INTRODUCTION:

“It’s right of every mother and her baby”

Health in its broad sense is not merely the absence of disease or provision of diagnostic or curative services.¹ It also includes provision of preventive services and incentives to improve health in every stage of life. In India, the government believes that health maintenance of people is a fundamental human right, does continuous efforts to reduce mortality and morbidity among vulnerable population².

Among centrally sponsored programme, Janani Suraksha Yojna is one of the key programmes running at full pledged way in almost all states of India; the focus is given to reduce the Maternal Mortality Rate (MMR), Infant Mortality Rate (IMR). It also concentrates some way to prevent population explosion and stabilization of family size.Mother has special role in family. Health of families and communities are tied to the health of mothers. Mother’s health at the time of conception is vital to have healthy baby and safe delivery. It is in return helps to build-up a healthy and prosperous nation^.

A cross sectional study was conducted by Parul Sharma, to assess the reduction of maternal and neonatal mortality by promoting institutional deliveries by providing cash incentive to beneficiaries as well as promoter. Ante -natal services are one of the most important component of JSY. Study was designed to assess the ante-natal characteristic of JSY beneficiaries. A total of 2221 married women (15-49 years) were interviewed out of which 1290(58.08%) women were from urban slums and 931(41.92%) women belonged to rural areas. Out of the total number of married women who delivered at govt. hospital i.e. 227 (75.17%), majority (78.42%) of the women were registered with the some health personals. Out of these, 74.15% women were registered with ASHA.Only 29.21% women went for three or more ANC visits. Only 48.31% women consumed hundred IFA tablets and the proportion was high (79.41%) in rural women. All the women received complete TT immunization. It was found that registration of the women with some health personnel was influenced by women’s religion and socio-economic status the level of education and socio-economic status was found to have a positive effect on the number of ANC visits. The consumption of IFA tablets was also found to be influenced by the educational status of the women ⁷

In 2013 a study was conducted by K Vikram et al to identify the beneficiary level factors of utilization of JSY scheme in urban slums and resettlement colonies of trans-Yamuna area of Delhi. A cross-sectional community based survey was done of mothers of infants in the selected areas of the two districts by stratified random sampling on a population proportionate basis. Socio-demographic factors, antenatal services availed and distances of nearest health facility were studied. Outcome variable, a beneficiary, was a woman who had ever interacted with the ASHA of her area during the antenatal period of previous pregnancy and had child birth in an institution. Descriptive tables were drawn; univariate analysis followed by multiple logistic regression was applied for identifying the predictors for availing the benefits. Of the 469 mothers interviewed, 333 (71%) had institutional delivery, 128 (27.3%) had benefited from JSY scheme and 68 (14.5%) had received cash benefits of JSY. Belonging to Hindu religion and having had more than 6 antenatal check ups were the significant predictors of availing the benefits of JSY. There is a need to improve the awareness among urban slum population about the utilization of JSY scheme. Targeting difficult to access areas with special measures and encouraging more antenatal visits were essential, prerequisites to improve the impact of JSY^.8

A study conducted at UP on utilization of JSY has revealed that 52% of women did not know about availability of JSY and only 24% knew the entire facilities covered by JSY¹⁴. The concurrent assessment of JSY done in India’s most backward states like Bihar, Rajasthan, Orissa, MP, UP has revealed knowledge on JSY was quite low. Only 6-11% of the mothers in MP, Orissa and Rajasthan knew about this aspect and 25% at Bihar.Among these states UP had quite low knowledge. The above studies reveal that awareness itself is less and it is one of the main obstacles in utilization of benefits¹⁶.

In India, many places such facilities are under utilized by many of the women either due to ignorance or with pre determined perception on delivery of services by the public sector. This has urged the investigator to tap certain rural areas and assess the knowledge and utilization of JSY’s benefits.¹⁵

STATEMENT OF PROBLEM:

“A descriptive study to assess the utilization and satisfaction of Janani Suraksha Yojna (JSY) packages among postnatal mother admitted in selected maternity hospital, Pune”.

OBJECTIVES:

1. To assess the utilization of Janani Suraksha Yojna packages among postnatal mothers.

2. To assess satisfaction of Janani Suraksha Yojna packages among postnatal mothers

3. To associate the utilization of Janani Suraksha Yojna packages with selected demographic variables among postnatal mothers.

4. To associate the satisfaction of Janani Suraksha Yojna packages with selected demographic variables among postnatal mothers.

