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Government of West Bengal Health & Family Welfare Department
Swasthya Bhavan GN‐ 29, Sector‐ V, Salt Lake
Kolkata—700091 No. H/CFW/Gen‐ 348 H/SFWB/ 11 Date: 09/08/2011 From: Commissioner (FW) & Secretary To Director of Health Services & Ex. Officio Secretary Director, Medical Education & Ex. Officio Secretary Sub: Introduction of Janani‐Shishu Suraksha Karyakram About 67,000 women in India die every year due to pregnancy related complications. Similarly, every year approximately 13 lakhs infants die within one year of birth. Out of total infants death 9 lakhs die within first four weeks of birth (2/3rd of infant death), about 7 lakhs i,e 75 % of total neonatal death is within first week ( majority within first two days after birth) of infancy period. Therefore first 28 days of infancy period are very crucial to save the lives of children. Both maternal and infant deaths could be reduced by ensuring timely access to quality services, both essential & emergency, in public health facilities without any burden of out of pocket expenses. With the launch of Janani Suraksha Yojona (JSY), the number of institutional deliveries has increased significantly but still there are more than 25% of pregnant women who hesitate to access health facilities. Those who have opted for institutional delivery are not willing to stay for 48 hours after delivery hampering the provision of essential services both to the mother and neonates. Important factors affecting access includes:
• High out of pocket expenses on— • User charges for OPD, admission, diagnostic tests, blood etc. • Purchasing Medicine 7 Consumables from market • In case of Caesarean Section the expenses can be very high. • Non availability of diet. • Transport required to take pregnant women, opting for delivery at public health
facilities , from home to facility, between facility in case of referral and back to home from facility.
Considering the above Government of India launched “Janani Shishu Suraksha Karyakram” on 1st June 2011 to be implemented nationally where all the pregnant
women opting for delivery at public health institution and newborn up to 30 days irrespective of financial and cast status will get free services as: Entitlements for Pregnant Women:
Free and zero expense Delivery and Caesarean Section. Free drugs and consumables Free essential Diagnostics ( Blood, Urine test and Ultra‐ sonography etc). Free diet during stay in health institutions ( Up to 3 days for normal delivery & 7
days for Caesarean Section) Free provision of blood Free transport from home to health institution. Free transport between facilities in case of referral Drop back from institution to home after 48 hours in case of normal delivery &
after 7 days in case of Caesarean Section. Exemption from all kinds of user charges.
Entitlement for Sick Newborns till 30 days after birth:
Free and zero expense treatment Free drugs and consumables Free diagnostics Free provision of blood. Free transport from home to health institution. Free transport between facilities in case of referral. Free drop back from facility to home. Exemption from all kinds of user charges.
Regarding Diagnostics: Both essential and desirable investigations are required to be conducted free of cost for pregnant women during ANC, INC, PNC up to 6 weeks after delivery which includes investigations required prior to both normal delivery and Caesarean Section. Similarly when a neonate is sick and needs urgent and priority treatment for conditions like infection, pneumonia etc is to be conducted free of cost. To implement this programme different orders had already been issued as:
1. Go NO. HFW/NRHM‐65/2010/571 dated 16/03/2011 regarding cashless transportation of pregnant women and sick neonates.
2. G,O No. HS‐275(20)/11/HF/O/FW/3M‐08/2011 dated 04/05/2011 regarding cashless delivery services and free treatment of sick neonates.
3. GO NO. HS‐428(20)/11/H/SFWB/14D‐01‐2011 dated 14/06/2011 regarding list of medicines and consumables required for cashless delivery and treatment of sick neonates.‐‐‐ This GO is under revision at present.
All the orders are in different phases of implementation. Now it has been decided that Janani‐Shishu Suraksha Karyakram will be implemented in full suing in all the public health facilities in this State latest by 15th August 2011.
Actions to be undertaken at District level: Nominate one District Nodal Officer—It is proposed that Dy. Chief Medical Officer of Health‐I of each district excepting Kolkata district should function as District Nodal Officer as because Dy. CMOH‐I is looking after vehicle / Store/ Diet etc. For Kolkata DFWO may act as Nodal Officer.
Circulate G.Os on free entitlements to all facility in charge. Widely publicise free entitlements in public domain in local language as specified in the section “Dissemination of entitlement in public domain” below.
Institute a grievance redressal mechanism for ensuring that the commitments are fulfilled in letter and spirit.
Regularly review the stock of drugs & consumables for ensuring availability at public health institutions.
