Celebrate Solutions: Using Cash Transfers to Promote Safe Births in India

By: Yousra Yusuf, Women Deliver

Global maternal mortality rates may be on the decline, but mothers in India continue to die from preventable causes at alarming rates. In 2010, 56,000 deaths were reported throughout the country, with one in every 140 women dying from pregnancy or childbirth-related causes. Through a conditional cash transfer program, Janani Suraksha Yojana (JSY), the Indian government is working to ensure that no woman dies while giving life.

Maternal deaths are largely caused by the three delays: 1) Delay in decision to seek professional care, 2) Delay in reaching the appropriate health facility and 3) Delay in receiving care after arriving at a hospital. For women with high-risk pregnancies in particular, access to skilled care is needed to respond to potentially life-threatening complications such as sepsis, hemorrhage, eclampsia, and obstructed labor. In India, where in every five minutes one woman dies of pregnancy-related complications, programs that focus on affordable and accessible health care are critical.

JSY was launched in 2005 by the National Rural Health Mission (NRHM) under the Indian government to encourage women to deliver in health facilities and to see trained professionals for ongoing care.  JSY uses a conditional cash transfer approach, providing pregnant women with cash incentives for giving birth in hospitals and using health facilities. The amount of the cash incentives differ between Indian states based on their performance in improving maternal health, ranging from 600 rupees (US $13) in high-performing urban areas to 1,400 rupees (US $31) in low-performing rural areas.

In the years since its inception, JSY has proven to be successful. In a study from the London School of Hygiene and Tropical Medicine, researchers found that from 2005-2008, private facility births increased from 39% to 51%, and public facility births increased from 20% to 39%. An evaluation commissioned by UNFPA shows that JSY has seen an increase in beneficiaries from 739,000 in 2005 to approximately 8,380,000 in 2009, with about 71% women in five states reporting an increased awareness of all-hours government facilities for delivery.

This program, together with other initiatives taken by the Indian government, can be credited with helping to bridge the gap in maternal health service access by poor and marginalized women, and will be one of the primary ways to help India reach its goal of decreasing maternal mortality rates down to 100 deaths per 100, 000 live births by 2015.

To read more about JSY, click here.

Flickr photograph via stevewright316.