maternal mortality Govt. of Gujarat launched scheme called Chiranjeevi Yojana ( CY) in Dec. Shortage of obstetricians in rural areas of India. The research. Background The Chiranjeevi Yojana (CY) is a Public-Private-Partnership between the state and private obstetricians in Gujarat, India, since. Effect of Chiranjeevi Yojana on institutional deliveries and neonatal and maternal outcomes in Gujarat, India: a difference-in-differences analysis.

Author: Vikree Mitaur
Country: Central African Republic
Language: English (Spanish)
Genre: Music
Published (Last): 16 November 2013
Pages: 383
PDF File Size: 4.52 Mb
ePub File Size: 6.89 Mb
ISBN: 235-7-71964-730-4
Downloads: 15676
Price: Free* [*Free Regsitration Required]
Uploader: Mukus

Beneficiaries Pregnant women from economically backward families Benefits Financial assistance Rs. Under these circumstances, where the state has a large and growing private health sector, a poorly functioning government sector, and a substantial proportion of the population eligible for social welfare programmes, an innovative scheme to co-opt the private sector to provide delivery care and access to emergency care seemed like a reasonable approach [12].

Chiranjeevi Yojana (CY)

In addition, it yyojana support to the attendant in exchange for lost wages. Some of the obstetricians, mostly in rural areas and currently participating in the scheme, commented that they were pleased that they could provide services free of charge to poor women while they themselves received uojana fees through the scheme.

Recent evidence suggests Chiranjeevi Yojana is failing to attract and retain private doctors, with increasing attrition of obstetricians from the scheme. Can public-private partnerships improve health in India? The proportion of population without any work is marginally higher in district 2 [20].

The payment method and formula encourage providers to reach a certain volume of work, avoid complicated transaction costs, and create a disincentive for unnecessary Caesarian sections. Involving private healthcare providers to reduce maternal mortality in India: In Gujarat, as in other states in India, there is a chronic shortage of chiranneevi in the public sector, and particularly in rural areas of the state [12]. Program Website Government of Gujarat: We continued to interview until no yojjana information was forthcoming, and reached saturation at 24 participants.

In addressing the trust in a public-private partnership, the difficulty lies in achieving the balance between the need for some Page 10 of 13 government control, and the need for trust. Three, time and resources spent attempting to coerce reluctant providers into joining the scheme is wasted, resulting in halfhearted delivery of services. Details of the financial package chieanjeevi the Chiranjeevi scheme 7. Younger obstetricians observed a clear economic benefit to their participation in the scheme, particularly in the early stages of establishing their practice.


The Chiranjeevi Scheme was implemented on a pilot basis in five districts, including Dahod, starting in December Maternal health financing chiranjeevi Gujarat: Nov 5, – state launched a public-private partnership PPP programme, Chidanjeevi Yojana CYunder which the state pays accredited private Page 12 of 13 Received: Improved healthcare-seeking behaviour This scheme encourages chiranjfevi women to deliver in a healthcare facility; for many, it is likely that they have accessed health services at an institution for the first time.

They are also thankful to Mr. As two past participants from rural areas stated: Efforts were made to obtain a sample with a wide range of practitioner characteristics in order to identify what central, shared experiences around participation are common to each group, as well as areas of difference. District profile The population hciranjeevi Dahod was 1, in when the study was implemented. Key program components Under the scheme the government contracts private providers that volunteer to render their services by signing a memorandum of understanding with the district government.

Chiranjivi Yojana

The percentage of deliveries conducted by private doctors was 41 in the case of CB and 32 in the case of NCM deliveries. Their apprehension, that chiranjeevvi class clients a source of major income to them may dislike visiting their facility alongside CY patients, discouraged their participation in the scheme. As an obstetrician who has never participated in the scheme remarked: The Ganguly et al.

There was a clear sense that clinically difficult cases cluster yojanq CY because of the socioeconomic background of the beneficiaries, and this deterred providers from participating. Maternal mortality is an important public-health issue in India, specifically in Gujarat.

Encouraging maternal health service utilization: Transport cash payment to mother. Shortlisted private practicing obstetricians were identified and invited chirannjeevi interview by phone; they were informed of the purpose cjiranjeevi the interview and estimated time required. As our study found in this context, junior doctors starting out in their practice and doctors in rural areas who face less competition for patients find the scheme more suited to their aims and objectives, and are more likely to deliver the scheme satisfactorily.


They said it was common for them to treat poor patients and charge them less. Study participants were qualified obstetricians whose facilities were eligible to participate in the CY scheme able to perform Caesarean sections and transfuse blood. Understanding this could lead to improvements in CY and better design and implementation of future public-private partnerships for widening access to services for underprivileged groups.

In India a lack of access to emergency obstetric care contributes to maternal deaths. We observed that the decision of private obstetricians to either continue or discontinue their enrolment in the CY was greatly influenced by decisions taken by their peer group through the local branch of their professional body FOGSI Federation of Obstetric and Gynaecological Society of India.

Panchayat Department | Chiranjivi yojana

Comprehensive Emergency Obstetric Care; C-section: In countries like India, where health care users face a choice between overstretched public systems or expensive and unregulated private services, successful public-private partnerships could harness the strengths and mitigate deficiencies of each sector.

The retention of private providers is compromised by procedural and remuneration problems, leading providers to perceive chiranjevei as an unprofitable proposition. Hciranjeevi, the evidence suggests that while some state partnerships with non-governmental organisations, voluntary organisations or the private for-profit sector have been successful, evidence remains mixed [].

Indian Institute of Management; High rates of adherence and treatment success in a public and public-private HIV clinic in India: