A Descriptive Study to Assess The Knowledge Among The Antenatal Mothers Regarding Janani Suraksha Yojana In A Selected Hospital of Bhopal, Madhya Pradesh

Abha Narwal¹, Geeta Bhardwaj² , Shyama Devi²

¹Assistant Lecturer, Shaheed Baba Deep Singh College of Nursing, Haryana.

²Nursing Demonstrator/Tutor, College of Nursing, RIMS and R, Saifai, Etawah, U.P.

*Corresponding Author Email: abhanarwal@ymail.com

ABSTRACT:

Background: Janani Suraksha Yojana (JSY) –a new maternity benefit scheme - was launched by Govt. of India in April 2005 with the objective of reducing maternal and neonatal mortality by promoting institutional deliveries by providing cash incentive to beneficiaries. Each year in India, roughly 30 million women experience pregnancy and 27 million have a live birth. Of these, an estimated 1, 36,000 maternal deaths and one million new born deaths occur each year, thus pregnancy-related mortality and morbidity continues to take a huge toll on the lives of Indian women and their new born.

Materials and Methods: A non experimental descriptive study was conducted. A total of 60 ANC registered were interviewed using pre designed questionnaire.

Results: Majority 34 (55.66%) of antenatal mothers had moderate knowledge regarding Janani Suraksha Yojana, 17 (28.34%) had inadequate knowledge and only 9 (15%) had adequate knowledge regarding JSY. The mean for overall knowledge of antenatal mothers was 15.6 (S.D= 3.4).

Conclusion: There is inadequate knowledge regarding JSY among antenatal mothers especially regarding the money packages.

KEY WORDS: Janani Suraksha Yojana, Knowledge, Institutional deliveries, Antenatal mothers.

1. INTRODUCTION:

Women and children are the greatest asset of a nation. Their health is the basis for the better health of the family as a whole and also of the nation¹. India contributes around 20 percent of global births. Each year in India, roughly 30 million women experience pregnancy and 27 million have a live birth. of these, an estimated 1, 36,000 maternal deaths and one million new born deaths occur each year, thus pregnancy-related mortality and morbidity continues to take a huge toll on the lives of Indian women and their new born. These considerations have led to the formulation of specific health services for mother and child in India². In 2005, Government of India launched a new Maternity Benefit Scheme under the National Rural Health Mission (NRHM) viz. Janani Suraksha Yojana (JSY)- (In Hindi Language; Janani= Mother, Suraksha= Protection, Yojana= Scheme). The scheme was being implemented with the objective of reducing maternal and neonatal mortality and promoting institutional delivery particularly among the poor pregnant women. JSY is a 100% centrally sponsored scheme and it integrates cash assistance with antenatal care, delivery and post-delivery care.

According to NRHM Management Information System Report (2012), In Bhopal Infant mortality rate is 50 per 1000 live births. In Bhopal division Maternal Mortality Rate is 287 per 1 lakh live births³. Most of maternal deaths are preventable, if women have available and accessible quality obstetric care in time. The key factors in saving maternal lives are skilled attendant at delivery, access to obstetric care and the existence of an effective referral system. Most of the potentially fatal obstetric complications require the skilled attendant to have the backup of a functioning health care system which is well equipped and having trained obstetrics and gynecology expert. Improved access to comprehensive essential obstetric care can avert 40% of the maternal deaths, appropriate utilization is also necessary⁴.

The poor health of the mother, including diseases that were not adequately treated before or during pregnancy, is often a factor contributing to new born deaths or to babies born too early and/or with low birth weight, which can cause future complications. Governments have a responsibility to ensure that every woman has access to quality maternity care, including prenatal and post-natal services⁵. The government has made it crucial part of its health delivery effort through Janani Suraksha Yojana. JSY initiated in April 2005 has the aspect of financial support and a new band of personnel being part of strategy. Even though government provides free of cost services to the citizens, but they are not utilizing these services up to the mark. As of date, systematic evaluations have not been undertaken.

