Health, Nutrition and Population Global Practice

• In 2005, one in every five maternal deaths and one in every three neonatal deaths worldwide occurred in India. Although the maternal mortality ratio (MMR) is declining, India is not on track to achieve related Millennium Development Goal (MDG). • Differences in reproductive health outcomes exist across states and regions and by income and social groups. Disparities stem from supply and demand issues. In 2005, the government launched the National Rural Health Mission (NRHM) to improve maternal and infant mortality rates. • The Janani Suraksha Yojana (JSY)—the world's largest conditional cash transfer (CCT) program for poor pregnant women—aims to increase institutional deliveries by reducing financial barriers to access and to narrow disparities by targeting weaker states and the poor. • Institutional deliveries have doubled in low-performing states and so has skilled birth attendance for socially disadvantaged groups. • Obstetric services, 24/7 primary health centers (PHCs), and first referral units are more widely available. • The key lessons from the JSY program include: fine-tuning supply-side inputs based on local needs; focusing continuously on quality improvements; providing a package of reproductive and child health (RCH) services in addition to safe delivery; and constantly monitoring and evaluating the equity program’s impact