Plugging the gaps

The care the state extends to a mother and her newborn is at the same time the most basic and the most challenging. India grasped its particular conundrum in maternal and neonatal healthcare even as its maternal and infant mortality rates were declining,the numbers were still cause for alarm when it launched one of its most imaginative programmes five years ago,the Janani Suraksha Yojana JSY. The conditional cash transfer mechanism to encourage institutional delivery brought many women to nearby health centres to have a child.

Now,as the Union health ministry tries to strengthen the scheme by supplementing cash transfer with free transport to health centres and free treatment to mother and child its crucial to learn from the JSY narrative. On how states like Madhya Pradesh,Orissa and Rajasthan achieved high levels of JSY uptake. In MP,for instance,the JSY proved to be a success as the state strengthened infrastructure,especially by accrediting health centres in far-flung areas.

At the same time,its critical to understand where and how JSY failed. Why the intervention proved to be insubstantial in populous states like Uttar Pradesh. Why the efficacy of a cash-transfer scheme,which is gaining traction in policy-making in state and Central levels,is based on a large part on awareness programmes. The message should reach before the money does,in this case,our poorest,illiterate women,who are in dire need of programmes like JSY. With the Centre setting up a task force to consider cash transfers for fuel subsidies,these lessons could have bearings on other welfare programmes.