Page 318 - ES 2020-21_Volume-1-2 [28-01-21]

JAY Ho: Ayushman Bharat's Jan Arogya Yojana (JAY) and Health Outcomes 301

proportion of institutional births in a public facility went up by 28 per cent in West Bengal, the
corresponding figure for the three states was 10 per cent. While share of births in a private health
facility delivered via caesarean section went up for both private and public sector providers, the
increase has been higher for public health facilities. This increase in public healthcare utilisation
for births via caesarean section has also been higher in states with PM-JAY versus that in West
Bengal. Bihar, Assam and Sikkim recorded a high 46 per cent jump from a lower base while this
increase in West Bengal was 21 per cent but from a higher base. PM-JAY thus seems to have
enabled citizens in these states to make greater use of the public healthcare infrastructure.

9.35 The adoption of PM-JAY in Bihar, Sikkim and Assam facilitated notable progress in health
outcomes pertaining to child vaccinations and vitamin-A supplementation. Though improvement
happened in all four states, the magnitude was greater in Bihar, Sikkim and Assam. For example,
the proportion of children with age 12-23 months who have received BCG vaccine increased by
1 per cent in West Bengal as compared to 4 per cent increase in adjoining states; the proportion
of children with age 12-23 months who have received three doses of penta or hepatitis B vaccine
increased by 5 per cent in West Bengal in comparison to 19 per cent increase in the adjoining
states. The only indicator which worsened was the proportion of children in the age group of
9-35 months who received a vitamin-A dose in the last six months, though the decline was
sharper in West Bengal (-6 per cent) vis-à-vis the adjoining states (-2 per cent) (Figure 13).

Figure 13: Child Vaccinations and Vitamin A Supplementation:
West Bengal versus Adjoining States (Bihar, Sikkim, Assam)

Source: National Family Health Survey (NFHS) 4 and 5

9.36 The data for the treatment of childhood diseases for children under the age of 5 years
suggest improvement in all four states irrespective of the adoption of PM-JAY. However, the
adjoining states (Bihar, Sikkim, Assam) registered greater improvements in comparison to West
Bengal. While the proportion of children with diarrhea in the 2 weeks preceding the survey
who received oral rehydration salts (oRS) increased by 16 per cent in West Bengal, it increased
by 31 per cent in the adjoining states, an increase of almost double magnitude. Similarly, the
proportion of children with diarrhea in the 2 weeks preceding the survey taken to a health