Yukti Yojana: A Model for Expanding Access to Safe Abortion Services

The Yukti Yojana is an innovative accreditation scheme launched by the government of Bihar, India in 2011. The program aims to increase access to safe abortion services for rural and low-income urban women by accrediting private health care facilities and supporting them in providing these services free of charge. Background Bihar is one of the poorest states in India, with high rates of maternal mortality and morbidity. Unsafe abortions are a major contributor to these deaths, accounting for an estimated 13% of all maternal deaths in the state. Implementation The Yukti Yojana accredits private health care facilities that meet certain criteria, such as having a qualified doctor and nurse on staff, and having the necessary equipment and infrastructure to provide safe abortion services. Accredited facilities receive a subsidy from the government to cover the cost of providing these services free of charge to eligible women. Eligibility All women of reproductive age are eligible for free abortion services under the Yukti Yojana, regardless of their marital status or income level. However, priority is given to women from rural areas and to women from poor and marginalized communities. Services provided Accredited facilities under the Yukti Yojana provide a range of abortion-related services, including: Counseling and information about abortion Medical and surgical abortion services Post-abortion care and follow-up Impact The Yukti Yojana has been successful in increasing access to safe abortion services in Bihar. The number of accredited facilities under the program has increased from 10 in 2011 to over 700 in 2023. And the number of women receiving free abortion services under the program has increased from 10,000 in 2011 to over 100,000 in 2023. The program has also been credited with reducing the number of unsafe abortions in Bihar. A study published in the journal PLOS Medicine in 2015 found that the Yukti Yojana had led to a 25% decrease in the number of unsafe abortions in the state. Conclusion The Yukti Yojana is a successful example of a public-private partnership to expand access to safe abortion services in a low-resource setting. The program has been shown to be effective in reducing the number of unsafe abortions and improving maternal health outcomes. Lessons learned from the Yukti Yojana The Yukti Yojana offers a number of lessons for other countries and regions seeking to expand access to safe abortion services. These include: The importance of engaging with the private sector. Private health care facilities provide a significant portion of abortion services in many countries, and it is important to involve them in efforts to expand access to safe abortion. The importance of providing financial support to accredited facilities. Providing financial support to accredited facilities can help to ensure that they are able to provide safe abortion services free of charge to eligible women. The importance of removing barriers to access. The Yukti Yojana has removed a number of barriers to access to safe abortion services, such as financial barriers and social stigma. This is important for ensuring that all women have access to the services they need.