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A Multi-Dimensional Assessment of Maternal-Child Health, Quality of Care, and Digital Innovations
Jyoti Kumari,
Ashish Ranjan Sinha,
Ram Barai Singh,
MAMTA BEHERA,
Dr. Kanchan Kumari
Journal of Applied Bioanalysis, Volume: 11, Issue: S2
Swansea University Author: MAMTA BEHERA
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DOI (Published version): 10.53555/jab.v11si2.504
Abstract
Background: Bihar has been one of the poorest states in India in terms of maternal and neonatal mortality. Furthermore, low maternal and child health indicators (MCH) exposed the state’s health system's vulnerabilities, which affect the overall health function and position the state low in nati...
| Published in: | Journal of Applied Bioanalysis |
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| ISSN: | 2405-710X |
| Published: |
Green Publication
2025
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| Online Access: |
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa71109 |
| Abstract: |
Background: Bihar has been one of the poorest states in India in terms of maternal and neonatal mortality. Furthermore, low maternal and child health indicators (MCH) exposed the state’s health system's vulnerabilities, which affect the overall health function and position the state low in national and global health rankings. Although frontline workers (FLWs), who are community representatives, are the direct point of contact for reaching the right beneficiaries, they often lack the necessary skills and capacities to deliver services on time. Apart from this, the state often witnessed operational challenges that prevented the smooth functioning of service provisions scheduled for beneficiaries. Women have been the most disadvantaged section when it comes to accessing various social welfare schemes meant for them. Due to socio-cultural norms, caste, educational status, and geographical differentiation, women's access to maternal benefit schemes is significantly influenced. These inequalities are not only social but also spatial, reflecting uneven regional development and the need for geographically inclusive social planning. Notably, the Janani Suraksha Yojana (JSY) and the Pradhan Mantri Matru Vandana Yojana (PMMVY) are the two major maternity benefit schemes operating in the state of Bihar to use conditional cash transfers (CCT) not only to improve MCH outcomes but also to promote equitable regional development through better social planning. Methods: This study assesses the effectiveness of JSY and PMMVY in Bihar. We used a cross-sectional survey of 390 frontline workers, supplemented by facility audits and beneficiary assessments, to examine program coverage, service quality, digital readiness, and psychosocial dimensions of implementation. A spatially comparative design was adopted across rural and semi-urban districts to capture geographic disparities in implementation and digital outreach. One rural district and one semi-urban district were chosen for the study, and within each district, five blocks were randomly selected. Stratified random sampling was employed to select study participants, and informed consent was obtained prior to collecting any data and information. All instruments were pre-tested with n = 10 frontline workers. Fieldwork took place from January 2024 to November 2024. Descriptive and multivariable statistical analyses were applied to examine regional and social variations in implementation. All analyses were performed using SPSS and R, with a statistical significance level of α = 0.05, and effect sizes reported with 95% confidence intervals. Results: Receipt of PMMVY and JSY was considered with significantly higher utilization of recommended maternal services, including four or more antenatal care visits ,institutional deliveries and early postnatal care in selected districts of Bihar (Table 2). From a CCT perspective, facilities rated as high-quality saw 7–11% higher program implementation rates (Table 3). FLWs reporting higher job satisfaction and support networks also had stronger program performance (Table 4). FLWs with higher digital engagement and literacy achieved substantially higher JSY/PMMVY awareness and timely enrolment (Table 5). Marked rural–urban and district-level variations indicate that spatial and infrastructural factors shape welfare delivery, while digital literacy serves as a bridging tool reducing geographic inequities. Conclusion: Findings highlight substantial uptake of JSY/PMMVY but reveal variation by geography, caste, and facility quality. Digital literacy and outreach significantly enhance awareness and timeliness of benefit delivery, while frontline workers’ job satisfaction and stress levels influence implementation effectiveness. Cash transfers alone are insufficient: complementary investments in service quality, equity-focused outreach, and digital systems are essential to maximise health impact in Bihar. These findings highlight the importance of spatially sensitive social planning and digital innovation in achieving equitable maternal welfare and balanced regional development. |
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| College: |
Faculty of Medicine, Health and Life Sciences |
| Issue: |
S2 |