Janani Shishu Suraksha
Karyakram
Reducing the maternal and infant mortality rate is the
key goal feature of the Reproductive and Child Health Programme under the
National Rural Health Mission. Several initiatives have been launched by the
Ministry of Health & Family Welfare under the Mission including Janani Suraksha Yojana, a
key intervention that has resulted in phenomenal growth in institutional
deliveries with more than one crore women beneficiaries annually. JSY was launched to promote
institutional deliveries so that skilled attendance at birth is made available and mothers and new born babies can be
saved from pregnancy related complications and deaths.
However, even though institutional delivery has
increased significantly, out of pocket expenses being incurred by pregnant
women and their families remained high. This has acted as a major barrier for
the pregnant women to opt for institutional attendance. They still prefer to
deliver at home. Due to this, a large number of sick neonates die on account of
poor access to health facilities.
To mitigate the problem, the Ministry of Health &
Family Welfare launched Janani Shishu SurakshaKaryakram (JSSK)
on 1st June, 2011 to
provide better health facilities for pregnant women and sick neonates. The scheme
emphasises utmost importance on “Free Entitlements”. The idea is to eliminate
out-of-pocket expenses for both pregnant women and sick
neonates.
Under
this scheme, pregnant women are entitled for free drugs and consumables, free
diagnostics, free blood whenever required, and free diet up to 3 days for
normal delivery and 7 days for C-section. This initiative also provides for free
transport from home to institution, between facilities in case of a referral
and drop back home. Similar entitlements have been put in place for all sick
newborns accessing public health institutions for treatment till 30 days after
birth. The JSSK initiative is estimated to benefit more than one crore pregnant women & newborns both in
urban & rural areas annually.
Access to mother and child health care service was
also hindered by the high out of pocket expenses on user charges for OPD, drugs
and consumables, diagnostic tests etc. In some cases such as severe anaemia or
haemorrhage requiring blood transfusion can also increase immediate expenses.
The same becomes still higher in case caesareansection is done.
So,
JSSK has been launched, to ensure that each and every pregnant woman and sick
neonates upto one month gets timely access to health
care services free of cost and without incurring any out of pocket
expenses.
Under
JSSK, free institutional delivery services (including caesarean operation) are
provided in government health facilities. Medicines including supplements such
as Iron Folic Acid are to be given free of cost to pregnant women. Further,
pregnant women are entitled to both essential and desirable investigations like
blood, urine tests and Ultra-Sonography etc. Furthermore, they are to be
provided with free diet during their stay in the health institutions (up to
three days for normal delivery & seven days for caesarean section). Not
only this, there is a provision of free blood transfusion if the need arises. A
significant number of maternal and neonatal deaths can be saved by providing
timely referral transport facility to the pregnant women. Pregnant women are
entitled to free transport from home to health centre, referral to higher
facility in case of need and drop back from the facility to home. Besides,
under JSSK there is exemption from all kinds of user charges including OPD fees
and admission charges.
Free
treatment is also provided to the sick new born upto thirty days after birth and all drugs
and consumables required are provided free of cost. As in the case of the
mother, the new born too is provided with free diagnostic services and there is
a provision of free blood transfusion if the need arises. The facility of free
transport from home to health institutions and back is also available.
In brief, institutional deliveries are a key
determinant of maternal mortality and quality provision of ante-natal and
post-natal services can reduce infant as well as maternal mortality. Janani Shishu Suraksha Karyakramsupplements
the cash assistance given to a pregnant woman under Janani Suraksha Yojana and is aimed at mitigating the burden
of out of pocket expenses incurred by pregnant women and sick newborns. Besides
it would be a major factor in enhancing access to public health institutions
and help bring down the Maternal Mortality ratio and Infant mortality rates.
The
launch of the Janani Shishu Suraksha Karyakram will encourage all pregnant women to
deliver at public health places and fulfil the commitment of achieving cent
percent institutional delivery. It will also empower service providers working
at the health facilities in providing quality ante-natal, intra-natal and
post-natal services at the institutions. Providing free treatment to sick
neonates will help in decreasing the neonatal mortality rate. This initiative
will help in reducing both maternal and infant mortality and morbidity.
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