Money can’t buy confidence in birth services, research shows

Cash is not a sufficient incentive for pregnant women in India to take up free institutional delivery services, new research shows. Less than 50% of eligible women take up the Janani Suraksha Yojana (JSY) Indian Government cash incentive scheme. A team of researchers based at institutions in India, Australia, and the UK, including Public Health Foundation of India, the University of Adelaide, and Lancaster University, identified that more significant factors are at play, including familial support and transport challenges. The study identified several obstacles in the uptake of the JSY including: Poor quality of care and infrastructure at institutions Lack of 'care-taker' at home to look after other children Trust in the skills of traditional birth attendants over the need for medical care The notion of childbirth as a 'natural event' requiring no institutional delivery care The research found that, overall, the use of maternal healthcare facilities is largely driven by the community health workers known as ASHAs (Accredited Social Health Activists). Their support services and efforts to generate awareness of the benefits of facility-based childbirth were major enabling factors in the accessing of delivery care. There was also a strong belief that institutional delivery care facilities were only for cases in which there were birth complications. Findings suggest that to promote accessing delivery care in India and other resource-poor country settings, it is important to employ well trained community health workers at the grass roots level to identify and help pregnant women.