Rajasthan’s cash plus model pushes up early breastfeeding rate, dietary diversity among new mothers

Raj Kumari with Anganwadi worker.
| Photo Credit: Special Arrangement

The recently released report card on Rajasthan’s Cash Plus model — India’s first State-led pilot to converge Direct Benefit Transfers (DBT) with Behaviour Change Communication (SBCC) for improving maternal and child nutrition — indicates a 49% rise in early breastfeeding (now reaching 90% of newborns), 44% of women being more receptive to home-based counselling, 49% improvement in dietary diversity among pregnant women, and 54% more women using cash specifically for nutrition.

The State government scheme augments the national Pradhan Mantri Matru Vandana Yojana (PMMVY), which provides financial assistance to pregnant and lactating women for their first living child. It aims to improve the health and nutrition of mothers and their infants by offering cash incentives. The scheme is implemented by the Ministry of Women and Child Development.

Rajasthan carried out the assessment of its enhanced programme through a three-year field study starting 2021.

“Rajasthan is the first to combine cash support for pregnant women with social and behaviour change interventions (SBCI), such as counselling, home visits, and sessions on nutrition and health. It also includes second-time mothers. This model is already showing a real impact on diet, early registration, and check-ups,” said Om Prakash Bunkar, Director, Women and Child Development Department, Rajasthan.

The scheme was started at the end of 2020 in five districts: Udaipur, Banswara, Dungarpur, Pratapgarh, and Baran, as a pilot. It was scaled up to cover the entire State in 2022. The announced budget for the scaled-up version of the scheme is ₹210 crore, targeting around 3.5 lakh second-time pregnant women in the State per year, as per the budget announcement.

Digital media

Through the programme, pregnant and lactating women are offered home-based and group nutrition counselling on maternal and child health and nutrition. The programme also includes community and social engagements to drive local behaviour change, and the use of digital media to target younger audiences and male household members.

While Rajasthan is focused on reducing mortality rates and improving overall well-being, the challenges it faces includes — incomplete data collection (maternal deaths), disparities in care with the large part of this densely populated State being rural and tackling poverty and lack of education cover.

Meanwhile, the initiative promotes healthy dietary practices, encourages institutional healthcare utilisation, and strengthens community support systems. To date, it has directly benefited over 3.3 million women, driving measurable improvements in maternal and child health outcomes across the state. As per the survey report, 80% of women reported improved affordability and access to nutritious food, attributing this to greater household awareness and counselling support.

Speaking about how the scheme has helped her, Raju Kumari from rural Rajasthan shared: “During pregnancy, the Anganwadi worker registered me and ensured I got vaccinations and checkups. My anemia was detected early, and I was given iron treatment and nutrition advice. With full support from my mother-in-law and others at home I had a normal delivery at a government hospital, and my baby weighed over 3 kg.”