Directorate of Health Services,Andaman & Nicobar Island , India

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Schemes implementing in the Family Welfare section of the Health Department

1. Janani Suraksha Yojna (JSY)

A pregnant woman belongs to BPL and ST categories are being paid cash assistance per delivery.

Objectives of JSY :

A pregnant woman belongs to BPL and ST categories are being paid cash assistance per delivery. The Beneficiaries details under this scheme are as follows:-

Year	No. of beneficiaries
2018-19	Institutional Deliveries Home Deliveries	- 248 - 3
2019-20	Institutional Deliveries Home Deliveries	- 322 - 6
2020-21	Institutional Deliveries Home Deliveries	- 141 -1

The ASHA were provided with honorarium for Rs. 600/- per Delivery for Rural Areas: Rs.300/- for antenatal component and Rs.300/- for facilitating institutional delivery and Rs.400 for Urban Areas: Rs.200/- for antenatal component and Rs.200/- for facilitating institutional delivery.

2.Janani Sishu Suraksha Karyakram (JSSK)

JSSK invokes a new approach to healthcare, placing, for the first time, utmost emphasis on entitlements and elimination of out-of-pocket expenses for both pregnant women and sick neonates. The initiative entitled all pregnant women delivering in public health institutions to absolutely free and cashless delivery, including caesarean section besides to and fro transport. Similar entitlements have been put in place for all mothers with their sick newborns accessing public health institutions for healthcare till 30 days after birth. They would also be entitles to free treatment besides free transport, both ways and between facilities in case of referral. To provide free referral transport to all pregnant women and sick Newborns 10 Nos. of dedicated vehicles have been provided to the health centres.

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.

Objectives of JSSK :

JSSK invokes a new approach to healthcare, placing, for the first time, utmost emphasis on entitlements and elimination of out-of-pocket expenses for both pregnant women and sick neonates. The initiative entitles all pregnant women delivering in public health institutions to absolutely free and cashless delivery, including caesarean section besides to and fro transport. Similar entitlements have been put in place for all sick newborns accessing public health institutions for healthcare till 30 days after birth. They would also be entitles to free treatment besides free transport, both ways and between facilities in case of referral.

Entitlements for pregnant Women

i) Free and zero expenses Delivery and Caesarean Section

ii). Free Drugs and Consumables.

iii). Free essential Diagnostics (Blood, Urine tests and Ultra-Sonography etc.)

iv). Free Diet during stay in the Health Institutions (Up to 3 days for normal delivery & 7 days for caesarean section)

v). Free Provision of Blood

vi). Free Transport from Home to Health Institutions

vii). Free Transport between facilities in case of referral

viii). Drop Back from Institutions to home after 48 Hrs stay

ix). Exemption from all kind of user charges

Entitlement for sick newborns till 30 day after birth

i) Free and zero expenses treatment

ii) Free Drugs and consumables

iii) Free Diagnostics

iv) Free Provision of Blood

v) Free Transport from Home to Health Institutions

vi) Free Transport between facilities in case of referral

vii) Drop Back from Institution to Home

viii) Exemption from all kind of User Charges

3. Family Planning Indemnities Scheme

A. Introduction:

India is the first country that launched a National Family Planning Programme in 1952, emphasizing fertility regulation for reducing birth rates to the extent necessary to stabilize the population at a level consistent with the socio-economic development and environment protection. Since then the demographic and health profiles of India have steadily improved.

B.1 Government of India scheme to compensate acceiors of sterlization for loss of wages

With a view to encourage people to adopt permanent method of Family Planning, Government has been implementing a Centrally Sponsored Scheme since 1981 to compensate the acceptors of sterilization for the loss of wages for the day on which he/she attended the medical facility for undergoing sterilization.

Under the Scheme, the Central Government released funds to States/UTs @ Rs.300 per Tubectomy, Rs.200 per Vasectomy and Rs.20 per IUD Insertion. The States/UTs had the flexibility to decide the amount of apportionment among various components, provided minimum amount of Rs.150 was paid to the acceptors of Tubectomy/Vasectomy and Rs.60 per Tubectomy, Rs.25 per Vasectomy and Rs.20 per IUD insertion was used by the medical facility towards drugs and dressing. This was intended to ensure quality of service in these procedures. Flexibility rested with the States for determining sub components of the remaining amount, within the total package. In the case of EAG States viz. Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Orissa, Rajasthan, Uttar Pradesh and Uttaranchal, the compensation package for sterilization had been raised from Rs.300/- to Rs.400/- per Tubectomy, Rs.200/- to Rs.400/-per Vasectomy if conducted in a public health facility or approved private sector health facility, and from Rs.20 to Rs.75 per IUD insertion, if conducted in an approved private sector health facility.

