Modi Govt JSY schemes, PMMVY work only health workers

While CHW provides critical maternal health services to prepare pregnant women for delivery, their contribution is rarely discussed.

Representative image of Community workers in India in the field of health.

The Pradhan Mantri Matru Vandana Yojana has recently been in news for its scarce financial assignment in the 2022-23 budget. Launched in 2017, and now integrated in Mission Shakti, the PMMVY provides RS 1,000 for early pregnancy registration, RS 2,000 after a prenatal care control six months in pregnancy and RS 2,000 after childbirth and vaccines for the newly born.

The objective of the plan is to improve the behavior related to maternal and child health and provide partial compensation for the loss of income so that the mother can take an adequate rest before joining the paid work. Public sector employees and those who receive similar benefits under any other law are excluded.

The controversy exploded when the Government of Narendra Modi announced that the second pregnancy would also be eligible to receive cash assistance, but only for a girl. It is not clear how the sex of the second child can be determined for the distribution of the first two installments, since it is illegal to determine the sex of the baby at birth in India.

Role of community health workers.

Despite these controversies, a crucial aspect of both PMMVY and JANANI SURAKSHA YOJANA (JSY), the first-generation maternal conditional cash transfer plan launched in 2005 that provides RS 1,000 for delivery at a health care institution, follows Being neglected in public discourse. This has to do with the crucial role played by community health workers (CHW) to make plans succeed.

The Indian Public Health Care System has three main types of CHWS: the auxiliary nurses (ANW), the workers of Anganwadi (AWW) and the most recent addition of 2005, accredited social health activists (ASHA). While the CHW provide critical maternal health services to prepare pregnant women for delivery and also provide timely information on a series of topics related to maternal and child health, their contribution is rarely quantified and discussed.

It has been increasingly recognized throughout the world that barriers other than the lack of cash, including inadequate information or the inaccurate knowledge of health requirements, can undermine investment in children, which negatively affects its health outcomes . Consequently, to increase the effects of cash income and induce a change of behavior, both PMMVY and JSY have a service component in which women trained CHWS as an interface between mothers and health centers.

These CHW are also responsible for registering mothers under the programs, ensuring that they receive antenna care checks (ANC). In addition, they also provide advice for institutional delivery, breastfeeding, immunization and birth control practices, among others. Therefore, you are likely to advise ChWS complemently transfer cash to improve maternal and child health outcomes.

Data on ChW services

To understand the role played by CHW, we analyze the fourth round of the National Survey of Health Family (NFHS-4) of 2015-16 and we extracted information about their mothers visits and their health advice to those who delivered in a health center Public And he had a child under 35 months at the time of the survey. This gave rise to a sample of 50,076 pairs of mother-children in the 10 low-yield states of India (LPS), as defined under the JSY - Uttar Pradesh, Uttarakhand, Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Assam , Rajasthan, Orissa and Jammu and Kashmir.

JSY's approach is in the 10 low-performance states because these had at least three out of every four births that take place at home in 2005 when the plan began. We focus on financial assistance received by institutional delivery (95 percent of them were JSY beneficiaries) from PMMVY benefit data.