Creating a free account will enable you to subscribe to our daily and weekly email newsletters, as well as customize your reading experience to show only the categories most relevant to you.
Signing up only take a few minutes, so why not give it a try and see what you've been missing out on.
A prominent program that claims to reduce infant and maternal deaths in rural India by encouraging mothers to deliver in private hospitals has been unsuccessful, despite the investment of more than $25 million since 2005, a new Duke University study finds.
The Chiranjeevi Yojana program in Gujarat, a state in northwestern India, received the Wall Street Journal Asian Innovation Award in 2006 and has been hailed by some as a model for wide adoption throughout India.
The program was launched in 2006 to help address the shortage of obstetricians at public hospitals accessible to low-income women in rural areas. It aimed to provide free childbirth care at participating private-sector hospitals to women who are below the poverty line. The hospitals are paid 1600 Indian rupees per delivery, approximately $30 to $40. The hospitals may offer additional services to patients and charge separate fees for them. By 2012, approximately 800 private-sector hospitals were participating and the program had helped pay for more than 800,000 deliveries.
Manoj Mohanan, Duke assistant professor of public policy, global health and economics, led the research team. The team surveyed 5,597 households in Gujarat to collect data on births that had occurred between 2005 and 2010. They found no statistically significant change in the probability of delivery in health care institutions, the probability of obstetric complications or the probability that physicians or nurses were present during childbirth.
"We were surprised to find, as well, that even among those who delivered at health care facilities there were no significant reductions in households' out-of-pocket expenditures for deliveries."
The findings were published online by the peer-reviewed international public health journal, Bulletin of the World Health Organization, in an article titled, "Impact of Chiranjeevi Yojana on institutional deliveries and birth outcomes in Gujarat, India: a difference-in-differences analysis."
While the study did not determine why patients' delivery costs did not decline or why the program is ineffective, several explanations are possible, Mohanan said. Media reports in India suggest that despite the promise of free care, hospitals were billing women for extra, chargeable services. Providers also complained that the reimbursement amounts were not adequate to cover costs of providing the service.
In addition, mothers may perceive the quality of care at participating private hospitals to be poor, so even when the care is provided for free, demand does not rise. Transportation costs from rural villages also could be a factor, he said.
Mohanan said previous research, which had suggested the program was very successful, had methodological limitations. It did not address the role of self-selection of institutional delivery by pregnant women and did not account for unrelated increases in institutional deliveries that probably occurred as a result of rapid economic growth in the region.
Citation: “Impact of Chiranjeevi Yojana on institutional deliveries and birth outcomes in Gujarat, India: a difference-in-differences analysis,” (pdf) by Manoj Mohanan, Sebastian Bauhoff, Gerard La Forgia, Kimberly Singer Babiarz, Kultar Singh and Grant Miller. Bulletin of the World Health Organization, Dec. 9, 2013.
This research was supported by the International Initiative for Impact Evaluation in New Delhi (via grant OW2:205), the UK Department for International Development and the World Bank.
Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our Pregnancy / Obstetrics category page for the latest news on this subject.
Please use one of the following formats to cite this article in your essay, paper or report:
Duke University. "Study shows maternal health program in India failing to deliver." Medical News Today. MediLexicon, Intl., 14 Dec. 2013. Web.
8 Mar. 2014. <http://www.medicalnewstoday.com/releases/270062>
Duke University. (2013, December 14). "Study shows maternal health program in India failing to deliver." Medical News Today. Retrieved from
Please note: If no author information is provided, the source is cited instead.
If you write about specific medications, operations, or procedures please do not name healthcare professionals by name.
For any corrections of factual information, or to contact our editorial team, please use our feedback form. Please send any medical news or health news press releases to:
Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. For more information, please read our terms and conditions.
This page was printed from: http://www.medicalnewstoday.com/releases/270062.php
Visit www.medicalnewstoday.com for medical news and health news headlines posted throughout the day, every day.
© 2004-2014 All rights reserved. MNT (logo) is the registered trade mark of MediLexicon International Limited.