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Table 1 Themes and subthemes categorized as barriers and remedial measures for India’s Janani Suraksha Yojana program

From: Barriers and prospects of India’s conditional cash transfer program to promote institutional delivery care: a qualitative analysis of the supply-side perspectives

Themes Subthemes Categories
At the health facility level
(Receipt of adequate healthcare)
Inability to manage birth complications
Referrals to private institutions
Insufficient healthcare personnel, medicine, equipment, distribution of resources
Vertical program structures and standalone nature of MCH program components
Barriers
Budgetary revisions to increase efficiency
Greater oversight to ensure availability of equipment, medicine, and medical staff
Employing more staff
Introducing feedback and review system
Building intra and inter program linkages
Remedial measures
Linkages between home and health-facility
(Timely transfer to health-facilities once the decision to seek health-facilities was reached)
Limited availability of drivers and vehicles
Delays in transport arrival
High cost of alternative transport
Poor quality of roads
Inadequate understanding and poor attitude/ behavior of service providers
Rent-seeking by service providers from beneficiaries
Barriers
Provision of alternative transport
Creation of an emergency number
Regular monitoring of ambulances
Budgetary revision to strengthen transport facilities
Training, motivation building of service providers
Remedial measures
At the community and household level
(Decisions to use health-facilities)
Decision-making power mostly influenced by elders in families
Misconceptions about home vs. institutional birth
Negative previous experiences
ASHAs: inadequate support and capacities
Barriers
Identifying pregnant women through direct observation and household visits
Counselling services during prenatal, delivery, and ante-natal check-ups
Awareness campaigns
Counselling targeting male family members
Utilizing media (e.g. radio, and TV) to provide reliable program information
Strengthening ASHA support mechanisms
Remedial measures