maternal and infant mortality rate is the key goal feature of the Reproductive
and Child Health Programme under the National Rural Health Mission. Several
initiatives have been launched by the Ministry of Health & Family Welfare
under the Mission including Janani Suraksha Yojana, a key
intervention that has resulted in phenomenal growth in institutional deliveries
with more than one crore women beneficiaries
annually. JSY was launched to promote institutional deliveries so that skilled
attendance at birth is made available and mothers and
new born babies can be saved from pregnancy related complications and deaths.
though institutional delivery has increased significantly, out of pocket
expenses being incurred by pregnant women and their families remained high.
This has acted as a major barrier for the pregnant women to opt for
institutional attendance. They still prefer to deliver at home. Due to this, a
large number of sick neonates die on account of poor access to health
To mitigate the
problem, the Ministry of Health & Family Welfare launched Janani Shishu Suraksha
Karyakram (JSSK) on 1st June, 2011 to
provide better health facilities for pregnant women and sick neonates. The
scheme emphasises utmost importance on “Free Entitlements”. The idea is to eliminate
out-of-pocket expenses for both pregnant women and sick neonates.
this scheme, pregnant women are entitled for free drugs and consumables, free
diagnostics, free blood whenever required, and free diet up to 3 days for
normal delivery and 7 days for C-section.
This initiative also provides for free transport from home to
institution, between facilities in case of a referral and drop back home.
Similar entitlements have been put in place for all sick newborns accessing
public health institutions for treatment till 30 days after birth. The JSSK
initiative is estimated to benefit more than one crore
pregnant women & newborns both in urban & rural areas annually.
has made considerable progress in reduction of Maternal Mortality Ratio (MMR)
and Infant Mortality Rate (IMR), but the pace at which these health indicators
are declining needs acceleration. The number of institutional deliveries has
increased significantly, after the launch of Janani Suraksha Yojna (JSY) in the year
2005 but many of those who opted for institutional deliveries were not willing
to stay for 48 hours, hampering the provision of essential services both to the
mother and neonate. Moreover, the first
48 hours after delivery are critical as complications like haemorrhage,
infection, high blood pressure, etc are more likely to develop during this
period and unsafe deliveries may result in maternal and infant morbidity or
to mother and child health care service was also hindered by the high out of pocket
expenses on user charges for OPD, drugs and consumables, diagnostic tests etc.
In some cases such as severe anaemia or haemorrhage requiring blood transfusion
can also increase immediate expenses. The same becomes still higher in case caesarean section is done.
JSSK has been launched, to ensure that each and every pregnant woman and sick
neonates upto one month gets timely access to health
care services free of cost and without incurring any out of pocket
JSSK, free institutional delivery services (including caesarean operation) are
provided in government health facilities. Medicines including supplements such
as Iron Folic Acid are to be given free of cost to pregnant women. Further,
pregnant women are entitled to both essential and desirable investigations like
blood, urine tests and Ultra-Sonography etc. Furthermore, they are to be
provided with free diet during their stay in the health institutions (up to three
days for normal delivery & seven days for caesarean section). Not only
this, there is a provision of free blood transfusion if the need arises. A
significant number of maternal and neonatal deaths can be saved by providing
timely referral transport facility to the pregnant women. Pregnant women are
entitled to free transport from home to health centre, referral to higher
facility in case of need and drop back from the facility to home. Besides,
under JSSK there is exemption from all kinds of user charges including OPD fees
and admission charges.
treatment is also provided to the sick new born upto thirty
days after birth and all drugs and consumables required are provided free of
cost. As in the case of the mother, the new born too is provided with free
diagnostic services and there is a provision of free blood transfusion if the
need arises. The facility of free transport from home to health institutions
and back is also available.
institutional deliveries are a key determinant of maternal mortality and
quality provision of ante-natal and post-natal services can reduce infant as
well as maternal mortality. Janani Shishu Suraksha Karyakram supplements the cash assistance given to a
pregnant woman under Janani Suraksha
Yojana and is aimed at mitigating the burden of out
of pocket expenses incurred by pregnant women and sick newborns. Besides it
would be a major factor in enhancing access to public health institutions and
help bring down the Maternal Mortality ratio and Infant mortality rates.
launch of the Janani Shishu
Suraksha Karyakram will
encourage all pregnant women to deliver at public health places and fulfil the
commitment of achieving cent percent institutional delivery. It will also
empower service providers working at the health facilities in providing quality
ante-natal, intra-natal and post-natal services at the institutions. Providing
free treatment to sick neonates will help in decreasing the neonatal mortality
rate. This initiative will help in reducing both maternal and infant mortality
*Additional Director General(Media
& Communication), PIB, New Delhi.
from the Ministry of Health & Family Welfare.