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Indian Journal of Obstetrics and Gynecology Research


Awareness and determinants of utilization of “Nischay Yan Scheme” free assured referral transportation services in rural part of West Bengal-India


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Author Details: Amitabha Dan, Bhatnagar Tarun, Achhelal Pasi, M Jalaluddin

Volume : 3

Issue : 1

Online ISSN : 2394-2754

Print ISSN : 2394-2746

Article First Page : 1

Article End Page : 6


Abstract

Background: National Rural Health Mission introduced ‘Nischay Yan’, a free assured referral transport, since 1st April 2011 in Nadia district, West Bengal, India to reduce neonatal mortality rate (NMR). We conducted a cross sectional study to estimate the prevalence of awareness and utilization of the scheme along with factors associated with its use in mothers and to describe the strengths and gaps in the scheme.
Method: A total of 575 mothers of children born between 1st July and 31st December 2011 in 23 clusters were surveyed. Univariate and multivariate logistic regression was done to study the determinants of awareness and utilization of Nischay Yan services.
Result:  Out of 575 mothers, 77.9% were aware of Nischay Yan and knew the number 102.Majority of the mothers (96.9%) got the information from ANM and ASHA. Only 187 of 575 (32.5%) mothers had availed the services of Nischay Yan. Of the187 mothers who availed Nischay Yan, 164 (87.7%) utilized it for delivery and 23(12.2%) for the purpose of neonatal care. ASHA escorted only 42 (22.4%) of 187 mothers. Of the187 mothers who utilized Nischay Yan, 77% availed the ambulance from doorstep and (82.4%) had to wait up to one hour to get the Nischay Yan. Half of 187 mothers reached a facility in two hours. One hundred seventy one (44%) of 388 mothers did not utilize Nischay Yan because of non availability of the ambulance.
On Univariate analysis mothers characteristics such as age (OR=2.9, 95% C.I=1.8 -5.1), living in nuclear family (OR=1.7, 95% C.I=1.03-2.8), Knowing the telephone number102 (OR=43.9,95% C.I=4.7-410.3), Knowing the danger sign for referral of pregnant woman(OR=6.5, 95% C.I=3.01-14.07), having three antenatal check-ups (OR=21.9, 95% C.I=2.2-219.5) and Possessing functioning mobile or landline phone (OR=12.44, 95% C.I=1.3-112.4) were significantly associated with use of Nischay Yan.
Conclusion: Majority of the mothers were aware of Nischay Yan scheme while only one third utilized it. Mothers who knew the number 102 and had functioning telephones were more likely to use Nischay Yan ambulance. Major cause of non use of Nischay Yan was non-availability of ambulance. The ambulance density was adequate as per programme but less as per requirement.

Keywords:
Ambulance, Nischay Yan scheme, Neonatal Mortality, Awareness, Nadia and West Bengal