TABLE 1:- JSY Payment Packages as recommended by Government of India

Category	Rural area		Total	Urban area		Total
Category	Mother’s Package	ASHA`s Package	Rs.	Mother’s Package	ASHA`s Package	Rs.
LPS	1,400	600	2,000	1,000	200	1,200
NE states (expect Assam) and rural areas of tribal district of other states	700	600	1,300	600	200	800
Others	700	NIL	700	600	NIL	600

Evaluation studies will help us know whether the programme is moving in the right direction and indicates required changes for betterment. Hence the Researcher felt to assess the knowledge and attitude among antenatal mothers regarding JSY. The present study is a pioneering attempt in this direction.

OBJECTIVES:

It was intended to assess the knowledge of antenatal mothers regarding Janani Suraksha Yojana and to find out association between knowledge of antenatal mothers regarding Janani Suraksha Yojana with selected demographic variables.

METHODS AND MATERIALS:

A non- experimental, Descriptive design was adopted. Purposive sampling technique was used to select 60 samples based on certain pre- determined criteria. The data generated by using investigator developed structured interview schedule, content validity of investigator developed tool was obtained from experts of related departments. The antenatal mothers knowledge was assessed by using investigator developed questionnaire. The methods used to estimate reliability of the tools in the study was Split-half method and Cronbach Alpha. Pilot study was conducted on 10 antenatal mothers with constructed tool with which it was found reliable respectively. Sample was selected using non probability sampling techniques

RESULT:

TABLE-1:- Frequency and Percentage of level of knowledge of antenatal mothers regarding Janani Suraksha Yojana N=60

Level of Knowledge	Frequency	Percentage
≤50%	17	28.34
51-74%	34	56.66
≥75%	9	15
Total	60	100

The present study depicts that majority 34 (56.6%) of antenatal mothers had moderate knowledge regarding Janani Suraksha Yojana, 17 (28.34%) had inadequate knowledge and only 9 (15%) had adequate knowledge regarding Janani Suraksha Yojana.

TABLE-2:-Mean, Standard Deviation and mean percentage of knowledge of antenatal mothers regarding Janani Suraksha Yojana N=60

Knowledge	Max Score	Mean	Standard Deviation	Mean %
Implementation	5	3.55	0.75	71%
Health Services	5	2.93	1.148	58.6%
Money Package	8	3.55	1.23	44.3%
ASHA worker	8	5.58	1.74	69.7%
Overall Knowledge	26	15.61	3.4	60%

· The present study represents Mean, Standard deviation and Mean percentage of aspects of Knowledge of antenatal mothers. It reveals that the subjects had a maximum mean of 3.55 with a standard deviation 0.75 and mean percentage 71% regarding implementation of Janani Suraksha Yojana.

· The Mean score of 2.93 with a standard deviation 1.14 and mean percentage 58.6% regarding Health services offered by JSY.

· The subjects obtained mean sore of 3.55, with a standard deviation of 1.23 and mean percentage 44.3% regarding money package under JSY.

· The subjects obtained maximum sore of 5.58 with Standard deviation1.74 and mean percentage of 69.7% regarding role of ASHA worker in JSY.

The present study represents the association between selected demographic variables and knowledge among antenatal mothers regarding Janani Suraksha Yojana. In relation to variables education, Family income per Month and Source of information , Chi-Square value obtained was 15.13, 9.33, and 9.16 respectively, which showed significance at P<0.05. This denotes that there is significant association between levels of knowledge with that of variables like education, Family income per Month and Source of information. In relation to variables, Age, Occupation, Religion and No. of Children, the Chi-square obtained was 2.47, 0.63, 1.58 and 3.28 respectively, which does not show any significance with the level of knowledge and hence there is no significant association with level of knowledge with selected demographic variables like Age, Occupation, Religion and No. of Children.

