India's Janani Suraksha Yojana, a conditional cash transfer programme to increase births in health facilities: an impact evaluation
India's Janani Suraksha Yojana, a conditional cash transfer programme to increase births in health facilities: an impact evaluation
复制标题
DOI：
10.1016/s0140-6736(10)60744-1
复制
发表时间：
2010-06-05
期刊：
影响因子：
168.9
通讯作者：
Gakidou, Emmanuela
中科院分区：
文献类型：
--
作者：
Lim, Stephen S.;Dandona, Lalit;Gakidou, Emmanuela
2005年，为了减少孕产妇和新生儿死亡人数，印度政府启动了有条件现金转移计划Janani Suraksha Yojana（JSY），激励妇女在医疗机构分娩我们独立评估了JSY对干预覆盖范围和健康结果的影响方法我们使用了2002年全国区级家庭调查的数据-2004年和2007- 2009年，根据社会经济和人口特征，评估从JSY获得财政援助的情况;并使用了三种分析方法（匹配，有与无比较，差异中的差异），以评估JSY对产前保健，设施分娩，围产期，新生儿，2007-08年JSY的实施情况因州而异，从不到5%到44%的分娩妇女接受JSY的现金支付。最贫穷和受教育程度最低的妇女并不总是有最高的机会获得JSY付款。JSY对增加产前护理和设施内分娩有显著影响。在匹配分析中，JSY付款与3.7的减少相关（95%可信区间2.2-5.2）每1 000例妊娠围产期死亡率和2.3（0.9 -3.7）每1 000例活产的新生儿死亡率在有无比较中，下降幅度为4.1（2.5-5.7）每1000例妊娠围产期死亡和2.4（0.7 - 4.1）每1000例活产新生儿死亡。但它们也强调，需要更好地针对最贫穷的妇女，并注意保健设施的产科护理质量。随着对该方案的财政和政治承诺的加强，持续的独立监测和评价对于衡量JSY的效果至关重要。
Background In 2005, with the goal of reducing the numbers of maternal and neonatal deaths, the Government of India launched Janani Suraksha Yojana (JSY), a conditional cash transfer scheme, to incentivise women to give birth in a health facility We independently assessed the effect of JSY on intervention coverage and health outcomesMethods We used data from the nationwide district-level household surveys done in 2002-04 and 2007-09 to assess receipt of financial assistance from JSY as a function of socioeconomic and demographic characteristics; and used three analytical approaches (matching, with-versus-without comparison, and differences in differences) to assess the effect of JSY on antenatal care, in-facility births, and perinatal, neonatal, and maternal deathsFindings Implementation of JSY in 2007-08 was highly variable by state from less than 5% to 44% of women giving birth receiving cash payments from JSY. The poorest and least educated women did not always have the highest odds of receiving JSY payments. JSY had a significant effect on increasing antenatal care and in-facility births. In the matching analysis, JSY payment was associated with a reduction of 3.7 (95% CI 2.2-5.2) perinatal deaths per 1000 pregnancies and 2.3 (0 9-3.7) neonatal deaths per 1000 livebirths In the with-versus-without comparison, the reductions were 4.1 (2.5-5.7) perinatal deaths per 1000 pregnancies and 2.4 (0 7-4 1) neonatal deaths per 1000 livebirths.Interpretation The findings of this assessment are encouraging, but they also emphasise the need for improved targeting of the poorest women and attention to quality of obstetric care in health facilities. Continued independent monitoring and evaluations are important to measure the effect of JSY as financial and political commitment to the programme intensifies.