Janani Shishu Suraksha Yojna (JSSY) - SIHFW) … at State Level • Issue Government order on free...

Janani Shishu Suraksha Yojna(JSSY)

State Institute of Health & Family Welfare, Jaipur

Need of JSSY

Janani S raksha Yojana n mber of instit tional

JSS

• Janani Suraksha Yojana - number of institutionaldeliveries has increased

• More than 25 % pregnant women still hesitate to• More than 25 % pregnant women still hesitate toaccess health facilities.

• High out of pocket expenses on :• High out of pocket expenses on :User charges for OPD, Admission, Diagnostictests Blood etctests ,Blood etcPurchasing medicines and other consumables

2SIHFW: an ISO 9001:2008 certified Institution

High expense on Caesarean Operation

Non availability of dietNon availability of diet

Expensive transport


Janani Shishu Suraksha Yojna

• Central Gov launched on 1 June, 2011 - JananiCentral Gov launched on 1 June, 2011 Janani

Shishu Suraksha Karyakram

• Rajasthan State Government launched on 12

September 2011 in all 33 districts- JananiSeptember 2011 in all 33 districts Janani

Shishu Suraksha Yojana


Objectivej

• Estimated to benefit more than one crore

pregnant women & new borns

• Emphasis on entitlements and elimination of out-

of pocket expenses for pregnant women andp p p g

sick neonates

• Enhancing access to public health institutions

• Reduce MMR & IMR• Reduce MMR & IMR


Entitlements for Pregnant Women• Free Delivery & C –Section• Free Drugs & Consumables before, during andg g

till 6 months after the delivery• Free Diagnostics(Blood, Urinetests &

Ultrasonography etc)• Free diet during stay (upto 3 days for normal

delivery & 7 days fro C-Section• Free transport from home to health institution,

b t h lth i tit ti i f f l &between health institution in case of referrals &drop back homeE ti f ll ki d f h• Exemption from all kinds of user charges


Entitlements for Sick Newborn till 30 d ft bi th30 days after birth

Free and ero e pense treatment• Free and zero expense treatment• Free drugs & consumables

F di ti• Free diagnostics• Free provision of blood• Free transport from home to health institution,

between health institution in case of referrals &droop back homedroop back home

• Exemption from all kinds of user charges


Actions at State Level• Issue Government order on free entitlements• Nominate a State Nodal Officer• Nominate a State Nodal Officer• Grievance redressal mechanism for ensuring the

implementationimplementation• Ensure regular procurement ,availability of drugs

& consumables& consumables.• Ensure functional lab facilities &diagnostic

servicesservices• Establish and Operationalising blood banks at

District levels & Blood Storage Centers at FRUs.District levels & Blood Storage Centers at FRUs.


• Establish district wise referral linkages with GPSEstablish district wise referral linkages with GPSfitted vehicles and centralized control rooms

• Provide required finances and necessaryq yadministrative steps

• Financially empower the districts and facility in-y p ycharges for emergency situations/stock outs.

• Regular monitoring & reporting• Review the implementation status

118679 private vehicles available for transport Of these 88757 are listed with the health facilities – Source: DM&HS


Actions at District Level

• Nominate a District Nodal OfficerCi l t G O f titl t t ll f ilit• Circulate G.O. on free entitlements to all facilityin chargesP bli i f titl t• Publicise free entitlements

• Grievance redressal mechanism for ensuring theimplementationimplementation

• Ensure availability of drugs and consumables atpublic health institutionspublic health institutions

• Ensure functional lab facilities &diagnosticservices at DH SDH FRU CHC and 24 x7 PHCsservices at DH,SDH,FRU,CHC and 24 x7 PHCs


• Prepare time bound action plans for establishing• Prepare time bound action plans for establishingand Operationalising blood banks at Districtlevels & Blood Storage Centers at FRUsg

• Review referral linkages & utilization bybeneficiaries

• Financially empower the Block MOs & Facility in-charges for emergency situations/stock outs

• Regular monitoring & reporting on designatedformats

• Review the implementation status during BlockMOs/MOs meeting


Dissemination of the entitlements i bli d iin public domain

• Publicise through print and electronic media• Display hoardings & boards in all Gov health p y g

facilities(Main entrance, Labour rooms, Female and Neonatal wards &OPDs)

• Utilize IEC budget sanctioned in PIP


Ensure Drugs & Consumablesg

• Notify drug list for RCH servicesNotify drug list for RCH services• Ensure regular procurement, uninterrupted

supply and availability of drugs & consumablespp y y g• Proper display of daily availability of drugs at

health facilityy• Empower Head of the District /Health facility to

procure drugs & consumables to prevent stockout

As per the guidelines total 93 types of drugs (14-Newborn,79-Mothers ) should be available at the facility


available at the facility

• Ensure the quality and shelf life of drugs• Ensure timely reporting on stock outs and expiry• Ensure timely reporting on stock outs and expiry

of drugs• Ensure availability of drugs at the dispensingEnsure availability of drugs at the dispensing

points (labour room, OT, indoors, casualty etc.)• Ensure “FIFO” protocol is used for expiry drugsEnsure FIFO protocol is used for expiry drugs• Ensure cleaning of drug stores with adequate