Ensure lab facility and diagnostic services are functional at all designated facilities particularly at DH, SDH, SGH, RH & BPHC.
Prepare time bound action plan for establishing and operationalising Blood bank or Blood storage centre at defined facilities.
Review referral linkage and their utilization by the beneficiaries. Provide required finances/ empowerment for utilization of funds to the identified facility in charge for above activities, particularly in emergency situations / stock outs.
Regularly monitor & report on designated formats on monthly bases ( Placed below). Review implementation status during District MIES meeting.
Dissemination of entitlement in public domain Display them prominently on adequate size hoardings & boards , which is clearly visible from distance in all Government Health Facilities e,g SCs, PHCs, RHs, BPHCs, SDHs, SGHs, & DHs ( Main entrance, Labour room, Maternity/female ward and outside out patient department). The IEC fund sanctioned and placed at DH&FWS from RCH/NRHM may be utilise for this purpose.
Continued;
The specimen of the hoardings / Boards: ( to be made in local language) National Emblem NRHM Emblem
Janani – Shishu Suraksha Karyakram Assures NIL out of pocket expenses in all
Government Health Facilities
Entitlement for Pregnant Women:
Free and zero expense Delivery and Caesarean Section. Free drugs and consumables Free essential Diagnostics ( Blood, Urine test and Ultra‐ sonography etc). Free diet during stay in health institutions ( Up to 3 days for normal delivery & 7
days for Caesarean Section) Free provision of blood Free transport from home to health institution. Free transport between facilities in case of referral Drop back from institution to home after 48 hours in case of normal delivery &
after 7 days in case of Caesarean Section. Exemption from all kinds of user charges.
Entitlement for Sick Newborns till 30 days after birth: Free and zero expense treatment Free drugs and consumables Free diagnostics Free provision of blood. Free transport from home to health institution. Free transport between facilities in case of referral. Free drop back from facility to home. Exemption from all kinds of user charges
In case of any grievances, please contact (Name & Telephone No.)
Continued
REPORTING FORMAT Implementation Status of Janani‐ Shishu Suraksha Karyakram ( district Level)
For the Month: Year: District: No. of indentified health facilities: District Nodal Officer in place—Yes / no District Grievance redressal officer in place—Yes / No
(A) CASHLESS SERVICES
SL No.
Provision for cashless deliveries for pregnant women and sick newborns at all govt, health facilities
Sub centre
PHC RH/BPHC SGH SDH DH/MCH
1 No. of Govt .health facilities in the district
1.a No. of facilities where delivery take place ( delivery point)
2 No. of facilities where free entitlements were displayed
3 No. of facilities where free diet is available to PW
4 No. of facilities where lab is functional for basic tests for PW
4.a No. of facilities with stock out of lab reagent / equipments not functioning
5 No. of facilities with stock out of essential drugs / supplies
6 No. of facilities collecting user charge for PW/ sick newborn for
i. OPD ii. Admission/delivery/C‐
Section
iii. Lab test / diagnostics iv. Blood
(B) Referral Transport (RT)
SL.No Referral Transport Services State vehicle EMRI/EMTS PPP Other1. Total No. of Ambulance/referral vehicles in
the district
2 Whether fitted with GPS ( Specify No) 3 No. of PW received (RT) services for i. Home to health institution ii. Transfer to higher level facility
for complication
iii. Drop back home 4 No. of sick newborn who used RT service for i. Home to health institution ii. Transfer to higher level facility
for complication
iii. Drop back home
5. No. of facilities where referral transport services are available ......................... 6. Whether District level call centre is in place (Y / N)..................
(C) Grievance Redressal :
Sl. No Grievance Redressal Stas detail 1 No. of complains/grievance cases related to free entitlements 2 No. of cases addressed / No. of cases pending 3 Average No. of days taken per case to address
Signature of District Nodal Officer.
You are requested to share this information to all concerned. D. Ghosh
Commissioner (FW) & Secretary to Government of West Bengal
No. H/SFWB/ /1(9) Date:
Copy for information to:
1. PA to Principal Secretary, Dept of H&FW 2. Spl. Secretary (MA) 3. Joint Secretary (TDE) 4. Addl. Mission Director, NRHM & Jt. Secretary (FW) 5. Jt. Director of Health Services (FW) & SFWO 6. Controller of Finance & Jt. Director of Health Services 7. Principal ( All Medical Colleges) 8. Chief Medical Officer of Health (All districts) 9. Programme Officer, NRHM with the request to upload this in Website.
D. Ghosh
Commissioner (FW) & Secretary