Janani Suraksha Yojana (JSY)

Janani Suraksha Yojana was launched in 2005 as a centrally sponsored scheme under the National Rural Health Mission, now subsumed in the National Health Mission. The premise is direct: the biggest avoidable cause of maternal and newborn death in India is the home delivery without a skilled attendant. If the state pays a cash incentive that more than covers the out of pocket cost of travelling to and delivering at a hospital, more women will choose the institutional route, and more lives will be saved.

Twenty years of data show the design worked. The institutional delivery rate has risen from about 39 percent in 2005 to over 89 percent by 2023, and maternal mortality has fallen from 254 to 97 per lakh live births. JSY did not cause all of this on its own. Janani Shishu Suraksha Karyakaram, Pradhan Mantri Surakshit Matritva Abhiyan and the broader strengthening of district hospitals all contributed. But JSY is the cash anchor that keeps the demand side strong.

For the woman and her family, JSY is not a salary or a long term entitlement. It is a one time payment that arrives a few days after delivery, designed to reimburse transport, food and lost wages. Used well, it can also fund the first month of postnatal nutrition and immunisation visits.

JSY treats states differently based on past institutional delivery performance. Low performing states, where the original 2005 baseline was poor, get the higher entitlement and broader coverage. High performing states get a smaller amount restricted to vulnerable groups.

In low performing states, every pregnant woman who delivers at a government or accredited private facility is eligible regardless of age, parity or income. The cash amount is Rs 1,400 in rural areas and Rs 1,000 in urban areas. The ASHA who escorts her receives Rs 600 rural and Rs 400 urban as a separate incentive paid for ensuring antenatal care visits and accompanying the mother to the facility.

In high performing states, eligibility is tighter. Only BPL, SC and ST women aged 19 and above qualify, and only for up to two live births. The cash amount is lower: Rs 700 rural and Rs 600 urban. The ASHA incentive is Rs 600 rural and Rs 400 urban, but only paid if the ASHA actually escorts the mother to the facility.

The reason for the distinction is fiscal. In states where 95 percent of deliveries are already institutional, the marginal value of a universal cash incentive is small and the leakage risk is high. Targeting the bottom of the income and caste pyramid keeps the scheme focused on those still at risk.

The process starts at pregnancy registration, ideally in the first trimester. Visit the Anganwadi centre or sub centre in your area. The ANM or ASHA will register the pregnancy, issue a Mother and Child Protection card and a JSY card, and add you to the antenatal care register. This is the document that tracks all four antenatal visits, the two tetanus injections and the iron and folic acid supplementation.

Open a bank account in the name of the pregnant woman if one does not already exist. Seed it with Aadhaar. This is non negotiable. The Rs 1,400 or applicable amount is paid through direct benefit transfer, and an unseeded account is the most common reason for delay.

Plan the delivery at a government facility or an accredited private facility. The ASHA will help you make the arrangement, including booking transport through the 102 ambulance service which is free for pregnant women. After delivery, the facility issues a discharge summary noting the date and time of delivery, the mother's name and the JSY card number.

The block accountant or facility data entry operator submits the JSY claim. Payment should reach the bank account within seven working days of discharge. If it does not, escalate through the ASHA, the block medical officer or the district programme manager. Most delays are bank account mismatches or data entry errors at the facility, both of which are fixable on a single visit.

Sunita, a 24 year old woman in rural Bihar, is pregnant with her second child. Bihar is a low performing state, so she qualifies regardless of caste or BPL status. She registers at the Anganwadi in the second month, completes four antenatal visits, and delivers at the primary health centre. The PHC issues the discharge summary. Eight days later, Rs 1,400 is credited to her Aadhaar seeded account. Her ASHA receives Rs 600 separately.

Meena, a 27 year old SC woman in urban Tamil Nadu, is pregnant with her first child. Tamil Nadu is a high performing state, so eligibility is restricted. As an SC woman aged above 19 with her first child, she qualifies. She registers, delivers at the government maternity hospital, and receives Rs 600 about ten days after discharge.

Pooja, a 22 year old non SC, non ST woman from a non BPL family in urban Maharashtra, delivers at a private nursing home. Maharashtra is a high performing state and she does not belong to a covered category. She is not eligible for JSY. However, she is still eligible for Pradhan Mantri Matru Vandana Yojana for her first living child, which is a separate entitlement.

The single biggest failure is not registering the pregnancy. Without a JSY card, the facility cannot file the claim, and there is no document trail to support eligibility. Register in the first trimester even if you intend to deliver at a city hospital. Registration is free and takes fifteen minutes.

The second biggest failure is the bank account. An account opened in the husband's name does not work. An account without Aadhaar seeding does not work. An account at a bank branch the ANM cannot read clearly from the form does not work. Take the passbook to the registration visit so the bank details can be copied exactly.

In high performing states, missing caste or BPL proof is the third common cause. The ration card or caste certificate should be in the file at the time the claim is submitted. Adding it after the fact requires re entering the claim and delays payment by weeks.

Before the seventh month of pregnancy, the ASHA should confirm five things with the family. First, the JSY card is in hand and antenatal visits are recorded. Second, the bank account exists, is in the mother's name and is Aadhaar seeded. Third, the family has identified the delivery facility and knows the route. Fourth, the 102 ambulance number is saved on a working phone in the household. Fifth, the family understands that JSY is paid after delivery, not before, so they should not pay anyone for it in advance.

If any of these are missing, the ASHA should resolve them before the eighth month. Once labour starts, there is no time to fix bank accounts or trace caste certificates.

• 01Pregnant woman aged 19 years or above at the time of delivery
• 02In low performing states, all pregnant women are eligible regardless of age or number of children for institutional delivery
• 03In high performing states, only BPL, SC and ST pregnant women aged 19 or above for up to two live births
• 04Must register the pregnancy at the local Anganwadi or sub centre and obtain a Mother and Child Protection card
• 05Delivery must take place at a government health facility or accredited private facility

• §Mother and Child Protection card or JSY card issued at registration
• §Aadhaar card of the mother
• §Bank passbook with Aadhaar seeded account
• §BPL card, SC or ST certificate where required for eligibility in high performing states
• §Discharge summary from the delivery facility
• §Referral slip from ASHA where applicable

• Pregnancy not registered before delivery, so no JSY card is on file
• Bank account not seeded with Aadhaar, blocking the direct benefit transfer
• Delivery at a non accredited private facility in states where only public and accredited facilities are covered
• In high performing states, missing BPL, SC or ST proof for women claiming the entitlement
• Age below 19 at the time of delivery in high performing states

• JSY Features and Frequently Asked Questions, National Health Mission, Ministry of Health and Family Welfarelink ↗
• National Family Health Survey 5 institutional delivery indicators, IIPS for Ministry of Health and Family Welfarelink ↗