Age limit relaxed for financial assistance to institutional deliveries #Goodnews


AARTI DHAR, The Hindu

Move expected to reduce neonatal, maternal mortality in young mothers

The Ministry of Health and Family Welfare has relaxed eligibility parameters for the Janani Suraksha Yojana (JSY), which provides financial assistance to mothers for institutional deliveries. Now, Below Party Line (BPL) women can access JSY benefits irrespective of their age and number of children.

All women from BPL category, Scheduled Castes and Scheduled Tribes in all States and Union Territories will be eligible for JSY benefits if they have given birth in a government or private accredited health facility. BPL women who prefer to deliver at home can also get JSY benefits.

Launched in 2005, the JSY is the government’s main scheme to enable women — especially those from vulnerable sections — to access institutional delivery. This was done to reduce maternal and neonatal mortality.

“The decision was taken after it was realised that a majority of women, who needed JSY benefits, remained out of the purview of the scheme because they had to prove they were 19 years of age and had no more than two children,” Anuradha Gupta, Additional Secretary and Mission Director, National Rural Health Mission (NRHM), told The Hindu on Tuesday.

The highest maternal mortality is reported among girls aged 14-15; the majority of these were out of the purview of the JSY as they were unable to produce proof of age or verify the number of children they had, Ms. Gupta explained.

Till now, the scheme provided assistance for institutional delivery to all pregnant women who give birth in a government or private accredited health facility in Low Performing States (those with bad health indicators, such as Uttar Pradesh, Bihar, Chhattisgarh, Madhya Pradesh, Uttarakhand, Jharkhand and Assam). A woman gets Rs.1,400 for delivery in a government facility or accredited private facility and Accredited Social Health Activist (ASHA) gets Rs. 600 in rural areas. In the urban areas, the amounts paid are Rs.1,000 and Rs. 400 respectively.

However, in High Performing States (those with good health indices, such as Kerala, Tamil Nadu and Karnataka), assistance for institutional delivery was available to women from BPL/SC/ST households, aged 19 or above and only up to two live births for delivery in a government or private accredited health facility. The financial entitlement was Rs. 700 to the mother and Rs. 600 for the ASHA in rural areas and Rs. 600 and Rs. 400 in urban settings.

Further, in all States/Union Territories, the scheme provided Rs. 500 to BPL women — aged 19 or above and who deliver up to two live births — who prefer to deliver at home. With the amendments, all women who deliver at home will be entitled to this amount, basically for nutrition.

The government claims that as a result of the scheme, there has been an increase in institutional deliveries — from 47 per cent in 2007-08 to 72.9 per cent in 2009 (Coverage Evaluation Survey) and, most recently, to approximately 79 per cent — as per Health Ministry data.

 


  • Henceforth, all BPL women will get JSY benefits
  • Many were excluded for being under 19

 

#Chhattisgarh #Andhra – Setback to health insurance


Published on Down To Earth (http://www.downtoearth.org.in)

Setback to health insurance

Author(s):

Kundan Pandey

0 Comments
Author(s): Kundan Pandey
Issue Date: Apr 30, 2013

Private hospitals in Chhattisgarh, Andhra refuse to treat under government insurance scheme

Strengthening primary healthcare facilities would cost one-third of what governments spend on health insuranceStrengthening primary healthcare facilities would cost one-third of what governments spend on health insurance (Courtesy: swasthindia.in)

LAST year when the Chhattisgarh government announced health insurance scheme for people above the poverty line (APL), it was touted as an initiative to improve healthcare delivery in the state. But within a few months of introducing it, Mukhyamantri Swasthya Bima Yojana (MSBY) has turned out to be a political gimmick to capure the vote bank as the government faces elections in October-November.

The state launched MSBY on the lines of the Centre’s Rastriya Swasthya Bima Yojana (RSBY), which caters to people below the poverty line (BPL). It provides cover for hospitalisation cost up to Rs 30,000 for a family of five on floater basis. The state has roped in the 350 private hospitals under RSBY for its MSBY scheme. But the hospitals are not willing to admit APL patients under the scheme, saying the insurance amount is too less.

Like RSBY, MSBY sets down the amount a hospital can charge for the treatment of a particular disease. For example, hospitals under the scheme can charge Rs 3,500 for treating pneumonia or malaria and Rs 9,500 for jaundice. The private hospital authorities say they treat BPL patients at such low rates as a welfare scheme. It would be difficult to provide the care to all at such low fees.

