1. National Maternity Benefit Scheme

2. Some facts Global: 529,000/year (400/100,000 births) 1 death every minute Lifetime risk: 1/50 30-100 morbidities / death India: 102,000/year (408/100,000 births) Rural: 619/100,000 births Overall: 1 death every 5 minutes MP: about 11,000/year – 1 death every hour (498/100,000 births) Source: Global: WHO, UNICEF, UNFPA, 2000; India: SRS, 1997; MP: NFHS, 1998-99

3. Some More Facts in Indian Context  MMR estimates: 437 to > 600  This means from 112,000 to 150,000 deaths per year  Or more than 1 per five minutes  And it means that 20% of all maternal deaths in the world are here!

4. When do maternal deaths occur?

5. Basics The scheme was launched on 15 th August 1995. as a part of NSAP and later transferred to the Health Ministry in the year 2001. as a part of NSAP and later transferred to the Health Ministry in the year 2001. Under NMBS, pregnant women,above 19 years,from BPL families were entitled to lump-sum cash assistance of Rs. 500, up to two live births, 8–12 weeks before delivery. Under NMBS, pregnant women,above 19 years,from BPL families were entitled to lump-sum cash assistance of Rs. 500, up to two live births, 8–12 weeks before delivery.

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

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

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

9. Supreme court orders NMBS should not be restricted or discontinued in any way. It sould be ensure that the BPL pregnant women get cash assistance 8-12 weeks prior to the delivery. It sould be ensure that the BPL pregnant women get cash assistance 8-12 weeks prior to the delivery. The amount shall be Rs 500 per birth irrespective of number of children and the age of the women. NOTE- the NMBS was merged into the Janani suraksha yojana (scheme for promoting institutional deliveries.) as a result many women who are eligible for NMBS and had a home delivery were not getting benefit. But according to SC order 20 November 07 clarified that NMBS must continue.

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

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

12. Find out what is happening In your area regarding the implementation of SC order. Surveys and informal enquires can be done for understanding the situation. Involve the AWW, ANM, ASHA,MPW, gram sabha and all concerned persons of the village in the enforcement of SC orders. 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 case of no responses approach to collector because collector is bound to register your complaint under the SC order. The public hearing is one of the good option to draw attention of the public as well as the government. If no action was taken on your complaint move to the advisor of the SC. Redressal mechanism