ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND
FAMILY WELFARE
(SHRI ASHWINI KUMAR CHOUBEY)
(a) & (b): Janani Shishu Suraksha Karyakaram (JSSK) has been launched with the objective to eliminate out of pocket expenses for both pregnant women and sick infants accessing public health institution for treatment.
The initiative was estimated to benefit more than 1 crore pregnant women access public health institutions every year in both urban and rural areas.
Entitlements for Pregnant Women under JSSK :
• Free and zero expense Delivery and Caesarean Section.
• Free Drugs and Consumables.
• Free Essential Diagnistics (Blood,Urine tests and Ultra sonography etc.)
• Free Diet during stay in the health institutions (up to 3 days for normal delivery and 7 days for caesarean section)
• Free Provision of Blood.
• Free Transport from Home to Health institutions.
• Free Transport between facilities in case of referral.
• Drop Back from institutions to home after 48 hrs stay.
• Exemption from all kinds of User Charges.
Entitlements for Sick infants under JSSK till one year after birth:
• Free and zero expense treatment
• Free Drugs and Consumables
• Free Diagnostics
• Free Provision of Blood
• Free Transport from Home to Health institutions.
• Free Transport between facilities in case of referral
• Drop back from institutions to home
• Exemption from all kinds of user charges.
The details of beneficiaries covered under the scheme since 2013-14, State/UT-wise is placed at Annexure.
(c): Periodic reviews and field visits are undertaken at various levels to assess the implementation of Janani Shishu Suraksha Karyakram (JSSK) by the States.
Since the launch of JSSK, Nine Common Review Missions (CRMs) have been undertaken and they have also independently reviewed the implementation of JSSK in selected States
NSSO (National Sample Survey Office), Ministry of Statistics & Programme implementation also conducting survey on utilization of different services under maternal health.
JSSK Evaluation was also conducted by Deloitte Touché Tohmatsu India Private Ltd. (Deloitte) as the Technical Support Agency (TSA) to the National Health Mission (NHM) in the States of J&K, Rajasthan, Uttarakhand and West Bengal in 2013. Deloitte also undertook JSSK evaluation in 6 states of Bihar, Madhya Pradesh, Rajasthan, Uttar Pradesh, Chhattisgarh and Jharkhand in 2017.
(d): The following observations are based on the reports including Andhra Pradesh;
As per NSSO 75th Round Survey Report (conducted in July 2017 to June 2018),
Rural: the percentage of women who gave birth in public facilities has been increased from 41% in 2014 to 68% in 2017-18 , the percentage of women who availed ANC services in Public health has been increased from 28% in 2014 to 76% in 2017-18, the percentage of women who availed PNC services in public has been increased from 40% in 2014 to 75% in 2017-18.
Urban: The percentage of women who gave birth in public facilities has been increased from 31% in 2014 to 48% in 2017-18, the percentage of women who availed ANC services in Public health has been increased from 37% in 2014 to 53% in 2017-18, the percentage of women who availed PNC services in public has been increased from 31% in 2014 to 51% in 2017-18.
Similarly, as per NSSO 75th Round Survey Report of Andhra Pradesh is as follows;
Rural: The percentage of women who gave birth in public facilities has been increased from 25% in 2014 to 48% in 2017-18, the percentage of women who availed PNC services in public has been increased from 46% in 2014 to 53% in 2017-18.
Urban: The percentage of women who gave birth in public facilities has been stagnant i,e 43% in both , the percentage of women who availed PNC services in public has been increased from 38% in 2014 to 46% in 2017-18.
Other observations are:
• Policy articulations and dissemination of information on the entitlements is present in all states.
• The awareness about the entitlements of pregnant women under the JSSK scheme has improved.
• The JSSK entitlements for pregnant women and sick infants upto one year of age is operational across all states, resulting in considerable reduction in out of pocket expenditures.
• Free drugs, diagnostics, diet and assured home to facility transport as well as drop back has improved across all the states.
• OPD and IPD services are provided free of cost to all pregnant beneficiaries in all the states.
• The provision for free diagnostic facilities, including basic lab tests, for pregnant women has improved significantly in most of the states.
• Provision for blood for pregnant women and sick infants is available at all the District Hospitals visited.
• Free diet is being provided to the pregnant beneficiaries in most of the States.
The above reviews & field visits have also highlighted the following:
• Awareness & IEC on JSSK needs further improvement
• Close monitoring by State & District on any out of pocket expenditure
• Out of pocket expenditure on drug, diagnostics and referral transport for pick up or drop back is still existing
• Emphasis on entitlements for newborn and infants needs improvement
• Grievance Redressal needs strengthening across all states.
(e): Steps taken by Govt. of India for effective implementation of JSSK are :
• Periodic Regional and State level Review meetings
• Communication through different channels with State Governments including letters, videoconferencing, etc
• Field visits by Central level teams to monitor the progress of implementation.
• Popularizing the Scheme through Information Education & Communication (IEC) & Behaviour Change Communication (BCC) strategies including mass media.
• Field level workers like ANMs and ASHAs are promoting this programme at the ground level through interpersonal communication
• Referral transport for pregnant women, sick neonates and infants is being provided by the States as per their local needs, using different models which include a network of emergency response vehicles using toll free number, government ambulances, available transport under public private partnership etc
• A mechanism of regular supportive supervisory visits to the states and districts to monitor the implementation of JSSK is also put in place and is effective in the implementation of the programme.
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