Study of impact of JSSK scheme on institutional deliveries and maternal mortality rate: Visakhapatnam district Andhra Pradesh

摘要

Background: To study the impact of JSSK scheme on institutional deliveries in Visakhapatnam district, A.P. To assess the awareness among the target population (i.e.,) delivered women regarding this programme. To evaluate the trends of MMR in Visakhapatnam district after the start of JSSK programme in 2011. Methods: This is an observational study, in the first phase all the data was collected on total number of deliveries occurred in Visakhapatnam district, A.P from year 2013-14 to 2017-October. This includes all institutional and home deliveries from Visakhapatnam district. Data of MMR and IMR, also collected for the same period. A point survey was done at VGH over a period of a month in October 2017. Total 464 delivered women during this period were given a structured questioner which includes age, parity, SC status, educational status, booked status and awareness about JSSK programme, its source of information and feedback was taken regarding satisfaction towards health services in VGH. Finally, a comparative analysis was done with MMR and IMR status of Visakhapatnam district and AP state with that of India. Results: In this study 87.8% of delivered women at VGH during the study period are unaware of JSSK programme. Level of socio economic status, education and parity played a big role in bringing out the awareness. Most of the awareness comes through anganwadi workers, ANMs and advertisements in media. 98.9% expressed their satisfaction with the health services at VGH. Conclusions: Pregnant women die in India due to a combination of important factors like, poverty, ineffective or unaffordable health services, Visakhapatnam district tops the lists of MMR and IMR in the state of Andhra Pradesh and most important factor effecting the JSSK success is lack of awareness in target population. There is a need to understand more about the individual- and area-level characteristics that contribute to variations in programme achievements. A greater in depth study should be undertaken at community level to analyse each maternal death individually. To achieve target MDG of MMR 100/2020 and IMR 28/2019 state needs to reach the unreached and motivate all needy women specially with low S.E. status towards institutional deliveries by proper campaigning to enlighten them that all maternal and child services including transport are absolutely free.