Introduction
Although India has made significant progress in Iinstitutional delivery after the implementation of National Rural Health Mission under which the Janani SurakshaYojna (JSY) is a sub-programme which played a vital role in the increase of institutional delivery in public facilties. However, a huge gap still, persists in terms of coverage and utilization of the JSY scheme, not only across socio-economic groups but also at district level in India. Therefore, this paper aims to provide an understanding of the JSY coverage at the district level in India. further, it tries to carve out the factors responsible for regional disparity of JSY coverage at district levels.
Mehtods
The study used the fourth round of National Family Health Survey data and restricts sample size (n=148,145) to the women aged 15-49 years who gave recent birth in the institution during five years preceding the survey. Bivariate and multivariate regression analysis wasused to fulfill the study objectives. Additionally, Moran’s I statistics and bivariate Local Indicator for Spatial Association (LISA) maps were used to understand spatial dependence and clustering of JSY coverage. Ordianry least square, spatial lag and spatial error models were used to examine the correlates of JSY utilization.
Results
The value of spatial-autocorrelation for JSY was 0.71 which depicts high dependence of the JSY coverage over districts of India. The overall coverage of JSY in India is 36.4% and it highly varied across different regions, districts, and even socioeconomic groups. The spatial error model depicts that if in a district the women with no schooling status increase by 10% than the benefits of JSY get increased by 2.3%. Similarly, if in a district the women from poor wealth quintile increases by 10% the benefits of JSY also increased by 4.6%. However coverage of JSY made greater imperative to understand it due to its clustering among distrcits of specific states only.
Conclusion
It is well reflected in the EAGs states in terms of spatial-inequality in service coverage. There is aneed to universalize the JSY programme at a very individual level. And, it is required to revisit the policy strategy and the implementation plans at regional or district levels.