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Janani Shishu Suraksha Karyakram (JSSK). Secretaries Review Meeting September 11, 2012. Dr Himanshu Bhushan, DC (MH). JANANI SHISHU SURAKSHA KARYAKRAM Launched on 1 st June, 2011. OBJECTIVES
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Janani Shishu Suraksha Karyakram (JSSK) Secretaries Review Meeting September 11, 2012 Dr Himanshu Bhushan, DC (MH)
JANANI SHISHU SURAKSHA KARYAKRAMLaunched on 1st June, 2011 OBJECTIVES • Eliminating out-of-pocket expenses for families of pregnant women and sick newborns in government health facilities • Reaching the unreached pregnant women (nearly 75 lakh a year who still deliver at home) • Timely access to care for sick newborns
JSSK Entitlements for pregnant women • Free and cashless delivery • Free C-section • Free drugs and consumables • Free diagnostics • Free provision of blood • Free diet during stay in health institutions • Up to 3 days for normal delivery • 7 days for Caesarean sections • Free transport • Home to health institution • Between health institutions in case of referral • Drop back home after delivery • Exemption from all kinds of user charges, including for seeking hospital care up to 6 weeks post delivery (for post natal complications)
JSSK Entitlements for sick neonates till 30 days after birth • Free treatment at the public health institutions • Free drugs and consumables • Free diagnostics • Free provision of blood • Free transport • Home to health institution • Between health institutions in case of referral • Drop back home after delivery • Exemption from all kinds of user charges
STATUS All the 35 States /UTs have initiated implementation of the scheme While Rs 1437 crores was approved under NRHM for the entitlements in 2011 -12 another 2103 crores have been sanctioned in 2012-13 for provision of free entitlements
JSSK – Status of Free Entitlements • Free entitlements to PW
JSSK – Status of Free Entitlements • Free entitlements to PW
JSSK – Status of Free Entitlements • Free entitlements to Sick –new-born
A real time incident • Sangeeta, FTP, reports to a CHC for her problems; No checks done; No medicines prescribed but simply written seen by Doctor & Nurse and referred to Civil Hospital • At Civil Hospital, BP checked 180/100; No anti hypertensive given however Inj Ceftriaxone was prescribed and then referred to DWH • At DWH, Hb done 7.5 gm%, Loading dose of Mag Sulph given and referred to the Medical College • At MC, full protocol of treatment started, but unfortunately between the 3 referrals, the foetus could not survive (IUD) and mother was in shock • WHY ALL THIS? • JUST BECAUSE SHE IS POOR AND HAS NO VOICE
JSSK IMPLEMENTATIONWay Forward • IEC for public & greater awareness about the free entitlements among all health providers • Orientation of clinicians and doctors for using rational antibiotics and generic drugs as per the technical guidelines not as per their habit of writing medicines. • Ensuring regular procurement and availability of drugs and consumables at health institutions • Orientation for Rational use of USG and its availability at DH, SDH, FRUs • Basic diagnostic facilities should be available at least at all delivery points • Emergency lab facilities should be at least at all DHs and FRUs. • Monitoring of ambulance network for their optimal utilization
JSSK IMPLEMENTATIONWay Forward • Establish district-wise assured referral linkages; GPS fitted vehicles; centralised control rooms • Grievance redressal mechanism to be institutionalised to ensure commitments are fulfilled in letter and spirit • Financially empower the districts and facility in-charges, particularly for emergencies / stock outs • Periodic field visits by State & District officials for monitoring the Implementation of free entitlements • Review by Secretary Health/ Mission Directors in Meetings at State and CMOs meetings at District levels