Program evaluation of the Janani Suraksha Yojna

Introduction The Janani Suraksha Yojana (JSY) was launched in 2005 as a response to high maternal mortality in India. The scheme was driven by global evidence that conditional cash transfers enable behaviour change, in this case, rise in institutional delivery. The scheme had a differential incentive entitlement based on urban or rural areas and high or low performing states. The incentives for women in rural areas of low performing states are: INR 1400 for institutional delivery and INR 500 for home deliveries. However in case of home deliveries many exclusionary practices denied benefits of the scheme to women below 19 years of age, higher parity and those entitled but without holding the Below Poverty Line (BPL) card. The paper draws on a study evaluating the effectiveness of the scheme. The objectives of the evaluation were: to assess trends in institutional delivery, the availability and quality of care at delivery and in post natal period; the capability of health institutions and the role of village level health workers called the Accredited Social Health Activists (ASHA). Impact evaluation on maternal mortality was not attempted.