摘要：Objective To evaluate the effect of the Chiranjeevi Yojana programme, a public–private partnership to improve maternal and neonatalhealth in Gujarat, India.Methods A household survey (n = 5597 households) was conducted in Gujarat to collect retrospective data on births within the preceding5 years. In an observational study using a difference-in-differences design, the relationship between the Chiranjeevi Yojana programmeand the probability of delivery in health-care institutions, the probability of obstetric complications and mean household expenditure fordeliveries was subsequently examined. In multivariate regressions, individual and household characteristics as well as district and year fixedeffects were controlled for. Data from the most recent District Level Household and Facility Survey (DLHS-3) wave conducted in Gujarat(n = 6484 households) were used in parallel analyses.Findings Between 2005 and 2010, the Chiranjeevi Yojana programme was not associated with a statistically significant change in theprobability of institutional delivery (2.42 percentage points; 95% confidence interval, CI: −5.90 to 10.74) or of birth-related complications(6.16 percentage points; 95% CI: −2.63 to 14.95). Estimates using DLHS-3 data were similar. Analyses of household expenditures indicatedthat mean household expenditure for private-sector deliveries had either not fallen or had fallen very little under the Chiranjeevi Yojanaprogramme.Conclusion The Chiranjeevi Yojana programme appears to have had no significant impact on institutional delivery rates or maternal healthoutcomes. The absence of estimated reductions in household spending for private-sector deliveries deserves further study.
