Yesterday’s article (dated 2nd July 2015) titled “Mother of all scams: For dole, pregnant five times in 10 months” in The Times of India ( one of the leading English daily in India), reports a disturbing fact related to one of the most important schemes – “Janani Suraksha Yojna “, under the National Health Mission (NHM). (Please Janani Suraksha Yojana (JSY) is an intervention, with the objective of reducing maternal mortality and neonatal mortality by promoting institutional delivery.
The scheme is implemented in all states and Union Territories (UTs) of India, with a special focus on eight EAG states (ie. Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Orissa, Rajasthan, Uttar Pradesh, and Uttarakhand) and Assam, which are the low performing states (LPS). The classification of low-performing and high-performing states were based on the institutional delivery rate of the states. States with equal to or less than 25% institutional delivery were classified as the Low-Performing States (LPS) and those above 25% were grouped under the High Performing States (HPS).
The Times of India report underscores some startling “facts”, which reports massive corruption in JSY money. As per the report in Bareilly district of Uttar Pradesh (one of the Low Performing States) “A woman, was declared pregnant three times in four months to avail benefits under the scheme. Another woman who had not conceived in 12 years was paid Rs 1,400 as honorarium by the health department. Yet another woman in Bahraich, a 60-year’s old-, pregnant’s got “a five times in 10 months”.
This is not an aberration. There have been several other instances and been reported in the past. Similar misuse and corruption around the JSY from Rajasthan was also reported titled “Janani Suraksha Yojana under scanner” in The Times of India newspaper approximately four years ago on the 26th July 2011. (Please Apparently, Rajasthan is also one of the Low Performing States.
Reading for These Upon, one’s Would like to Understand how states For for These have fared on the key health indicators directory Specially Maternal Mortality Ration (the MMR) and Neo reports-Natal Mortality Rate (NNMR). MMR is defined as the ratio of maternal deaths per 1,00,000 live births and NNMR is defined as the number of neonates dying before reaching 28 days of age, per 1,000 live births in a given year.
As per the AHS data shown in the figure, all the states barring Uttrakhand has very high MMR, which is more than 200. Madhya Pradesh reports the highest proportion of the JSY beneficiaries (73%) followed by Odisha (70%), but its NNMR is higher than most of the other states. Not sure, if the JSY benefits have translated into improved MMR and NNMR. Assam reports the highest MMR (301) among the LPS, although more than 55% have availed the JSY benefits. However, this data needs to be seen with abundant caution. I had access to the raw data, I could run some tests to understand the association between JSY uptake and mortality indicators, but in absence of the raw data, we can at least see some trends, which are definitely not too encouraging.
As per the World Bank data estimates, Israel has the lowest MMR of 2 per 1,00,000 live births. India’s neighboring countries like Pakistan (170), Sri Lanka (29th), Malaysia (29th), China (32), Bhutan (120) Bangladesh (170), Nepal (190), too reports relatively better MMR status than these states. (The Source: http://data.worldbank.org/indicator/SH.STA.MMRT/countries/all?display=default ).
These trends sufficiently suggest that it’s high time the implementers start showing more seriousness in effective implementation and motoring of the national schemes in order to achieve better results. We can just hope that with the improved financial inclusion and the idea of making Direct Benefit Transfers (DBT), helps in eliminating these widespread scams and the benefits reaches to the real beneficiaries. Nothing can be worse than seeing mothers dying while delivering a child.