Mortality impact evaluation of chiranjeevi scheme of government of Gujarat

Abstract

The maternal mortality ratio of Gujarat was 148/100,000 live births in 2009 (SRS, 2011a) and the infant mortality rate 41/1000 live births in 2011 (SRS, 2011b). The government of Gujarat announced Chiranjeevi Yojana in 2005 to reduce maternal and infant mortality. The scheme was pilot tested in five backward districts in the state. In 2007 the scheme was scaled up for the whole state. Under this scheme the state government paid private obstetricians a fixed sum of money to conduct free child birth services to BPL and tribal women. In 2010, Indian Institute Management, Ahmedabad carried out an impact evaluation study by selecting Banaskantha district which was one of the five pilot districts. Four blocks were selected from the district. The study was done in two phases. The first phase of the study collected records of all births, maternal deaths, infant deaths, deaths of women in the reproductive age group (15-49 years) and stillbirths. The study identified 34,375 births, 78 maternal deaths, 609 deaths of women in reproductive age group, 319 still births and 762 neonatal deaths over a two year reference period: May 2008-April 2010. The second phase of the study used case control method in which verbal autopsies were carried out for all identified maternal deaths. Two controls (mothers with complication in child birth and mothers with no complication during child birth) were selected for each maternal death. Verbal autopsies were also carried out for alternate neonatal deaths and stillbirths. One control was selected for each of the neonatal deaths and stillbirths. Results showed that there was reduction in maternal mortality, neonatal mortality and stillbirth for those women who availed the benefit of the scheme compared with the eligible non beneficiaries. However, these results were statistically not significant, due small number of maternal deaths, neonatal deaths and stillbirths collected during our reference period.