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      Maternal Healthcare Financing: Gujarat's Chiranjeevi Scheme and Its Beneficiaries

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          Abstract

          Maternal mortality is an important public-health issue in India, specifically in Gujarat. Contributing factors are the Government's inability to operationalize the First Referral Units and to provide an adequate level of skilled birth attendants, especially to the poor. In response, the Gujarat state has developed a unique public-private partnership called the Chiranjeevi Scheme. This scheme focuses on institutional delivery, specifically emergency obstetric care for the poor. The objective of the study was to explore the targeting of the scheme, its coverage, and socioeconomic profile of the beneficiaries and to assess financial protection offered by the scheme, if any, in Dahod, one of the initial pilot districts of Gujarat. A household-level survey of beneficiaries (n=262) and non-users (n=394) indicated that the scheme is well-targeted to the poor but many poor people do not use the services. The beneficiaries saved more than Rs 3,000 (US$ 75) in delivery-related expenses and were generally satisfied with the scheme. The study provided insights on how to improve the scheme further. Such a financing scheme could be replicated in other states and countries to address the cost barrier, especially in areas where high numbers of private specialists are available.

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          Maternal mortality in resource-poor settings: policy barriers to care.

          Maternal mortality remains one of the most daunting public health problems in resource-poor settings, and reductions in maternal mortality have been identified as a prominent component of the United Nations Millennium Development Goals. The World Health Organization estimates that 515000 women die each year from pregnancy-related causes, and almost all of these deaths occur in developing countries. Evidence has shown that access to and utilization of high-quality emergency obstetric care (EmOC) is central to efforts aimed at reducing maternal mortality. We analyzed health care policies that restrict access to life-saving EmOC in most resource-poor settings, focusing on examples from rural India, a country of more than 1 billion people that contributes approximately 20% to 24% of the world's maternal deaths.
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            Meeting MDG-5: an impossible dream?

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              Indian public-private partnership for skilled birth-attendance.

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                Author and article information

                Journal
                J Health Popul Nutr
                JHPN
                Journal of Health, Population, and Nutrition
                International Centre for Diarrhoeal Disease Research, Bangladesh
                1606-0997
                April 2009
                : 27
                : 2
                : 249-258
                Affiliations
                [1] 1 Indian Institute of Management, Vastrapur, Ahmedabad 380 015, India
                [2] 2 Maternal Health Division, Department of Health, Government of Gujarat, India
                Author notes
                Correspondence and reprint requests should be addressed to: Dr. Dileep V. Mavalankar, Professor, Indian Institute of Management, Vastrapur, Ahmedabad 380 015, India, Email: dileep@ 123456iimahd.ernet.in
                Article
                jhpn0027-0249
                10.3329/jhpn.v27i2.3367
                2761781
                19489419
                71a16c19-54ed-4173-bf5b-53cbcf8f6443
                © INTERNATIONAL CENTRE FOR DIARRHOEAL DISEASE RESEARCH, BANGLADESH

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Nutrition & Dietetics
                chiranjeevi scheme,private-public relationship,obstetric care,delivery,india,maternal mortality,emergency obstetric care

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