Presented By

Dr. Fredrick Stephen

P.G in Community Medicine

Introduction

JSSK launched in June 1st 2011 in Mewat district in Haryana.

Collaborative effort of NRHM and MoHFW

Free services to all pregnant women & Sick neonates accessing public

health institutions.

Cashless service to pregnant women including normal deliveries and

caesarean sections

Treatment of sick newborn till 30 days .

To be implemented in all Govt. hospitals across States and U.T

Assured totally free maternity services up to 42 days and

newborn care up to 30 days to all beneficiaries in all Govt.

institutions.

Irrespective of financial status e.g. BPL or not

Entitled to receive free transport, drugs, consumables and Blood.

Free diet during the stay

3 days for normal delivery

7 days for caesarean section

•JSSK supplements cash initiative of JSY

• Bound to benefit 1 crore pregnant mothers and neonates

•Increase access of health care to 70 lakh mothers delivering at

home

Rationale for Launching

67,000 women die every year due to Preg. Related causes

13 lakh infants die within 1 year of birth

9 lakh newborn die within first 4 weeks of birth

Out of that 7 lakh neonates die within the first week

Current pace in decline of IMR , MMR not sufficient

to meet MDG and targets under NRHM.

•25% pregnant women Hesitate to access Health institutions

•Those who opt for institutional delivery don’t stay for more

than 48 hrs

Factors affecting AccessibilityHigh out of pocket (OOP) expenses on …

User charges for OPD, diagnostic tests, blood etc

Purchasing of medicines and other consumables

Escalating Cost of caesarean operations

Logistics

Non availability of proper diet in most institutions

Goals of JSSK

Provision of maternal and newborn care

A continuum of care approach,

Ensuring care during critical periods of delivery and

postnatal period

Addresses the need of the mother and the newborn

Ensure a seamless transition from home and village to

facility and back again.

Entitlement for Pregnant Women

•Free and zero expense delivery & cesarean section

• Free drugs and consumables

• Free essential and desirable diagnostics (Blood & urine tests, USG, etc)

during Ante Natal Care, Intra Natal Care and Post Natal care

• Free diet

• Free provision of blood

• Free transport – home to hospital, inter hospital and drop back to home

• Exemption of all kinds of user charges

Entitlement for Sick newborn till 30 days after birth

• Free and zero expense treatment

• Free drugs and consumables

• Free essential diagnostics (Blood & urine tests, USG, etc)

• Free provision of blood

• Free transport – home to hospital, inter hospital and drop back to

home

• Exemption of all kinds of user charges

The “3 Ds” Drugs and Consumables

All essentials to be given free of cost during ANC, INC, PNC and up to 6

weeks.

Neonates to be given priority treatment

• Diagnostics

All investigations required prior to normal / caesarean delivery to be made

free of cost

Applies to neonates also

• Diet

Non availability of diet demotivates mothers from staying for at least 48 hrs

Blood

Required for Transfusion, Anemia ,PPH, C-section e.t.c

Will be provided free of cost without user charges

• Exemption from user charges

OPD, Admissions, Diagnostic tests, Blood

Exploitation by private labs

• Referral Transport

Alleviates the pressure to leave the health facility earlier than desirable

Obviates OOP expenses

Implementing the New Initiative1. Actions at state level

2. Actions at District Level

3. Dissemination of Entitlements in Public Domain

4. Ensure Drugs and Consumables

5. Strengthen Diagnostics

6. Ensure Provision of diet

7. Ensure availability of Blood

8. Exemption from all Kinds of User Charges

9. Referral Transport

10. Grievance Redressal

11. Funds

12. Monitoring and Follow up

V) Strengthen Diagnostics

Ensure lab and diagnostic facilities at all govt healthcare points

Ensure regular pregnancy test, HB and urine routine at SC level

Rational posting of lab techs

Emergency investigations available round the clock in FRU onwards.

Uninterrupted supply of lab reagents

Local heads empowered to procure reagents in stock outs.

VI) Ensure Provision of Diet

Cooked food to be provided up to 24x7 PHC

Services can be outsourced.

Local seasonal food, fruits, milk and egg can be given for proper nutrition

MO to monitor quality of food

Diet for 3 days for normal delivery and for 7 days in cesarean operation.

Health facility to be provided funds for diet in advance.

VII) Ensure availability of blood in case of need

Time bound action plan to operationalise blood banks and blood storage units

Maintain adequate stock of each blood group

Ensure availability of reagents and consumables used for blood testing and

transfusion

Mandatory screening of blood before storage

Organize voluntary blood donation camps

Assure electric backup and funds for POL

Blood bank in charge to periodically visit blood storage units.

VIII) Exemption from all Kinds of User Fee Charges

Issue GO for Exemption from any user fee for pregnant women and sick newborn up to 30 days at public health facilities

IX) Referral Transport

Ensure no area left uncovered, 24x7

Any mode of transport can be used- Govt. vehicle, 108, PPP.

Toll free number at district / State level

Take action in designated time frame and convey to the complainant

Maintain proper records of actions taken.

Establish linkages for inaccessible areas

Publicize free transport through print and electronic media

Monitor services at each level including utilization of each vehicle & number of cases

Transported

X) Grievance Redressal

Prominently display the names, address, email, tel. nos., mobile phone nos., fax nos.

of grievance Redressal authorities at facility level, district level, state level and

disseminate them widely in public domain.

Set up help desk / suggestion box, complaint box

Keep fixed hours at least 1 hour on any two working days to meet the complainants

and address their grievances

Take action in designated time frame and convey to the complainant

Maintain proper records of actions taken.

XI) Funds

Reflect the requirement of funds in the state PIP under NRHM in addition to

resources available from state budget

XII) Monitoring and Funds

At national level Scheme will be monitored by NHSRC under MoHFW

At state and district level , respective nodal officers will monitor the progress

CMO will review the progress of the Scheme.

THANK YOU