s Package Rs. LPS 1400 600 2000 1000 200 1200 HPS 700 700 600 600 Rs. 300 is paid to beneficiaries for transportation who has come directly to institution for delivery without ASHA in Rural area. Beneficiary brought by 108 Ambulance the beneficiary & RMRS are paid 150/- each (Transportation) SIHFW: an ISO9001: 2008 certified institution 16

PowerPoint Presentation: 

ASHA- Sahayogini is paid the first installment of Rs 100/- (for ANC reg , TT injection, 3 ANCs, IFA tab and motivation) at the institution at the time of discharge of the beneficiary. ASHA- Sahayogini is paid the second installment of Rs 100/- after 42 nd day on completion of 5 PNC (1, 3, 7, 28, 42 nd day) for mother & the new born & immunisation of new born with BCG, DPT-I and OPV-I In Rural area Rs. 400/- for transport is paid with first installment. SIHFW: an ISO9001: 2008 certified institution 17

PowerPoint Presentation: 

Benefits to trained Dai: 10-06-09 onward if trained Dai escorts the beneficiary:- Trained Dai is being paid Rs. 200/- for escorting the beneficiary for institutional delivery. Except 5 districts Alwar , Bharatpur , Bhilwara , Dausa & Jhunjhunu . Benefits to JMC:- 11-08-09 onward if JMC escorts the beneficiary:- JMC is being paid Rs. 200/- for escorting the beneficiary for institutional delivery. SIHFW: an ISO9001: 2008 certified institution 18

PowerPoint Presentation: 

All BPL pregnant women a cash assistance of Rs. 500/- 8-12 weeks prior to delivery. The remaining amount is being paid on institutional delivery. An amount of Rs.500 for home delivery is paid for a BPL Beneficiary, Irrespective of age & number of Children. SIHFW: an ISO9001: 2008 certified institution 19

JSY: Special approach for LPS: 

JSY: Special approach for LPS Age restriction removed Restricting benefits of JSY up to 2 births removed. the benefits of the scheme are extended to all pregnant women in LPS states irrespective of birth orders. No need for any marriage or BPL certification provided woman delivers in Government or accredited private health institution. GOI set the guidelines depending the specific context of the state. For Exa . In Rajasthan 5 liters of Desi Ghee is also provided to BPL women at the time of her first delivery SIHFW: an ISO9001: 2008 certified institution 20

Number of JSY beneficiaries (in Lakhs): 

Number of JSY beneficiaries (in Lakhs ) Year Rajasthan Financial Progress 05-06 0.05 17.70 06-07 3.88 3056.00 07-08 7.75 13005.00 08-09 9.17 14975.23 09-10 9.78 16248.08 10-11 9.86 18004.04 Source-DM&HS SIHFW: an ISO9001: 2008 certified institution 21

JSY: Institution Delivery: 

JSY: Institution Delivery 22 SIHFW: an ISO9001: 2008 certified institution Source: Pragati Prativedan 2010-11 & DM&HS

Accrediting of Private Facilities under JSY: 

Accrediting of Private Facilities under JSY Under JSY a provision of facility to avail services of private hospitals through accreditation Up-to two private hospitals per block are to be accredited as tehsil or block level. Source:-Paying for performance: The Janani Suraksh Program in India SIHFW: an ISO9001: 2008 certified institution 23

Main Difficulties of JSY: 

Main Difficulties of JSY Non availability of Referral Transport at block level. ASHA is not assisting pregnant women at most places. Delayed Payment of JSY incentive to the beneficiaries & ASHA- Sahayogini . Women are discharged after delivery before minimum recommended stay. Reporting of physical and financial progress of JSY is not timely and consistent. Lack of required specialists at the facilities SIHFW: an ISO9001: 2008 certified institution 24

Rajasthan Janani-Shishu Suraksha Yojana (RJSSY): 

Rajasthan Janani-Shishu Suraksha Yojana (RJSSY) Object- Assures NIL out of pocket expenses in all Government Health Institutions For Pregnant Women & Newborns. Source:-DM&HS SIHFW: an ISO9001: 2008 certified institution 25

