Awareness and Utilization of Services under Janani Shishu Suraksha Karyakram: A Cross-Sectional Study in the Department of Obstetrics, J.A. Group of Hospitals, Gwalior

Abstract

Background: Janani Shishu Suraksha Karyakram (JSSK) was launched by the Government of India in 2011 under the National Health Mission to reduce maternal and infant mortality. It aims to eliminate out-of-pocket expenditure for pregnant women and sick neonates by providing free and cashless services, including institutional delivery, transport, drugs, diagnostics, diet, and user charges in public health institutions. Evaluating the awareness and utilization of these services is crucial to improving the effectiveness of the program and ensuring that beneficiaries fully avail their entitlements. Aims: To assess the awareness and utilization of services under JSSK in the Maternity Unit of JA Group of Hospitals, Gwalior. Objectives: (1) To assess the level of awareness of different components of JSSK services among beneficiaries. (2) To determine the source of awareness and knowledge about the components of JSSK. (3) To identify factors influencing the awareness and utilization of these services and service satisfaction. (4) To determine gaps in service delivery and information dissemination. Materials and Methods: A hospital-based cross-sectional study was conducted from July to September 2025 among 220 randomly selected postnatal women. Data were collected using a pre-tested semi-structured questionnaire on awareness and utilization of JSSK services. Data were compiled in Excel and analyzed in the Statistical Package for the Social Sciences using descriptive statistics and Chi-square tests. Results: Among 220 postnatal women, overall awareness of JSSK was high (87.3%), with better knowledge of free delivery (90%) and drugs (80%) than diagnostics (53.6%), diet (57.2%), and user charge exemption (47.2%). Accredited Social Health Activists workers were the main source of information (66.4%). Utilization of key services was good: Free delivery (96.3%), drugs (83.6%), and transport (71.8% home-to-facility; 61.8% while complete utilization of all entitlements was low (33.6%). Full awareness of all components was observed in only 38.6%, and maternal education significantly influenced awareness and utilization. Conclusion: The study concluded that although awareness and utilization of major JSSK services, particularly free delivery, drugs, and transport, were satisfactory, awareness and uptake of diagnostics, diet, and user charge exemption remained suboptimal. Maternal education significantly influenced both awareness and utilization. These findings highlighted the need for strengthened counseling, improved diagnostic availability, and better information dissemination to ensure that beneficiaries receive the full range of JSSK entitlements.