National Maternity Benefit National Maternity Benefit SchemeScheme

Some facts Some facts

Global: 529,000/year (400/100,000 Global: 529,000/year (400/100,000 births)births)

1 death every minute1 death every minuteLifetime risk: 1/50Lifetime risk: 1/5030-100 morbidities / death30-100 morbidities / death

India: 102,000/year (408/100,000 births)India: 102,000/year (408/100,000 births)Rural: 619/100,000 birthsRural: 619/100,000 birthsOverall: 1 death every 5 minutesOverall: 1 death every 5 minutesMP: about 11,000/year – 1 death MP: about 11,000/year – 1 death every hour (498/100,000 births)every hour (498/100,000 births)

Source: Global: WHO, UNICEF, UNFPA, 2000; India: SRS, 1997; MP: NFHS, 1998-99Source: Global: WHO, UNICEF, UNFPA, 2000; India: SRS, 1997; MP: NFHS, 1998-99

Some More Facts in Indian ContextSome More Facts in Indian Context

MMR estimates: 437 to > 600MMR estimates: 437 to > 600

This means from 112,000 to 150,000 This means from 112,000 to 150,000 deaths per yeardeaths per year

Or more than 1 per five minutesOr more than 1 per five minutes

And it means that 20% of all maternal And it means that 20% of all maternal deaths in the world are here!deaths in the world are here!

When do maternal deaths occur? When do maternal deaths occur?

25%

50%

20%

5%

During Pregnancy

Within 24 hrs ofdelivery2-7 days afterdelivery2-6 weeks afterdelivery

BasicsBasicsThe scheme was launched on 15The scheme was launched on 15thth August 1995. August 1995.

as a part of NSAP and later transferred to the as a part of NSAP and later transferred to the Health Ministry in the year 2001.Health Ministry in the year 2001.

Under NMBS, pregnant women ,above 19 Under NMBS, pregnant women ,above 19 years ,from BPL families were entitled to years ,from BPL families were entitled to lump-sum cash assistance of Rs. 500, up to lump-sum cash assistance of Rs. 500, up to two live births, 8two live births, 8––12 weeks before delivery.12 weeks before delivery.

JSY…JSY…

The National Maternity Benefit Scheme was The National Maternity Benefit Scheme was modified into a new scheme called Janani modified into a new scheme called Janani Suraksha Yojana (JSY) and launched w.e.f 12th Suraksha Yojana (JSY) and launched w.e.f 12th April, 2005.April, 2005.The objectives of the JSY are reducing maternal The objectives of the JSY are reducing maternal mortality/infant mortality through increased mortality/infant mortality through increased delivery at health institutions while the focus of delivery at health institutions while the focus of the NMBS was provision of maternity benefits.the NMBS was provision of maternity benefits.The guidelines did not retain the objective of The guidelines did not retain the objective of ensuring food security for all pregnant BPL ensuring food security for all pregnant BPL women unencumbered by any other women unencumbered by any other conditionalities.conditionalities.

Effect on home deliveriesEffect on home deliveries

Calculations in the Sixth Report of the Calculations in the Sixth Report of the Commissioners showed that on an Commissioners showed that on an average nearly 65.5% of the eligible average nearly 65.5% of the eligible beneficiaries under NMBS would get zero beneficiaries under NMBS would get zero direct cash assistance under JSY, direct cash assistance under JSY, because they would be debarred by the because they would be debarred by the eligibility requirements introduced by JSY.eligibility requirements introduced by JSY.

