title: Evaluation of Nischay scheme in improving antenatal care in a northern state of India.
abstract: OBJECTIVE
  To evaluate Nischay scheme (provision of pregnancy detection kit) in improving antenatal care.
  
  
  METHODS
  A natural experiment design was conducted during September 2011 to April 2012 in a randomly selected district of Haryana state of India. Community Health Center (CHC), Primary Health Center (PHC), sub-center and villages were selected using random sampling technique. The retrospective record analysis of antenatal data pertaining to 6 months before (April to September 2008) and after (October 2008 till March 2009) the launch of Nischay scheme was compared in the study. Only those centers were included in the study which have timely and adequate supply of the kits so that pregnant women would not have been missed (to be diagnosed as pregnant). The training status of ANMs and ASHA of selected sub-centers along with their knowledge about usage of kits was assessed. Besides this, beneficiaries were interviewed from selected sub-centers about their awareness and utilization of Nischay scheme.
  
  
  RESULTS
  Before 6 months of a launch of Nischay scheme, the median of ANC registration per sub-center per month was in the range of 18-25.5, whereas after 6 months it was 16-22.5. The difference in key ANC parameters (ANC registration, ANC < 12 weeks and completed three ANC) before and after introduction of the scheme was not found to be statistically significant. Only 15.6 % of beneficiaries were aware about Nischay scheme. The primary source of the information is either ANM (60 %) or ASHA (40 %). Those who were aware of this scheme had utilized this kit from the nearby sub-center. All (100 %) ANMs and 93 % of ASHAs had been adequately trained about using Nischay kit and interpreting the result.
  
  
  CONCLUSIONS
  There was no significant change in ANC registration in the period of 6 months after the launch of the scheme despite trainings to the frontline health workers. Further research is required to understand the bottlenecks so that corrective actions can be taken.
authors.affiliation: School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), 160012, Chandigarh, India, sonugoel007@yahoo.co.in.
authors.forename: Sonu
authors.initials: S
authors.lastname: Goel
authors.forename: Preeti
authors.initials: P
authors.lastname: Gupta
authors.forename: Arun K
authors.initials: AK
authors.lastname: Aggarwal
authors.forename: Binod K
authors.initials: BK
authors.lastname: Patro
authors.forename: Jagdeep
authors.initials: J
authors.lastname: Kaur
authors.forename: Neelam
authors.initials: N
authors.lastname: Aggarwal
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India; D011247:Pregnancy; D011258:Pregnancy Tests / Q000295:instrumentation / Q000379:methods; D011295:Prenatal Care / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D019035:Rural Health Services / Q000706:statistics & numerical data*