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India's Janani Suraksha Yojana, a conditional cash transfer programme to increase births in health facilities: an impact evaluation
In 2005, with the goal of reducing the numbers of maternal and neonatal deaths, the Government of India launched Janani Suraksha Yojana (JSY), a conditional cash transfer scheme, to incentivise women to give birth in a health facility. We independently assessed the effect of JSY on intervention coverage and health outcomes.
We used data from the nationwide district-level household surveys done in 2002–04 and 2007–09 to assess receipt of financial assistance from JSY as a function of socioeconomic and demographic characteristics; and used three analytical approaches (matching, with-versus-without comparison, and differences in differences) to assess the effect of JSY on antenatal care, in-facility births, and perinatal, neonatal, and maternal deaths.
Implementation of JSY in 2007–08 was highly variable by state—from less than 5% to 44% of women giving birth receiving cash payments from JSY. The poorest and least educated women did not always have the highest odds of receiving JSY payments. JSY had a significant effect on increasing antenatal care and in-facility births. In the matching analysis, JSY payment was associated with a reduction of 3·7 (95% CI 2·2–5·2) perinatal deaths per 1000 pregnancies and 2·3 (0·9–3·7) neonatal deaths per 1000 livebirths. In the with-versus-without comparison, the reductions were 4·1 (2·5–5·7) perinatal deaths per 1000 pregnancies and 2·4 (0·7–4·1) neonatal deaths per 1000 livebirths.
The findings of this assessment are encouraging, but they also emphasise the need for improved targeting of the poorest women and attention to quality of obstetric care in health facilities. Continued independent monitoring and evaluations are important to measure the effect of JSY as financial and political commitment to the programme intensifies.
Bill & Melinda Gates Foundation.
Journal Article
A flying start? Maternity leave benefits and long-run outcomes of children
We study a change in maternity leave entitlements in Norway. Mothers giving birth before July 1, 1977, were eligible for 12 weeks of unpaid leave, while those giving birth after that date were entitled to 4 months of paid leave and 12 months of unpaid leave. The increased time spent with the child led to a 2 percentage point decline in high school dropout rates and a 5 percent increase in wages at age 30. These effects were larger for the children of mothers who, in the absence of the reform, would have taken very low levels of unpaid leave.
Journal Article
Expansions in Maternity Leave Coverage and Mothers’ Labor Market Outcomes after Childbirth
This article analyzes the impact of five major expansions in maternity leave coverage in Germany on mothers’ labor market outcomes after childbirth. To identify the causal impact of the reforms, we use a difference-in-difference design that compares labor market outcomes of mothers who give birth shortly before and shortly after a change in maternity leave legislation in years of policy changes and years when no changes have taken place. Each expansion in leave coverage reduced mothers’ postbirth employment rates in the short run. The longer-run effects of the expansions on mothers’ postbirth labor market outcomes are, however, small.
Journal Article
WHAT IS THE CASE FOR PAID MATERNITY LEAVE?
We assess the case for generous government-funded maternity leave, focusing on a series of policy reforms in Norway that expanded paid leave from 18 to 35 weeks. We find the reforms do not crowd out unpaid leave and that mothers spend more time at home without a reduction in family income. The increased maternity leave has little effect on children's schooling, parental earnings and labor force participation, completed fertility, marriage, or divorce. The expansions, whose net costs amounted to 0.25% of GDP, have negative redistribution properties and imply a considerable increases in taxes at a cost to economic efficiency.
Journal Article
Don't forget to scream : unspoken truths about motherhood
Like grief or falling in love, becoming a mother is an experience both ordinary and transformative. You are prepared for the sleeplessness and wonder, the noise and the chaos, the pram in the hall. But the extent to which this new life can turn your inner world upside-down - nothing prepares you for that. In this frank, funny and fearless memoir, Marianne Levy writes with heart-wrenching honesty about love and loss, rage and pain, fear and joy. She breaks the silence around the emotional turmoil that having a child can unleash and asks why motherhood is at once so venerated and so undervalued -- Source other than Library of Congress.
Book
Providers’ perceptions of disrespect and abuse during childbirth: a mixed-methods study in Kenya
Abstract
Disrespect and abuse during childbirth are violations of women’s human rights and an indicator of poor-quality care. Disrespect and abuse during childbirth are widespread, yet data on providers’ perspectives on the topic are limited. We examined providers’ perspectives on the frequency and drivers of disrespect and abuse during facility-based childbirth in a rural county in Kenya. We used data from a mixed-methods study in a rural county in Western Kenya with 49 maternity providers (32 clinical and 17 non-clinical) in 2016. Providers were asked structured questions on disrespect and abuse, followed by open-ended questions on why certain behaviours were exhibited (or not). Most providers reported that women were often treated with dignity and respect. However, 53% of providers reported ever observing other providers verbally abuse women and 45% reported doing so themselves. Observation of physical abuse was reported by 37% of providers while 35% reported doing so themselves. Drivers of disrespect and abuse included perceptions of women being difficult, stress and burnout, facility culture and lack of accountability, poor facility infrastructure and lack of medicines and supplies, and provider attitudes. Provider bias, training and women’s empowerment influenced how different women were treated. We conclude that disrespect and abuse are driven by difficult situations in a health system coupled with a facilitating sociocultural environment. Providers resorted to disrespect and abuse as a means of gaining compliance when they were stressed and feeling helpless. Interventions to address disrespect and abuse need to tackle the multiplicity of contributing factors. These should include empowering providers to deal with difficult situations, develop positive coping mechanisms for stress and address their biases. We also need to change the culture in facilities and strengthen the health systems to address the system-level stressors.
Journal Article