ASSUMPTIONS:

1. There is minimum utilization of Janani Suraksha Yojna.

2. Every mother and her baby has right to deliver in safe hands with maximum utilization of sources provided by government for benefit of both the mother and her baby.

3. Women utilizes the benefits of Janani Suraksha Yojna to some extent.

INCLUSION CRITERIA:

· Postnatal mothers under Janani Suraksha Yojna scheme.

· Those who belongs to BPL category or belongs to low castes (SC/ST).

· Postnatal mothers who can read and write Marathi.

EXCLUSION CRITERIA:

· Postnatal mothers who are critically sick.

· Those who are not willing to be the part of study sample.

MATERIALS AND METHODS:

Research Approach:

Research approach is systematic, objective method of discovery with empirical evidence. The choice of research approach constitutes one of the major decisions, which must be made in conducting a research study as the approach taken on a research project can greatly affect its outcome.The research method adopted, for the study was Qualitative approach because the study aims at assessing the Utilization and Satisfaction of Janani Suraksha Yojna among the postnatal mothers.

Research Design:

The design adopted for the present study was Cross sectional study design.

Cross sectional research design is one of the broad categories of research designs, in which the researcher observes the phenomena as they occur naturally, & no external variables are introduced. It is a research design in which variables are not deliberately manipulated, nor is the setting controlled. In non-experimental research, researchers collect data without making changes.

Variables:

Independent Variable: Janani Suraksha Yojna packages

Dependent Variable: Postnatal mothers.

Demographic variables: Age, education, occupation, income, type of family, no. of childrens.

Research Setting:

The study was conducted in a corporation hospital of Pune city

Population:

The target population consists of people or things that meet the designated set of criteria of interest to the researcher. The population of the present study comprises of the postnatal mothers. Accessible population is the aggregate of participants who confirm to designate criteria and are accessible as a pool of subjects for a study (Polit and Beck 2004). The accessible population for the study was of postnatal mothers under JSY scheme from selected Hospital.

Sample:

Total number of postnatal mothers selected for study was 110.Sample selected were the postnatal mothers in selected maternity hospital.

Sampling Technique:

Non probability Purposive sampling technique is used for the present study.

Development of Tool:

The data-gathering tool was constructed by the investigator in the light of the literature reviewed & her experience in the clinical field to ensure the adequacy & validity of the content.

The tool consisted of Semi structured interview and rating scale which had 3 sections-

Section I. Demographic data

Section II. Self structured questioners on utilization of JSY.

Section III. Rating scale for Satisfaction of JSY.

Description of Tool:

Section I. Demographic data includes characteristics like Age, caste, Type of family, Monthly Family Income, Educational Qualification, Occupation, no. of childrens.

Section II. Self structured questioners on utilization of JSY.

Section III. Rating scale for Satisfaction of JSY.

Data collection Procedure:

It was planned to select the subjects for study who attended immunization unit with their babies, mothers from family welfare unit. To select the sample needed for the study, the investigator approached the proper authorities for obtaining the necessary permission and cooperation. The nature of the study was briefly explained and it was ensured by the investigator that the normal routine of the hospital won’t be disturb ed. Using the self structured interview technique for the utilization of Janani Suraksha Yojna among the postnatal mothers and rating scale for satisfaction of Janani Suraksha Yojna were conducted. Data was recorded in the format developed for the purpose.

Plan for Data Analysis:

The data analysis was planned to include descriptive and inferential statistics and present them in form of tables, graphs and figures. The data was planned to be set in excel file, entered and to use statistical package of social sciences for entering the data in the computer.

RESULT:

FINDINGS OF SECTION I:

Description of samples according to demographic characteristics:

In majority (53.6%) of the subjects are in the age group of 21-25 years, 24.5% of the subjects were in the age group of <20 years and 21.8% of the subjects were in the age group of >25 years.In majority (60.9%) of the subjects education status is secondary school, 20.9% of the subjects were illiterate, 15.5% of the subjects had taken higher secondary education, and 2.7% are graduates. In majority (69.1%) of the subjects belongs to schedule caste, 27.3 belongs to others i.e. BPL, and 3.6% of the subjects belongs to schedule tribes.In majority (74.5%) of the subjects income is 5001 – 10000, (20.9%) of the subjects family income is <5000, and (4.5%) of the subjects family income is >10000. In majority (55.5%) of the subjects belongs to joint family, and (44.5%) of the subjects belongs to nuclear family. In majority (44.5%) of the subjects total no. of children is one, (41.8%) of the subjects total no. of children is two, (13.6%) of the subjects has three children.

