262183 Understanding Women's Perception of Quality and Satisfaction with care: Role of Conditional Cash Transfer Scheme in Promoting Institutional Births

Tuesday, October 30, 2012

Bilal Avan, Dr , Department of Disease Control, London School of Hygiene &Tropical, London, United Kingdom
Sanghita Bhattacharyya, Dr , Public Health, Public Health Foundation of India, New Delhi, India
Aradhana Srivastava, Dr , Research, Public Health foundation of India, New Delhi, India
Half million women die annually due to childbirth and India alone accounts for fifth of global maternal mortality burden. Efforts under health sector reform program to prevent death and morbidity introduced Janani Suraksha Yojana (JSY), conditional cash transfer scheme promoting institutional deliveries. Evaluation studies have acknowledged JSY as effective in generating demand, however, none has touched upon women's perspective on quality of care (QoC) and their level of satisfaction. The paper explores issues around women's perceptions of quality and determinants of care for home and facility births in context of JSY. The study uses qualitative method; in-depth interview, focus group discussion with recently delivered mother, who have delivered in primary level facility and at home, randomly selected around catchment areas of functional facility, in Jharkhand, India. Though cash incentive is instrumental for institutional delivery but other determinants are responsible like: assurance of appropriate medical care for complication, feeling of privacy, comfort at facility due to presence of family members in delivery room, promptness in care. Factors that are deterring utilization of health services are prevalence of informal payment at facility, cultural practice, lack of trust on providers. Lack of birth preparedness and readily available transport is also leading to unexpected homebirths. Women have limited expectations of QoC as seeking pain reduction, fast labor is most desirable, she has no ability to judge hygiene or QoC from clinical perspective. JSY is stimulant in increasing institutional delivery but whether cash incentive schemes themselves a significant facilitator of patient satisfaction needs further exploration.

Learning Areas:
Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Provision of health care to the public
Public health or related research

Learning Objectives:
To evaluate and compare of women's perspective and satisfaction with the health services for maternal care in the context of health sector reforms in India

Keywords: Maternal and Child Health, Health Care Reform

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am leading studies related to MCH issues in several developing countries of the world and at present Senior Lecturer at London School of Hygiene and Tropical Medicine
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
London School of Hygiene and Tropical Medicine Maternal Health Employment (includes retainer)

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.