Entitlements for Pregnant Women : 

Entitlements for Pregnant Women Free delivery Free caesarian section Free drugs & consumables Free diagnostics (Blood, Urine tests & Ultra sonography etc.) Free diet during stay (up to 3days for normal delivery & 7 days) Free provision of blood Free transport from home to health institutions, between health institutions in case of referrals and drop back home Exemption from all kinds of user charges Source:-DM&HS SIHFW: an ISO9001: 2008 certified institution 26

Entitlements for Sick Newborn till 30 days after birth: 

Entitlements for Sick Newborn till 30 days after birth Free and zero expense treatment Free drugs & consumables Free diagnostics Free provision of blood Free transport from home to health institutions, between health institutions in case of referrals and drop back home Exemption from all kinds of user charges Source:-DM&HS SIHFW: an ISO9001: 2008 certified institution 27

Status of RJSSY as on 31st Oct, 2011 : 

Status of RJSSY as on 31 st Oct, 2011 S.No Services No. of Beneficiaries 1 Total Deliveries 122617 2 No. of pregnant women provided free medicine 216259 3 No. of pregnant women provided free lab tests 110023 4 No. of pregnant women availed free hot food 182352 5 No. of pregnant women provided free referral transport 60782 6 No. Sick Neonates (30 days) received free medicine 36378 7 No. Sick Neonates (30 days) received free lab tests 12326 8 No. Sick Neonates (30 days) received free referral transport 2447 Source:-DM&HS SIHFW: an ISO9001: 2008 certified institution 28

Research on JSY: 

Research on JSY A study by Center for Operational Research & Training (2007), conducted Rajasthan “compared the number of deliveries in public sector facilities before and after the JSY program“. Findings:- Number of institutional deliveries in the public sector increased by 36%. Study of motivation for institutional delivery, more than half of mothers ( 173 mothers interviewed) stated that the JSY incentive payment was a major factor in their decision to deliver (Study conducted in Rajasthan by Center for Operational Research & Training facility.) Source:-Paying for performance: The Janani Suraksh Program in India SIHFW: an ISO9001: 2008 certified institution 29

PowerPoint Presentation: 

Population Research Center at Mohan Lal Sukhadiya Uni. Conducted a study (2007-08) in two districts Banswara (high record of institutional deliveries )& Barmer (low performance) in Rajasthan. 200 beneficiaries were interviewed. Findings:- JSY program contributed to increased access to antenatal and postpartum care as well as to increased institutional deliveries . Research Cont. Source:-Paying for performance: The Janani Suraksh Program in India SIHFW: an ISO9001: 2008 certified institution 30

Case Study: 

Case Study Radha , a newly married young woman in a small village in rural Rajasthan, she was pregnant and her due date was just one week away. Against the wishes of her in-laws, Radha had left her husband’s village and returned to her parents’ home. SIHFW: an ISO9001: 2008 certified institution 31

PowerPoint Presentation: 

She was planning to deliver her baby at home , just as her mother, Prema , had given birth to her at home 18 years earlier. According to Prema , Radha’s in-laws had recently learned about a government program that is providing a cash payment to women who opt for institutional delivery over the traditional practice of home delivery. SIHFW: an ISO9001: 2008 certified institution 32

PowerPoint Presentation: 

Prema said that the decision of where Radha would deliver caused a conflict between the two families. She said that Radha’s in-laws wanted Radha to deliver in an institution but Prema did not agree with that. ASHA got information that Radha wants to deliver at home, she contacted Radha and suggested for institutional delivery. SIHFW: an ISO9001: 2008 certified institution 33

PowerPoint Presentation: 

She gave some examples of her neighbors who delivered in hospitals. ASHA ensured that she delivers in an institution. Now Radha is ready for the institutional delivery, her mother informed her in-laws. And after two days Radha delivered a girl in institution and received good care & incentive from JSY also. SIHFW: an ISO9001: 2008 certified institution 34

PowerPoint Presentation: 

Thank You For more details log on to www. sihfwrajasthan.com or contact : Director-SIHFW on sihfwraj@yahoo.co.in SIHFW: an ISO9001: 2008 certified institution 35