Table 3: Association between selected demographic variables and the knowledge of antenatal mothers regarding Janani Suraksha Yojana. N=60

Sample characteristics	Below Median	Above median	Chi-square	df	P Value
1. Age
≤ 18 years	0	2	2.47	2	0.29 NS
19-25 years	14	26
26-44 years	9	9
45 and above	0	0
2. Education
Illiterate	4	2	15.13	3	0.0017* S
Primary Education	15	10
Secondary Education	4	18
Graduate & PG	0	7
3. Occupation
Housewife	16	29	0.63	2	0.729 NS
Daily wager/laborer	03	03
Private	04	05
Govt.	0	0
4. Religion
Hindu	12	24	1.58	2	0.453 NS
Muslim	9	12
Christian	3	1
Others	0	0
5.No. of children
None	7	18	3.28	2	0.194 NS
1	12	17
2	4	2
3 or more	0	0
6.Family income per month
Rs. 3249-5414/-	10	6	9.33	3	0.025* S
Rs. 5415-8121/-	5	17
Rs. 8122-10829/-	2	9
Rs.10830- 21659	6	5
7. Source of information
ASHA or any Health personnel	9	5	9.16	3	0.027* S
Doctor	3	3
Relatives, neighbors or other users of JSY	6	7
Mass Media	5	22

CONCLUSION:

· Majority of the antenatal mothers had inadequate knowledge with regard to money packages under Janani Suraksha Yojana.

· There was a positive correlation between knowledge and some variables among antenatal mothers regarding Janani Suraksha Yojana.

This study reveals that there is inadequate knowledge regarding Janani Suraksha Yojana among antenatal mothers. Hence the individual in community could be given health education repeatedly.

RECOMMENDATIONS:

1. A comparative study can be done between rural and urban antenatal mothers.

2. A comparative study could be done to assess the knowledge and attitude of housewives and working mothers regarding Janani Suraksha Yojana.

3. An experimental study can be done using self instructional module to improve the knowledge of mothers.

IMPLICATIONS:

The study has major implications for nursing practice, Nursing Education, Nursing Administration, Nursing Research and Public education.

ETHICAL CLEARANCE:

All administrative permission from ethical committee of Institute was taken. Informed written consents were taken from participants before data collection.

REFERENCES :

1. Abbad A, Roy J, Sahu K.B. Maternal and child health care. The journal of Family Welfare. 52 (1); 2006.

2. Narayanan Devadasan. Maya Annie Elias. A conditional cash assistance programme for promoting institutional deliveries among the poor in India: process evaluation results. Ethno-med2008; 2(1): 278-279.

3. All India Summary of NRHM Program : MIS Report as on 31-03-2012; 2012

4. Amarjit Singh. Private Public Partnership: A solution to Maternal Maternity. The Journal of Family Welfare. 52; 2006.

5. Khan M.E, Avishekh hazra. Impact of JSY on selected family health behaviors in rural India. Family Health journal. 56(1); 2010:12-15.

6. Paul, V.K., H. S. Sachdev, D. Mavalankar, P. Ramachandran, M. J. Sankar, N. Bhandari, V. Shreenivas, et al. Reproductive health and child health and nutrition in India meeting the challenge. Lancet. 377(9762); 2011: 332-349.

7. Why make every mother and child count? Health Action. 18(4); 2005: 4-5.

8. United Nations. Millennium Development Goals. Available at: http://www.un.org/millenniumgoals/2007.

9. Sample Registration System Office of Registrar General, India. Special Bulletin on Maternal Mortality in India 2007-09. Available from URL: http://www.censusindia.gov.in/vital_statisitcs/SRS_Bulletins/Final-MMR%20Bulletin-2007-09_070711.pdf. [Accessed on Jan 5, 2012]

Received on 19.02.2016 Modified on 05.04.2016

Asian J. Nur. Edu. and Research. 2016; 6(3): 377-380

DOI: 10.5958/2349-2996.2016.00070.7