The Janani Suraksha Yojana (JSY), a flagship program under the National Rural Health Mission (NRHM), is a safe motherhood intervention designed to reduce maternal and neonatal mortality by promoting institutional delivery among poor pregnant women. Launched in 2005, the JSY is a 100% centrally sponsored scheme that integrates cash assistance with delivery and post-delivery care.
Objectives of the Janani Suraksha Yojana (JSY)
The primary objectives of the JSY are:
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Reduce Maternal and Neonatal Mortality: To significantly reduce maternal and neonatal mortality rates by encouraging institutional deliveries.
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Promote Institutional Delivery: To increase the number of pregnant women, especially from poor families, delivering in public health institutions.
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Provide Cash Assistance: To offer cash assistance to pregnant women to help meet delivery and post-delivery expenses.
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Ensure Quality Care: To improve access to quality obstetric care services for mothers and newborns.
Role of ASHA and Link Workers
The JSY recognizes the crucial role of community health workers in promoting institutional deliveries. Accredited Social Health Activists (ASHAs), Anganwadi Workers (AWWs), or other identified link workers serve as a bridge between the government and pregnant women, with responsibilities that include:
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Identifying and registering pregnant women for antenatal care (ANC).
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Assisting women in obtaining necessary certifications.
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Ensuring women receive at least three ANC checkups, including TT injections and IFA tablets.
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Identifying a functional health center for referral and delivery.
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Counseling women on the benefits of institutional delivery.
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Escorting women to health centers and staying with them until discharge.
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Arranging for newborn immunization up to 14 weeks of age.
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Reporting births and deaths of mothers or children to ANMs/MOs.
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Providing postnatal care and counseling for breastfeeding and family planning.
Key Features of the JSY Scheme
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Focus on Poor Women: The scheme prioritizes poor pregnant women, particularly those in states with low institutional delivery rates.
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Cash Assistance: Provides cash assistance to pregnant women to cover delivery and post-delivery expenses.
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Institutional Delivery: Promotes delivery in government health centers or accredited private institutions.
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Special Dispensation for LPS States: Special considerations are provided for Low Performing States (LPS) to encourage institutional deliveries.
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BPL Certification: In High Performing States (HPS), BPL certification is generally required to access JSY benefits, while in LPS states, it is not mandatory for women delivering in government institutions.
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Cash Assistance for Home Delivery: In LPS and HPS states, BPL pregnant women who prefer home delivery are eligible for cash assistance limited to two live births.
Cash Assistance Details
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LPS States (Rural): Mother’s Package: Rs. 1400, ASHA’s Package: Rs. 600. Total: Rs. 2000
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LPS States (Urban): Mother’s Package: Rs. 1000, ASHA’s Package: Rs. 200. Total: Rs. 1200
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HPS States (Rural): Mother’s Package: Rs. 700, ASHA’s Package: Rs. 200. Total: Rs. 900
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HPS States (Urban): Mother’s Package: Rs. 600, ASHA’s Package: Rs. 200. Total: Rs. 800
Disbursement of Cash Assistance
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Cash assistance should be disbursed to the mother at the health institution, preferably at the time of delivery.
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At least three-fourths (3/4) of the cash assistance under JSY should be paid to the beneficiary in one go, importantly, at the time of delivery.
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ASHA’s cash incentive is disbursed after her postnatal visit to the beneficiary and after the child is immunized for BCG.
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For home deliveries, cash assistance is disbursed at the time of delivery or around 7 days before delivery.
Limitations of Cash Assistance
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The scheme does not provide ASHA package to women choosing to deliver in an accredited private institution.
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Cash assistance is limited to two live births in HPS states for home deliveries.
Key Operational Guidelines
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Micro-Birth Plan: ANMs/ASHAs are required to prepare a micro-birth plan for each beneficiary.
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Referral Slips: A referral slip is mandatory for women accessing accredited private institutions, indicating JSY registration, reason for referral, and cash disbursed.
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Grievance Redressal: A grievance redressal cell should be established at the district level to address complaints related to the scheme.
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Data Collection: Regular reporting of data on fund utilization and beneficiaries is essential.
Conclusion
The Janani Suraksha Yojana (JSY) is a vital program that has significantly contributed to improving maternal and neonatal health in India. By promoting institutional deliveries, providing cash assistance, and empowering community health workers, the scheme is reducing mortality rates and ensuring that more women and newborns receive essential care during this critical period.