Ajay Sahay, president of the Chhattisgarh chapter of Indian Medical Association (IMA), says, “We have informed the government about our demands to increase the insurance amount to somewhere between Rs 1.5 lakh and Rs 2 lakh.” On April 4, a group of private hospital authorities held a meeting with the state’s health minister, principal secretary and other government officials to discuss their grievance. “Instead of proper solution, they proposed increasing the cost of one treatment and reduce that of the other. They also said that we would have to treat MSBY beneficiaries, if we want to treat people under RSBY,” says Sahay. “We are now left with no option except refusing BPL patients as well.” Sahay alleges that the government did not consult the private health sector while planning MSBY, but now it wants the sector to implement the scheme before the elections.

Can private players help?

In December last year, the Chhattisgarh government had tried to outsource diagnostic facilities for government hospitals to strengthen its public healthcare system. But no private party showed interest to provide diagnostic facilities in remote areas of the state.

“It is not strange or unexpected,” says T Sundararaman, executive director of National Health Systems Resource Centre, a technical support institution with the National Rural Health Mission. Private sector works for the maximum margin and is demanding just that, he adds. But increasing the insurance amount is not the solution, Sundararaman says, citing the example of Andhra Pradesh, where the private health sector is demanding an increase in the insurance amount from the existing Rs 1.5 lakh.

Private hospitals in Andhra Pradesh have threatened to discontinue providing treatment under Rajiv Arogyasri scheme for BPL category from May 3 if their demands are not met. Every year about 200,000 patients undergo surgery under the scheme for 938 listed diseases.

B Bhaskar Rao, president of Andhra Pradesh Specialty Hospitals Association (ASHA) says the government launched the scheme six years ago. But there has been no hike in the amount despite requests by the private doctors’ association. “We demand that the government raise the insurance amount by 30 per cent and thereafter increase it by 5 per cent every year,” says Rao.

To achieve universal healthcare, senior public health specialist Sakthivel Selvaraj, says governments should focus on strengthening primary healthcare facilities. After all, this would cost one-third of what they spend on insurance, he says, adding, “We have never invested sufficiently in public health system which can solve the problem.”

 

Setback to Chhattisgarh health care services


SUVOJIT BAGCHI, The Hindu, March 30, 2013

Private hospitals refuse treatment under government insurance schemes

The Chhattisgarh government has had to accept yet another setback while trying desperately to rope in private players to strengthen public health care services.

At least 20 major private hospitals have refused to provide treatment under the Chief Minister’s health insurance scheme — Mukhyamantri Swasthya Bima Yojana (MSBY). Reportedly, they are also not following guidelines to provide treatment under the national health insurance scheme, Rashtriya Swasthya Bima Yojana (RSBY), and are charging money from the patients.

Hospital owners claimed that the insured amount paid for treatment of the patients below poverty line (BPL) under RSBY is “very low.” In addition, introduction of a scheme for the people above poverty line (APL) under MSBY will “seriously damage business and thus will affect services.”

State health officials, hospital management and representatives of insurance companies and Third Party Administrators (TPA) held a meeting on Thursday. According to local news reports, Director, Health Services, Dr. Kamalpreet Singh, said rates had already been “upwardly revised” under RSBY and MSBY after consultation with private hospitals.

Under the new list, 272 categories of treatment, commonly called ‘packages,’ were increased by four to 200 per cent. Another 22 packages had been added and the new list will be applicable from April 1. However, major private players are not happy with the revised rate list and refused to implement the insurance schemes in their hospitals. The move angered the government and the health department has decided to de-panel the hospitals, the sources said.

Earlier this month, the government faced a setback while trying to introduce the policy of Public Private Partnership (PPP) in public health facilities. No private diagnostic centre had come forward to set up radiology and laboratory facilities in the two most underdeveloped divisions with high percentage of rural population — Bastar in south and Surguja in north Chhattisgarh following governments directives.

The Chhattisgarh Government’s Directorate of Health Services had to seek fresh bids for newly aligned divisions. According to the sources, while a good number of applications were filed for affluent divisions such as Raipur and Bilaspur, not receiving a single application for the poorer divisions illustrate the private players’ reluctance to acknowledge health care as a social service. However, the proponents of Chhattisgarh’s public-private venture in health care were optimistic about its future, even after these recent rounds of setbacks.

 


  • Major private players are not happy with the revised rate list
  • Government to “de-panel” hospitals that refuse to cooperate

 

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