Janani-Shishu Suraksha Karyakram

Janani-Shishu Suraksha Karyakram.

In Jun 2011, Ministry of Health and Family Welfare, Government of India launched the Janani–Shishu Suraksha Karyakram (JSSK), a national initiative to make available better health facilities for women and child.

The new initiative of JSSK would provide completely free and cashless services to pregnant women including normal deliveries and caesarean operations and sick new born (up to 30 days after birth) in Government health institutions in both rural and urban areas. The new JSSK initiative is estimated to benefit more than one crore pregnant women & newborns who access public health institutions every year in both urban & rural areas.

The Free Entitlements under JSSK would include:

  1. Free and Cashless Delivery
  2. Free C-Section
  3. Free treatment of sick-new-born up to 30 days
  4. Exemption from User Charges
  5. Free Drugs and Consumables
  6. Free Diagnostics
  7. Free Diet during stay in the health institutions – 3 days in case of normal delivery and 7 days in case of caesarean section
  8. Free Provision of Blood
  9. Free Transport from Home to Health Institutions
  10. Free Transport between facilities in case of referral as also Drop Back from Institutions to home after 48hrs stay.
  11. Free Entitlements for Sick newborns till 30 days after birth similarly include Free treatment, Free drugs and consumables, Free diagnostics, Free provision of blood, Exemption from user charges, Free Transport from Home to Health Institutions, Free Transport between facilities in case of referral and Free drop Back from Institutions to home.

As noted by the Union Health and Family Welfare Minister Sh Ghulam Nabi Azad the number of institutional deliveries has increased from seven lakhs (2005-06) to more than a crore (2010-11).

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 and Infant mortality rates.

Janani Suraksha Yojana (JSY)

Launched in 2005 Janani Suraksha Yojana is an ambitious scheme under the National Rural Health Mission (NRHM), the Government of India's flagship health programme. The scheme is intervention for safe motherhood and seeks to reduce maternal and neo-natal mortality by promoting institutional delivery, i.e. by providing a cash incentive to mothers who deliver their babies in a health facility.

The scheme is fully sponsored by the Central Government and is implemented in all states and Union Territories (UTs), with special focus on low performing states.

Low Performing States

Uttar Pradesh, Uttaranchal, Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Assam, Rajasthan, Orissa and Jammu and Kashmir have been identified as Low Performing States while all others are High Performing States.

Eligibility for Cash Assistance:

  • LPS States - All pregnant women delivering in Government health centres or accredited private institutions.
  • HPS States - BPL pregnant women, aged 19 years and above.
  • LPS & HPS - All SC and ST women delivering in a government health centre or accredited private institutions

The Yojana has identified ASHA, (the Accredited Social Health Activist) as an effective link between the Government and the poor pregnant women in l0 low performing states.

The brief role of ASHA or other link health worker associated with JSY would be to:

  • Identify pregnant woman as a beneficiary of the scheme and report or facilitate registration for ANC
  • Assist the pregnant woman to obtain necessary certifications wherever necessary,
  • Provide and / or help the women in receiving at least three ANC checkups including TT injections, IFA tablets,
  • Identify a functional Government health centre or an accredited private health institution for referral and delivery,
  • Counsel for institutional delivery, etc.

Latest Report on Maternal Mortality Rates - Jul 2011

As per the latest Sample Registration Survey data released in Jul 2011, the Maternal Mortality Ratio (MMR) of India has declined to 212 per 1,00,000 live births in 2007-09 from 254 in 2004-06, thus recording a fall of 42 points or 17 percent. The highest decline in MMR has been observed in Assam (90 points) followed by Uttar Pradesh/Uttarakhand (81 points), Rajasthan (70 points), Madhya Pradesh/Chhattisgarh (66 points), Bihar/Jharkhand (51 points) and Orissa (45 points).

Kerala has shown an outstanding performance recording and MMR of 81 per 1,00,000 live births. While Tamil Nadu recorded an MMR of 97 per 1,00,000 live births, Maharashtra is a close third with 104 per 1,00,000 live births.

Improving maternal health by reducing the Maternal Mortality Ratio by three quarters between 1990 and 2015 is one of the Millennium Development Goals (Goal 5) of the United Nations. The target for India is to achieve the Maternal Mortality Ratio of 109 by 2015.

Earlier this year, the SRS data on Infant Mortality Rates for 2009 had also indicated 3 points decline when compared to the figures of 2008 - being pegged at 50 per one thousand live births compared to the figure of 53 for the period 2008.

The neo-natal mortality rate (deaths in less than 29 days) in 2009 is registered at 34 per one thousand live births, accounting for 67% of total infant mortality deaths.

Besides, the early neo-natal mortality (less than 7 days) has been estimated at 27 per 1000 live births indicating that 54% of total infant deaths are occurring before 7 days of birth.

Janani Shishu Suraksha Karyakaram and Janani Suraksha Yojana are two schemes of the government aimed at reducing both the infant and maternal mortality rates in India.