Paying for Performance: The Janani Suraksha Yojana Program in India

Vikas Dagur, Katherine Senauer and Kimberly Switlick-Prose

The pay-for-performance (P4P) Janani Suraksha Yojana (JSY) program in India consists of supply-side payments to individual community health workers and demand-side payments to women accessing a continuum of maternal and newborn health services at government or accredited private institutions. Its overall goal is to reduce maternal and infant mortality through increasing institutional deliveries, especially by poor women and members of scheduled caste/scheduled tribe communities.

Key features of the JSY program include a graded scale for payments; payments are greater within rural communities and within the 10 states that have been classified as low performing based on established health and demographic indicators, including institutional birth rate. In addition, the program offers a demand-side payment to poor women even for home deliveries. The JSY program is being implemented in all states, but each state has the authority to adapt and modify the program to best fit its local context. This case study provides an example of a government-led, centrally funded, nation.

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