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.

Funding: World Health Organisation (WHO)

Duration : 04.02.2011 to 15.04.2012

Partners

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