比较简尼萨拉克沙亚约纳（JSY）和增强型阿罗格亚拉克希米计划（ALS）在改善印度南部海得拉巴城市住区母婴健康结果的作用。

Comparison of Janani Suraksha Yojana (JSY) and augmented Arogya Laxmi scheme (ALS) in improving maternal and child health outcomes in urban settlements of Hyderabad, South India.

机构信息

Clinical Epidemiology Division, Indian Council of Medical Research-National Institute of Nutrition (ICMR-NIN), Hyderabad, India.

Maternal and Child Health, Nutrition Division, Indian Council of Medical Research-National Institute of Nutrition (ICMR-NIN), Hyderabad, India.

出版信息

BMC Pregnancy Childbirth. 2024 Mar 8;24(1):188. doi: 10.1186/s12884-024-06381-7.

DOI:10.1186/s12884-024-06381-7

PMID:38459455

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10921561/

Abstract

BACKGROUND

India accounts for the largest number of global neonatal deaths with around 20 per 1000 live births. To improve the utilization of government services for institutional deliveries, Augmented Arogya Laxmi Scheme (ALS) was launched in Telangana state of southern India. This study assessed the effectiveness of the Janani Suraksha Yojana (JSY), which combines cash assistance with delivery and post-delivery care, in comparison to ALS in improving the outcomes related to antenatal, natal, and postnatal care in urban settlements of Hyderabad, Telangana, southern India.

METHODS

This was a two-year cross-sectional study conducted in 14 urban settlements of Hyderabad city from September 2017- August 2019. All mothers delivered during the 18 months preceding the survey were enrolled after a written informed consent. Field investigators collected data on variables related to socio-demographic characteristics, awareness, and utilization of JSY and ALS programs. Variables related to antenatal history, antenatal care, complications during birth, delivery outcomes, newborn care, and postnatal care till 28 days were assessed. We used multivariable logistic regression model to examine the association between the different maternal, child, and socio-demographic characteristics of the two study groups.

RESULTS

A total of 926 mothers were beneficiaries of Janani Suraksha Yojana (JSY) program while 933 mothers were beneficiaries of augmented Arogya Laxmi Scheme (ALS). Mothers in ALS group (AOR 1.71; 95% CI 1.21-2.43) were at increased odds of having more than eight antenatal care (ANC) visits compared to the mothers availing JSY. Mothers in ALS group were at decreased odds of having complications like severe pain in the abdomen (AOR 0.43; 95% CI 0.22-0.86), swelling of legs or feet (AOR 0.59; 95% CI 0.44-0.80) compared to mothers in JSY group. Children of mothers in the ALS group had increased odds of receiving breastfeeding within 30 minutes of birth (AOR 1.46; 95% CI 1.13-1.88) compared to children of mothers in JSY group.

CONCLUSIONS

The newly launched augmented ALS led to the increased utilization of the government health facilities and improved the maternal and child health outcomes.

摘要

背景

印度的全球新生儿死亡人数最多，每 1000 例活产中有 20 例。为了提高对机构分娩政府服务的利用，印度南部特伦甘纳邦推出了增强型 Arogya Laxmi 计划（ALS）。本研究评估了 Janani Suraksha Yojana（JSY）的效果，该计划将现金援助与分娩和产后护理相结合，与 ALS 相比，在改善印度南部海得拉巴市的城市住区的产前、分娩和产后护理结果方面的效果。

方法

这是一项为期两年的横断面研究，于 2017 年 9 月至 2019 年 8 月在海得拉巴市的 14 个城市住区进行。所有在调查前 18 个月分娩的母亲在书面知情同意后都被纳入研究。现场调查员收集了与 JSY 和 ALS 计划的意识和利用相关的社会人口统计学特征、意识和利用等变量的数据。评估了与产前史、产前护理、分娩期间并发症、分娩结果、新生儿护理和产后 28 天内护理相关的变量。我们使用多变量逻辑回归模型来检查两个研究组的不同产妇、儿童和社会人口统计学特征之间的关联。

结果

共有 926 名母亲是 Janani Suraksha Yojana（JSY）计划的受益者，933 名母亲是增强型 Arogya Laxmi 计划（ALS）的受益者。与 JSY 相比，ALS 组的母亲（AOR 1.71；95%CI 1.21-2.43）有更多的八次以上产前护理（ANC）就诊的可能性更高。与 JSY 组相比，ALS 组的母亲发生严重腹痛（AOR 0.43；95%CI 0.22-0.86）、腿部或脚部肿胀（AOR 0.59；95%CI 0.44-0.80）等并发症的可能性较低。与 JSY 组的母亲相比，ALS 组的儿童有更高的可能性在出生后 30 分钟内进行母乳喂养（AOR 1.46；95%CI 1.13-1.88）。