FINDINGS OF SECTION II:

Analysis of data to compare subject characteristics in between the subjects:

P value (0.84) i.e. there is no any significant relationship between the Age and utilization of JSY. P value (0.41) i.e. there is no any significant relationship between the Age and satisfaction of JSY. P value (0.42) i.e. there is no any significant relationship between the education and utilization of JSY. P value (0.50) i.e. there is no any significant relationship between the education and satisfaction of JSY P value (0.69) i.e. there is no any significant relationship between the caste and utilization of JSY. P value (0.48) i.e. there is no any significant relationship between the caste and satisfaction of JSY. P value (0.13) i.e. there is no any significant relationship between the family income and satisfaction of JSY. P value (0.85) i.e. there is no any significant relationship between the type of family and utilization of JSY. P value (0.55) i.e there is no any significant relationship between the type of family and satisfaction of JSY. P value (0.32) i.e. there is no any significant relationship between the number. of children and utilization of JSY.P value (0.20) i.e there is no any significant relationship between the no. of children and satisfaction of JSY

CONCLUSION:

Findings of the study concluded that, utilization of Janani Suraksha Yojna package among the postnatal mothers is (100%). Where components such as ANC registration, ANC Care, 3 ANC Visits, 2 TT Doses, IFA Tablets, Delivery by health professional, 3 PNC Checkups, PNC care by hp, baby immunized, breast feeding education, Incentives provided, family planning education, Baby checkup by health professionals is being used 100% and components such as Complications identified (41.81%), Complications managed (43.63%), Transport (79%), Information about JSY(95.45%), Immediate admission (82.72%), benefit within a week (98.18%), Rx of sick baby free for 30day (29.09%) is found to be utilized by the postnatal mothers. Level of satisfaction shows that there is 100% satisfaction of Janani Suraksha Yojna among the postnatal mothers, were (78.18%) mothers are fully satisfied, (21.82%) mothers are partially satisfied, and 0% are not satisfied.

RECOMMENDATIONS:

1. This study can be replicated using many hospitals/community and larger sample size

2. A study can be done in different settings.

3. Structured teaching program can be conducted on Janani Suraksha Yojna.

4. Follow-up studies can be done on the same sample to know the level of utilization and satisfaction in further pregnancy.

REFERENCE:

1. Park K. Concept of health and disease. Preventive and social medicine 19^th edition.New Delhi: Banarsidas Bhanot; 2008. P. 11-14.

2. Gulani KK. Community health concepts. Community health nursing principles and practices. New Delhi: Kumar publishing house; 2005. P.16-23.

3. Kranti Suresh Vora, Doctor of Philosophy, 2012 drum.lib.umd.edu

4. B Randive - ‎2015, Dec 15, 2015 - Janani Suraksha Yojna (JSY) to promote institutional births in India, www.diva-portal.org/smash/get/diva2:882982.

5. R Kumar - ‎2016, www.ejmanager.com/mnstemps/67/67-1448961803.

6. Dr Harpreet Kaur, Associate Professor, Department of Community Medicine, National Journal Of Research In Community Medicine, Vol 4, Issue 1, Jan-March 2015.SGRDIMSAR Amritsar (Punjab).com

7. Parul Sharma, Kishore, Jayanti Semwa l& S.D. Kandpal. Awareness of Janani Suraksha Yojana amongst married women (15-49 years) in our field practice area of Dehradun. Souvenir IAPSMCON 2010; O-32.

8. Vikram K, Sharma AK, Kannan AT. Indian J Med Res. 2013 Sep;138(3):340-.PMID:24135178

9. Arshaan Furniturewala, Shashank Pareek and Sourya Mookerjee Impact of JSY and JSSK Programs in the district of Pune. October 2015 with DOI: 10.13140/RG.2.1.1897.0327

10. Kumar Vikas; Misra, Sunil Kumar; Kaushal, Suneel Kumar; Gupta, Subhash Chand;Khan,Amir Maroof 2015-01-01 www.science.gov/topicpages/s/suraksha +yojana+jsy.html

11. Govt of India. Maternal Mortality in India: 1997-2003. Registrar General of Census Operation, NewDelhi.2006. Available from: http://www.censusindia. net/Maternal Mortality in India 1997-2003.doc.

