Jannai Shishu Suraksha Karyakaram (JSSK)

1. Janani Shishu Suraksha Karyakram (JSSK) Presented By Dr. Fredrick Stephen P.G in Community Medicine

2. Introduction JSSK launched in June 1 st 2011 in Mewat district in Haryana. Collaborative effort of NRHM and MoHFW Free services to all pregnant women & Sick neonates accessing public health institutions. Cashless service to pregnant women including normal deliveries and caesarean sections Treatment of sick newborn till 30 days .

3. To be implemented in all Govt. hospitals across States and U.T Assured totally free maternity services up to 42 days and newborn care up to 30 days to all beneficiaries in all Govt. institutions. Irrespective of financial status e.g. BPL or not Entitled to receive free transport, drugs, consumables and Blood.

4. Free diet during the stay 3 days for normal delivery 7 days for caesarean section JSSK supplements cash initiative of JSY Bound to benefit 1 crore pregnant mothers and neonates Increase access of health care to 70 lakh mothers delivering at hom e

5. Rationale for Launching 67,000 women die every year due to Preg . Related causes 13 lakh infants die within 1 year of birth 9 lakh newborn die within first 4 weeks of birth Out of that 7 lakh neonates die within the first week

6. Current pace in decline of IMR , MMR not sufficient to meet MDG and targets under NRHM. 25% pregnant women Hesitate to access Health institutions Those who opt for institutional delivery don’t stay for more than 48 hrs

7. Factors affecting Accessibility High out of pocket (OOP) expenses on … User charges for OPD, diagnostic tests, blood etc Purchasing of medicines and other consumables Escalating Cost of caesarean operations Logistics Non availability of proper diet in most institutions

8. Goals of JSSK Provision of maternal and newborn care A continuum of care approach, Ensuring care during critical periods of delivery and postnatal period Addresses the need of the mother and the newborn Ensure a seamless transition from home and village to facility and back again.

9. Entitlement for Pregnant Women Free and zero expense delivery & cesarean section • Free drugs and consumables • Free essential and desirable diagnostics (Blood & urine tests, USG, etc) during Ante Natal Care, Intra Natal Care and Post Natal care • Free diet • Free provision of blood • Free transport – home to hospital, inter hospital and drop back to home • Exemption of all kinds of user charges

10. Entitlement for Sick newborn till 30 days after birth • Free and zero expense treatment • Free drugs and consumables • Free essential diagnostics (Blood & urine tests, USG, etc) • Free provision of blood • Free transport – home to hospital, inter hospital and drop back to home • Exemption of all kinds of user charges

11. The “3 Ds” Drugs and Consumables All essentials to be given free of cost during ANC, INC, PNC and up to 6 weeks. Neonates to be given priority treatment Diagnostics All investigations required prior to normal / caesarean delivery to be made free of cost Applies to neonates also Diet Non availability of diet demotivates mothers from staying for at least 48 hrs

12. Blood Required for Transfusion, Anemia ,PPH, C-section e.t.c Will be provided free of cost without user charges Exemption from user charges OPD, Admissions, Diagnostic tests, Blood Exploitation by private labs Referral Transport Alleviates the pressure to leave the health facility earlier than desirable Obviates OOP expenses

13. Implementing the New Initiative Actions at state level Actions at District Level Dissemination of Entitlements in Public Domain Ensure Drugs and Consumables Strengthen Diagnostics Ensure Provision of diet Ensure availability of Blood Exemption from all Kinds of User Charges Referral Transport Grievance Redressal Funds Monitoring and Follow up

14. V) Strengthen Diagnostics Ensure lab and diagnostic facilities at all govt healthcare points Ensure regular pregnancy test, HB and urine routine at SC level Rational posting of lab techs Emergency investigations available round the clock in FRU onwards. Uninterrupted supply of lab reagents Local heads empowered to procure reagents in stock outs. VI) Ensure Provision of Diet Cooked food to be provided up to 24x7 PHC Services can be outsourced. Local seasonal food, fruits, milk and egg can be given for proper nutrition MO to monitor quality of food Diet for 3 days for normal delivery and for 7 days in cesarean operation. Health facility to be provided funds for diet in advance.

15. VII) Ensure availability of blood in case of need Time bound action plan to operationalise blood banks and blood storage units Maintain adequate stock of each blood group Ensure availability of reagents and consumables used for blood testing and transfusion Mandatory screening of blood before storage Organize voluntary blood donation camps Assure electric backup and funds for POL Blood bank in charge to periodically visit blood storage units.

16. VIII) Exemption from all Kinds of User Fee Charges Issue GO for Exemption from any user fee for pregnant women and sick newborn up to 30 days at public health facilities IX) Referral Transport Ensure no area left uncovered, 24x7 Any mode of transport can be used- Govt. vehicle, 108, PPP. Toll free number at district / State level Take action in designated time frame and convey to the complainant Maintain proper records of actions taken. Establish linkages for inaccessible areas Publicize free transport through print and electronic media Monitor services at each level including utilization of each vehicle & number of cases Transported

17. X) Grievance Redressal Prominently display the names, address, email, tel. nos., mobile phone nos., fax nos. of grievance Redressal authorities at facility level, district level, state level and disseminate them widely in public domain. Set up help desk / suggestion box, complaint box Keep fixed hours at least 1 hour on any two working days to meet the complainants and address their grievances Take action in designated time frame and convey to the complainant Maintain proper records of actions taken.

18. XI) Funds Reflect the requirement of funds in the state PIP under NRHM in addition to resources available from state budget XII) Monitoring and Funds At national level Scheme will be monitored by NHSRC under MoHFW At state and district level , respective nodal officers will monitor the progress CMO will review the progress of the Scheme.

19. THANK YOU