State intervention in reproductive health of women an evaluative study of Janani Suraksha Yojana and Janani Shishu Suraksha Karyakram in rural Punjab

Abstract

Given the dismal state of maternal and reproductive health of women in India, JananiSurakshaYojana (JSY) and JananiShishuSurakshaKaryakram(JSSK), two health schemes, were executed by Government of India, to meet the Millennium Development Goal 5, by providing free health care services to pregnant women, including both pre as well as post-natal care, apart from facilitating institutional deliveries. Despite impressive statistics on female literacy, total fertility rate, etc., the State of Punjab has failed to achieve this goal. An evaluative study of the two schemes, by focusing upon two districts of Punjab, has led to this Thesis. A mixed method approach was employed to capture the ground reality, by holding personal interviews with women beneficiaries apart from other stakeholders including their husbands, ASHAs, ANMs, pharmacists, ambulance drivers, district programme managers, etc., in Fatehgarh Sahib and Ferozepur (best performing and worst performing districts, respectively, on selected indicators of reproductive health of women). The study highlights multiple bottlenecks in the execution of Schemes, such as shortage of manpower and infrastructure in health facilities, low compliance among women owing to cultural norms, patriarchal mindset, son-preference, child marriage, etc., acting as barriers in desired outcomes. The import of the study lies in a critical analysis of the Schemes from the perspectives of various stakeholders and identification of bottlenecks by employing Tanahashi Model leading to insightful and comprehensive understanding of the ground reality, on the basis of which a number of policy recommendations are suggested, towards the end, for enhancing the effectiveness of the two Schemes. newline