12. Stephan SL, Lalit D, Joseph A H, Spencer LJ, Margarettte CH, Emmanuela G. India’s Janani Suraksha Yojna, a conditional cash transfer programme to increase birth in health facilities: and impact evaluation. Public health foundation of India, New Delhi, Lancer 2010: 375:2009- 23

13. Govt of India, Annual Report 2005-06. Delhi: Ministry of health and family welfare, Govt of India, 2005.

14. Govt of India, Annual Report 2006-07. Delhi: Ministry of health and family welfare, Govt of India, 2007

15. The Hindu online India’s national new paper, 2007[updated 2007 December7 Friday].http://www.hindu.com/2007/12/07/stories/2007 120 756,290 300.htm

16. Varma DS, Khan ME, Hazra A. Increasing institutional delivery and access to emergency obstetric care services in rural uttar pradesh. journel of FW 2010.Jan.

17. BarbarK, Glenva E, Audray B, Shirlee T. Fundamentals of nursing Concept, Process and Practice.7^thed.South Asia:Pearson Education;2006.

18. Basavanthappa BT. Nursing Theories.1^stedition.Jaypee publishers: 2007, P.89 - 93.

19. Sanjeev Gupta, Mahatma Gandhi Medical College.., Puducherry, Epidemiology, Obstetrics, Primary Care 9.57, January 2011, https: //www. researchgate. net/.../ 21548728 5_ Assessment_ of_Janani_Suraksha_Yojana.

20. Vaishali AS. Shekar T. Utilization of JSY among beneficiaries in Orissa. East Afr Med J 2009 Jan; 78(18):564-86.

21. N. Ramakrishna Reddy, SG. Kishore, PG. Viswanatha, TS. Ranganath, D. Shanmugapriy Int J Community Med Public Health. 2016; 3(2): 512-516 doi: 10.18203/2394-6040.ijcmph20160442.

22. Thansia K. Seemanth HR. The operational mechanism, utilization, non-utilization, awareness and perception of mothers on Janani Suraksha Yojna in south Orissa. East Afr Med J 2009 May; 28(11):64-76.

23. VijaykumarS,imsear.hellis.org/bitstream/123456789/150587/1/ijrms2014v 2n1p122.pdf by VS Singh - ‎2014

24. K Panja - ‎2012 Department of Community Medicine, B.S. Medical College, Bankura, India.https://www.ncbi.nlm.nih.gov/pubmed/22684178

25. www.rguhs.ac.in/cdc/onlinecdc/uploads/05_N011_39180.docJun 1, 2012

26. Nair k.s.Tejshree.Y.L. A rapid appraisal on functioning of Janani Suraksha Yojna in India. National institute of health and family welfare; 2007-08(4):1-

27. Janani Suraksha Yojana (JSY) – an exploratory study, April 2012, Karnataka State Health System Resource Centre and Jagruti Dharwad.

28. UNFPA, United Nations Population Fund, india unfpa.org/sites/asiapacific/ files/pub-pdf/JSYConcurrentAssessment

29. S Chaturvedi.journals.plos.org/plosone /articleid= 10.1371 /journal .pone .0096773 May 8, 2014

30. John D. status of Janani Suraksha Yojna in Maharashtra, health action 2008, Jul; 10: 15

31. Centre for operations research and training. Janani Suraksha Yojna in Jharkhand [home page on the internet]. New Delhi: CORT;[updated on Apr 2007 cited on 2006 Jan], http://www.cortindia.com/RP/RP-2007.

32. Polit Denise.F. Beck Cheryl Tatano.Nursing Research.Eight Edition. New Delhi. Wolters Kluwer; 2008

33. Burns Nancy and Grove K. Susan. Understanding Nursing Research: Building evidence based practice.4^thed. New Delhi: Elsevier publishers; 2007

34. Sharma Suresh. K. Nursing Research and Statistics. First Edition. India: Reed Elsevier; 2011. Pg no-145

35. Boswell, Carol, Cannon, Sharon.Nursing Research. First Edition.U.S.A: Jones and Barlett Publishers; 2007

36. Brockopp Dorothy Y, Hastings-Tolsma Marie T. Fundamentals of Nursing Research. Third Edition. U.S.: Jones and Barlett Publishers; 2003.

Received on 28.11.2018 Modified on 29.01.2019

Int. J. Nur. Edu. and Research. 2019; 7(3):344-348.

DOI: 10.5958/2454-2660.2019.00078.4