Janani Suraksha Yojana (JSY) & Janani Shishu Suraksha Karyakram (JSSK)
JSY, launched on 12 April 2005, is a conditional cash transfer scheme to promote institutional delivery among pregnant women from BPL and marginalised households. JSSK, launched on 1 June 2011, expanded the entitlement to free and zero-expense delivery, free transport, and free treatment for sick newborns. Together, these schemes have driven India's institutional delivery rate from 39% (NFHS-3, 2005-06) to 89% (NFHS-5, 2019-21).
JSY is a centrally sponsored scheme launched on 12 April 2005 under the National Rural Health Mission (now NHM). It integrates cash assistance with antenatal care and institutional delivery. The scheme categorises states into High Performing States (HPS) (8 Empowered Action Group states plus Jammu & Kashmir, Himachal Pradesh, Uttarakhand, and the North-Eastern states) and Low Performing States (LPS) (the rest of India). Cash assistance differs by category:
| Beneficiary | HPS (Rs) | LPS (Rs) |
|---|---|---|
| Rural mother (1st live birth, BPL/Scheduled Caste/Scheduled Tribe) | 1,400 | 1,700 |
| Urban mother (1st live birth, BPL/SC/ST) | 1,000 | 1,400 |
| ASHA for bringing mother to facility | 600 (rural) / 400 (urban) | 600 (rural) / 400 (urban) |
Cash is paid to the mother through Direct Benefit Transfer to her Aadhaar-linked bank account, ideally within 7 days of delivery but in practice often delayed. ASHA's incentive is for escorting the mother, providing postnatal visits, and ensuring newborn registration.
JSSK, launched on 1 June 2011, complements JSY by providing free and cashless services to pregnant women and sick newborns. The four key entitlements under JSSK:
- Free and zero-expense delivery: Including C-section — no charges for drugs, consumables, diagnostics, diet during stay, or blood transfusion
- Free transport: From home to health institution, between facilities in case of referral, and from institution back to home — through Janani Express / 102 / 108 ambulance services
- Free screening and treatment for complications during pregnancy: Including management of preeclampsia, eclampsia, haemorrhage, sepsis
- Free treatment for sick newborns (up to 30 days): Including NICU care, phototherapy, surfactant, ventilation, and treatment of birth asphyxia
JSSK eliminates user fees that previously pushed 7% of Indian families into poverty each year due to out-of-pocket health expenditure on maternal and newborn care. JSSK is universal — not restricted by BPL status or parity.
JSY eligibility differs from JSSK eligibility:
- JSY (cash): BPL-certified women aged 19 years and above, up to 2 live births. SC/ST women are automatically eligible. In LPS states, all women from rural areas are eligible; in urban areas, BPL certification is required.
- JSSK (free services): Universal — every pregnant woman delivering at a public health facility and every sick newborn up to 30 days is entitled to the free entitlements, regardless of income, caste, parity, or age.
The 'up to 2 live births' restriction in JSY was removed in 2018 for Low Performing States but retained in High Performing States to discourage higher-order births. JSSK has no parity limit.
| Feature | JSY | JSSK |
|---|---|---|
| Year launched | 2005 | 2011 |
| Type | Cash transfer (DBT) | Free services at facility |
| Eligibility | BPL/SC/ST women ≥ 19 yrs, up to 2 live births | All pregnant women & sick newborns (universal) |
| Benefit | Rs 1,400-1,700 in rural; Rs 1,000-1,400 in urban | Free delivery, C-section, drugs, diagnostics, transport, NICU |
| Parity limit | Yes (2 live births) | No |
| Income criteria | BPL in LPS urban areas; SC/ST automatic | None |
| Mode of payment | DBT to mother's bank account | Direct facility-level service delivery |
According to NFHS-5 (2019-21), institutional delivery in India reached 88.6% — up from 38.7% in NFHS-3 (2005-06) when JSY was just launched. In rural areas, the rise was even more dramatic: from 31% to 87%. C-section rates also rose, raising concerns about over-medicalisation, especially in private facilities where C-section rates exceed 40% in some southern states.
MMR declined from 254 (2004-06) to 97 (2018-20) per lakh live births over the JSY/JSSK era. While sanitation, female education, and broader health system strengthening also contributed, the JSY/JSSK combination of cash incentive plus zero-expense delivery is widely credited as the single largest driver. Reference: NHM JSY page and NFHS-5 report.
JSY and JSSK together reshaped Indian maternal health financing by replacing out-of-pocket payments with cash transfer plus zero-expense service delivery. For UPSC CMS aspirants, the cash amounts, the HPS/LPS distinction, and the four JSSK entitlements are extremely high-yield PSM topics.