A part from providing cash compensation to the acceptor of sterilization for loss of wages, transportation, diet, drugs, dressing etc out of the funds released to States/UTs under this scheme, some States/UTs were apportioning some amount for creating a miscellaneous purpose fund. This fund was utilized for payment of ex-gratia to the acceptor of sterilization or his/her nominee in the unlikely event of his/her death or incapacitation or for treatment of post operative complications attributable to the procedure of sterilization, as under:-

i) Rs. 50,000/- per case of death.

ii) Rs. 30,000/- per case of incapacitation.

iii)Rs. 20,000/- per case of cost of treatment of serious post operation complication.

Any liability in excess of the above limit was to be borne by the State/UT/NGO/ Voluntary Organization concerned from their own resources.

B.2 Directives of Hon'ble supreme court

The Hon’ble Supreme Court of India in its Order dated 1.3.2005 in Civil Writ Petition No. 209/2003 (Ramakant Rai V/s Union of India) has, inter alia, directed the Union of India and States/UTs for ensuring enforcement of Union Government’s Guidelines for conducting sterilization procedures and norms for bringing out uniformity with regard of sterilization procedures by –

1. Creation of panel of Doctors/Health Facilities for conducting sterilization procedures and laying down of criteria for empanelment of doctors forconducting sterilization procedures.

2. Laying down of checklist to be followed by every Doctor before carrying out sterilization procedure.

3. Laying down of uniform proforma for obtaining of Consent of person undergoing sterilization.

4. Setting up of Quality Assurance Committee for ensuring enforcement of pre and postoperative guidelines regarding sterilization procedures.

5. The State shall also bring into effect an Insurance Policy etc., until such time the Union of India prescribes a standard format.

The above all directions have been taken into consideration and consolidated in the updated manuals on Standards and Quality Assurance in Sterilization Services available on the Ministry’s website (www.mohfw.nic.in) under “Family Welfare Activities”. The Family Planning Insurance Scheme is one of the initiatives launched under direction from the Hon’ble Supreme Court w.e.f. from 29th November, 2005,which has been modified as the Family Planning Indemnity Scheme effective from 01.04.2013.

C. Applicability of the family planning identity scheme (FPIS): w.e.f 1st APRIL 2013.

The Family Planning Indemnity Scheme is uniformly applicable for all States/UTs. With effect, 01.04.2013, it has been decided that States/UTs would process and make payment of claims to accepters of sterilization in the event of death/failures/complications /Indemnity cover to doctors/health facilities. It is envisaged that States/UTs would make suitable budget provisions for implementation of the scheme through their respective State/UT Program Implementation Plans (PIPs) under the National Rural Health Mission (NRHM) and the scheme may be renamed “Family Planning Indemnity Scheme”.

It will be the responsibility of the District Official designated for the scheme by the State Government to ensure timely filing and processing, including payment of eligible claims. With effect from 1st April 2013, liability in respect of such cases would be met by the State Government/UT Administration from funds released by Government of India, under the National Rural Health Mission (NRHM), through State Programme Implementation Plans (PIPs). The allocation of funds by Government of India to the States /UTs would be on the basis of either average amount of claims paid during the last 3 years, or an amount not exceeding Rs 50/- per accepter of sterilization, whichever is less. However if the State wishes to provision more or spends more than the allocation, the state may make necessary provision/undertake payment of claims, from their state budget .States whose claim ratios are less would also be free to allocate lesser funds than their due, so that resources within the approved envelope for their PIP could be better utilized. In those States/UTs where the average number of claims reported in the last 3 years is less, an amount to the extent of Rs 5 lakhs may be proposed. The States/UTs may plan for the payment of compensation to sterilization accepters as per the scheme, under budget head A.3.5.4 –Other Strategies/activities Sub-Head A.3.5.4.1.

D. Settlement of cases not covered the family planning insurance scheme (FPIS):

There might be cases not covered by the Family Planning Insurance Scheme, viz. cases of sterilization operations conducted before coming into force of Insurance Scheme, ie prior to 29th November,2005,cases not covered under the National Protocol or the cases already pending in courts etc. Liability in respect of such cases would be met by the State Government/UT Administration from the Miscellaneous Purpose Contingency Fund created in respective State/UT by apportioning some amount from the grants released to them by the Union Government under the Scheme of Compensation for loss of wages foe acceptors of Sterilization/IUD insertions or under the Scheme of Flexible Funding for State Programme Implementation Plans(PIPs).