Publication:

Factors influencing the utilization of free delivery care under Janani Shishu Suraksha Karyakram in Kamrup district, Assam, India

Background Janani Shishu Suraksha Karyakram (JSSK) was initiated in 2011 to reduce the out of pocket expenditure incurred by pregnant women and sick neonates accessing public health facilities in India.  Aim of the study was to assess the factors influencing utilization of free delivery care under JSSK among beneficiaries in rural areas of kamrup district in Assam, India.

Methods A cross-sectional study with multistage random sampling design was conducted in rural Kamrup from August 2013 to July 2014 among 387 mothers with infants.  They were interviewed using a pre-designed and pre-tested semi-structured interview schedule. Statistical analysis used: Chi-square, Odds ratio (OR) and logistic regression.

Results Utilization of free delivery care under JSSK was 83.2% among the beneficiaries. Factors significantly associated with utilization of free delivery, after bivariate logistic regression, were education, age, socioeconomic status, early registration and parity. On multivariate logistic regression, considering all variables, age group below 25 years (OR=2.3; Confidence Interval= 1.33-3.99), Socio-economic class III and below (OR=2.27; CI= 1.32-3.88), early registration (OR=4.3; CI= 2.47-7.56) and single parity (OR=2.08; CI=1.19-3.63) were found to be predictors for utilization of the services.

Conclusions The majority of beneficiary mothers in the rural areas had received ‘free delivery’ care under JSSK available in the public health facilities. However utilization of the benefit was not achieved universally among all the mothers. There should be focussed action at grass-root level to motivate the multipara and older pregnant women in the rural areas to utilize the services to enhance pregnancy outcome.