Exploring the Bottlenecks: An Assessment of the Implementation Process of Janani Suraksha Yojana in the State of West Bengal, India

Introduction: Empirical research reported that Janani Suraksha Yojana (JSY) accomplished the proximate target of increasing institutional delivery. However, discontents existed on the process and other outcomes of the scheme. Methods: To assess the implementation process of JSY in West Bengal, a cross-sectional study was conducted in six districts with population of 29.5 million covering 80 health sub-centers, 12 Primary health centers, 12 community health centers and six district hospitals. Data regarding barriers for utilization were collected through structured interview of the women who delivered within last 12 months. In-depth interviews of health personnel at different levels of government health system and review of relevant records were conducted to assess their awareness as well as flow of fund, record keeping and community-based monitoring of the scheme. Results: Almost universal awareness regarding benefits and conditionality of JSY among beneficiaries and health personnel, flexibility from health institutions for making the process of disbursement more users’ friendly, regular record keeping in cash books are the strengths of this scheme. Delay in disbursement and multiple visits from beneficiaries for receipt of incentive, almost no system of assessing the requirement of fund, inequitable distribution of fund and diversion of fund from other head to meet the expenses of JSY, lack of community-level monitoring of the scheme might potentially affect the success of the scheme. Conclusion: Removal of procedural complexities for beneficiaries, smooth flow of fund based on actual need and community-level monitoring are a few challenges that are to be redressed urgently.