RSBY Project Overview

by iphindia | Oct 31, 2011 | Latest Updates, Research

Background

The Rashtriya Swasthya Bima Yojna (RSBY), along with the National Rural Health Mission (NRHM), is a flagship programme introduced by the central government in April 2008, to increase the breadth, depth and height of coverage so that ultimately universal coverage can be achieved.

Key features of this scheme are a systematic focus on the poor with an aim to try and cover all BPL families within a period of five years, covering more than 700 hospitalisation packages, thereby protecting the poor from major health shocks, and finally a cashless mechanism through the “smart card”. The RSBY is an excellent attempt at providing social protection in health for the vulnerable and poor in India.The scale of RSBY, its clear social purpose, as well as its original design also make the scheme a tremendous learning opportunity for social policy-makers in India and all over the world.

Hence, there is a need to study the RSBY in more detail and identify what works and what does not work, and also understand why. This is also an excellent opportunity to provide feedback to policy makers and managers of this scheme, so that the scheme can be further strengthened.

Objectives

1. To study the impact of the RSBY scheme in Patan district of Gujarat state in terms of enrolment rates, access to quality hospital care and financial protection
2. To list and understand the issues with governance, enrolment, utilisation and monitoring of the scheme

Methodology:
Two dimensions are being studied and hence, two distinct methodologies are used:

• To look at what is happening, a household survey will be conducted using a structured, closed ended questionnaire.
• To understand why certain events are happening, qualitative methods like key informant interviews and focus group discussions will be conducted.

Expected deliverables

This study will assess the performance of the RSBY vis-a-vis enrolment, access to quality hospital care and financial protection. .All the three dimensions of universal coverage – the coverage of the BPL families, the depth of the RSBY package and the out-of-pocket payments will be considered during analysis and interpretation of results. The study results are expected to provide an explanation to policy makers and managers to enable them to make necessary corrective actions to improve the effectiveness and efficiency of the RSBY. The results will hence, be disseminated to stakeholders from district to national levels through a workshop and also to academicians, activists and policy makers via publications in peer reviewed journals.

Partners

Indian Institute of Public Health (IIPH), Gandhinagar
Institute of Tropical Medicine (ITG), Antwerp, Belgium

Health Inc. Project Overview

by iphindia | Oct 31, 2011 | Latest Updates, Research

Title – Socially inclusive health care financing in West Africa and India

Short title – Financing health care for inclusion

Project Acronym – Health Inc

Duration – 36 months

In most low- and middle- income countries (LMIC), out-of-pocket payments make up a large proportion of total health expenditure (on average 75% in Asia and 50% in Africa). At the international level, there is now a consensus that out-of-pocket payments for health care increase inequity and as a result, increased risk pooling is necessary. There has been a recent proliferation of health financing reforms in LMIC which aim to introduce prepayment at affordable prices for low socio-economic groups and targeted subsidies for indigents and other vulnerable groups. However, while such reforms have led to increased utilization of health care, it is often the case that the poor and informal sector continue to be excluded from coverage.

The research project Health Inc. (Financing health care for inclusion) puts forward the hypothesis that social exclusion is an important cause of the limited success of recent health financing reforms.

In four countries/states (Ghana, Karnataka, Maharashtra and Senegal), Health Inc. will employ mixed methods to analyse whether different types of financing arrangements not only overcome social exclusion to successfully cover poorer population groups but, crucially, also increase social inclusion by empowering socially marginalised groups. A multi-sectoral stakeholder analysis will additionally explore whether vulnerable population groups participate in policy making and whether their needs are represented and understood.  Health Inc. will also identify and test policy recommendations.

This will be done through a process of comparing and contrasting policies across contexts in order to elicit lessons. Following this, local policy makers and population groups will be consulted in a feasibility analysis.

Using a wide range of media, Health Inc. will disseminate those lessons learnt among different target populations: local, national and international public health authorities, researchers and health and development cooperation actors in general. Health Inc. will also consolidate and expand international research networks and build the capacity of the partners in the consortium.

Funded under : 7th FWP (Seventh Framework Programme) by the European Union