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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...

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Published in: Journal of Applied Bioanalysis
ISSN: 2405-710X
Published: Green Publication 2025
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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 &#x3B1; = 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&#x2013;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&#x2013;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&#x2019; 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. 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spelling 2025-12-08T11:20:05.6568326 v2 71109 2025-12-08 A Multi-Dimensional Assessment of Maternal-Child Health, Quality of Care, and Digital Innovations 1c77904f5ea36fc60eb5ec6639ed5f74 MAMTA BEHERA MAMTA BEHERA true false 2025-12-08 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. Journal Article Journal of Applied Bioanalysis 11 S2 Green Publication 2405-710X 13 10 2025 2025-10-13 10.53555/jab.v11si2.504 COLLEGE NANME COLLEGE CODE Swansea University 2025-12-08T11:20:05.6568326 2025-12-08T11:00:10.1111575 Faculty of Medicine, Health and Life Sciences School of Psychology Jyoti Kumari 1 Ashish Ranjan Sinha 2 Ram Barai Singh 3 MAMTA BEHERA 4 Dr. Kanchan Kumari 5 71109__35783__7380906aba5f4599a7e7fd74a029279e.pdf 71109.VoR.pdf 2025-12-08T11:06:11.1343519 Output 958916 application/pdf Version of Record true Released under the terms of a Creative Commons (CC-BY) licence. true eng https://creativecommons.org/licenses/by/4.0/deed.en
title A Multi-Dimensional Assessment of Maternal-Child Health, Quality of Care, and Digital Innovations
spellingShingle A Multi-Dimensional Assessment of Maternal-Child Health, Quality of Care, and Digital Innovations
MAMTA BEHERA
title_short A Multi-Dimensional Assessment of Maternal-Child Health, Quality of Care, and Digital Innovations
title_full A Multi-Dimensional Assessment of Maternal-Child Health, Quality of Care, and Digital Innovations
title_fullStr A Multi-Dimensional Assessment of Maternal-Child Health, Quality of Care, and Digital Innovations
title_full_unstemmed A Multi-Dimensional Assessment of Maternal-Child Health, Quality of Care, and Digital Innovations
title_sort A Multi-Dimensional Assessment of Maternal-Child Health, Quality of Care, and Digital Innovations
author_id_str_mv 1c77904f5ea36fc60eb5ec6639ed5f74
author_id_fullname_str_mv 1c77904f5ea36fc60eb5ec6639ed5f74_***_MAMTA BEHERA
author MAMTA BEHERA
author2 Jyoti Kumari
Ashish Ranjan Sinha
Ram Barai Singh
MAMTA BEHERA
Dr. Kanchan Kumari
format Journal article
container_title Journal of Applied Bioanalysis
container_volume 11
container_issue S2
publishDate 2025
institution Swansea University
issn 2405-710X
doi_str_mv 10.53555/jab.v11si2.504
publisher Green Publication
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Psychology{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Psychology
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description 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.
published_date 2025-10-13T05:26:28Z
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