In response to the intervention by the Commissioners, a In response to the intervention by the Commissioners, a letter communicating the following modifications to the letter communicating the following modifications to the

Janani Suraksha Yojana was sent to the CommissionersJanani Suraksha Yojana was sent to the Commissioners

Rs. 500/- will be paid to all pregnant eligible BPL women Rs. 500/- will be paid to all pregnant eligible BPL women irrespective of place of delivery under JSY and also it is irrespective of place of delivery under JSY and also it is not mandatory that the benefits are given only after ante-not mandatory that the benefits are given only after ante-natal check upsnatal check ups..Women who have institutional delivery will be paid a Women who have institutional delivery will be paid a higher amount.higher amount.In low performing states, the age bar and restriction of In low performing states, the age bar and restriction of number of births for which assistance is provided under number of births for which assistance is provided under NMBS, have been removed. For institutional delivery NMBS, have been removed. For institutional delivery BPL criteria has been removed.BPL criteria has been removed.Given the frequent changes and low priority of the Given the frequent changes and low priority of the scheme to many state governments, the scheme had scheme to many state governments, the scheme had become almost non-functional in many states become almost non-functional in many states

Supreme court ordersSupreme court orders

NMBS should not be restricted or discontinued NMBS should not be restricted or discontinued in any way.in any way. It sould be ensure that the BPL pregnant It sould be ensure that the BPL pregnant women get cash assistance 8-12 weeks prior women get cash assistance 8-12 weeks prior to the delivery.to the delivery.The amount shall be Rs 500 per birth The amount shall be Rs 500 per birth irrespective of number of children and the age irrespective of number of children and the age of the women.of the women.

NOTE- NOTE- the NMBS was merged into the Janani the NMBS was merged into the Janani suraksha yojana (scheme for promoting suraksha yojana (scheme for promoting institutional deliveries.) as a result many institutional deliveries.) as a result many women who are eligible for NMBS and had a women who are eligible for NMBS and had a home delivery were not getting benefit. But home delivery were not getting benefit. But according to SC order 20 November 07 according to SC order 20 November 07 clarified that NMBS must continue.clarified that NMBS must continue.

What to check?What to check?Do Women of BPL families get the Benefit of NMBS.Do Women of BPL families get the Benefit of NMBS.Do all beneficiaries get Rs 500.Do all beneficiaries get Rs 500.Did they get it 8-12 weeks prior to delivery.Did they get it 8-12 weeks prior to delivery.If not when did they get the benefit.If not when did they get the benefit.Did the beneficiaries complain that they have to pay Did the beneficiaries complain that they have to pay bribes to receive the benefit.bribes to receive the benefit.Is the time taken to sanction of benefit after Is the time taken to sanction of benefit after submitting the application too long?submitting the application too long?Who disburse the cash assistance to the beneficiary.Who disburse the cash assistance to the beneficiary.Is the gram sabha is involved in identifying the Is the gram sabha is involved in identifying the beneficiaries?beneficiaries?If yes than the people who have been recommended If yes than the people who have been recommended by the gram sabha received the benefit?by the gram sabha received the benefit?List out the people who are eligible but didn’t received List out the people who are eligible but didn’t received the benefitsthe benefits

IssuesIssuesHealth facility is out of reach for far off groups. Health facility is out of reach for far off groups. Ineffective fund disbursal system Ineffective fund disbursal system Involvement of gram Panchayat and other stakeholders.Involvement of gram Panchayat and other stakeholders.BPL CertificationBPL CertificationLow cash Assistance Low cash Assistance Tendency of the govt. to link with Family planning etc.Tendency of the govt. to link with Family planning etc.

Find out what is happening In your area regarding the Find out what is happening In your area regarding the implementation of SC order.implementation of SC order.Surveys and informal enquires can be done for Surveys and informal enquires can be done for understanding the situation.understanding the situation.Involve the AWW, ANM, ASHA,MPW, gram sabha and all Involve the AWW, ANM, ASHA,MPW, gram sabha and all concerned persons of the village in the enforcement of SC concerned persons of the village in the enforcement of SC orders.orders.In case of any violation of the SC order starts at local level.In case of any violation of the SC order starts at local level.If it does not work try to approach the concerned officers.If it does not work try to approach the concerned officers.If case of no responses approach to collector because If case of no responses approach to collector because collector is bound to register your complaint under the SC collector is bound to register your complaint under the SC order.order.The public hearing is one of the good option to draw The public hearing is one of the good option to draw attention of the public as well as the government.attention of the public as well as the government.If no action was taken on your complaint move to the advisor If no action was taken on your complaint move to the advisor of the SC.of the SC.

Redressal mechanismRedressal mechanism