ventilation and coolingg


District Wise Availability of Drugs st ct se a ab ty o ugs

93 90 90

65

90 90

61

84 83 86

76

6773

66 65

79

63

73 76

65

49

28

55

40 41

51

38

50 52 50 50

41

56

31

42

24

7

Pro

pose

dA

jmer

Alw

arB

arm

erB

aran

Ban

swar

aB

undi

Bha

ratp

urB

ikan

erB

hilw

ara

Chu

ruC

hitto

rgar

hD

holp

urD

unga

rpur

Dau

saH

anum

anga

rhJa

ipur

IJa

ipur

IIJh

alw

ara

Jodh

pur

Jais

alm

erJa

lore

Jhun

jhun

uK

arau

liK

ota

Nag

aur

Pali

Pra

tapg

arh

Raj

sam

and

Sik

arS

irohi

S.G

anga

naga

rS

. Mad

hopu

rTo

nkU

daip

ur

H S

Source:-DM&HS Rajasthan


InterpretationInterpretation• As per the guidelines total 93 types of drugs (14-

N b 79 M th ) h ld b il bl t thNewborn,79-Mothers) should be available at thefacility.B t i di t i t h th il bilit 50• But maximum districts shows the availability 50-55 types of drugs. Out of which Banswara &Bharatpur shows maximum availability i e 90 &Bharatpur shows maximum availability i.e. 90 &Tonk shows lowest availability i.e.7.


Strengthen Diagnosticg g

• Ensure lab & diagnostic services atEnsure lab & diagnostic services atDH, SDH, FRU, CHC & 24 x 7 PHCs

• Ensure availability of routine investigations likey gpregnancy test, Hb & urine at sub-center level

• Ensure rational posting of Lab technicians forp gintegrated & comprehensive utilization inprogram

• Ensure availability of round the clockinvestigation


• Ensure uninterrupted supply of reagents,Ensure uninterrupted supply of reagents,

consumables and other essentials required for

lab investigations

• Empower the Head of the district/Health facilityEmpower the Head of the district/Health facility

to procure reagents, consumables and other

essentials to prevent their shortage/stock-out

• Free investigations can be provided through• Free investigations can be provided through

PPP/outsourcing if in house lab & diagnostic

services are not available18SIHFW: an ISO 9001:2008 certified Institution

Ensure Provision of Diet

• At all delivery points from district hospital up to• At all delivery points from district hospital up to24x7 PHC

• Outsourcing of kitchen & manpower if notOutsourcing of kitchen & manpower if notavailable

• Proper nutritious diet should be givenProper nutritious diet should be given• Quality of food should be monitor be facility in –

chargeg


• Diet is to be provided :p3 days- Normal Delivery

7 days- C –Section

• Funds should be received in advance for• Funds should be received in advance for

ensuring provision of free diet


Availability of Bloody

• Prepare time bound action plans for establishing• Prepare time bound action plans for establishing

and Operationalising Blood Banks at District

levels & Blood Storage Centres at FRUs

M i t i d t t k f h bl d• Maintain adequate stock for each blood group

• Ensure availability of reagents and consumablesy g

for blood grouping, cross matching and blood

transfusion21SIHFW: an ISO 9001:2008 certified Institution

• Ensure mandatory screening of blood beforestorage & organize blood donation campsstorage & organize blood donation camps

• Adequate funds to blood banks for electric backup and POLp

• Alternate sources of power back up for bloodbag refrigerators

• Regular monitoring & supervision should bedone by MO in-charge/ lab technician at bloodstorage unit


Status of Blood Banks & Blood Storage CentersBlood Storage Centers


Operationalising List of Blood Banks



Operationalising List of Blood Storage CentersStorage Centers



Exemption of User Chargesp g

• Issue Government order for exemption from any

user charges for pregnant women & sick new

borns up to 30 days , at public health facilitiesborns up to 30 days , at public health facilities


Referral Transportp

• Ensure universal reach of the referral transportEnsure universal reach of the referral transportwith 24x7 referral services

• State is free to use- Gov. ambulances, EMRI,, ,referral transport PPP model etc

• Establish call centers with toll free number, at,district or sate level

• GPS provide to ambulances for effectivetracking & management


• Establish linkages for the inaccessible areas(hilly terrain, flooded or tribal areas etc.) to the( y )road head/pick up points

• Publicize free & assured referral transportthrough print & electronic media

• Monitor & supervise the utilization of the eachvehicle & number of cases transported

If referral provide by private vehicle payment should be:If referral provide by private vehicle payment should be:12 Km > 125Rs12Km -25 Km – 250Rs25 Km< 7Rs added per Km


Source:-G.O ,DM&HS Rajasthan

District Wise List of Functional 108 A b lAmbulances


Source:-108 Ambulance Services ZHCL Rajasthan as on July 2012

Budget for Transportation (Sep 2011 M h 2012) R j th2011- March 2012)-Rajasthan

For pregnant Women For Sick ne bornFor pregnant Women For Sick newborn Child

Total 1462 Lakh 523.60 LakhTotal 1462 Lakh 523.60 Lakh

Source: G.O, rajswasthya.nic.in


Grievance Redressal• Display & disseminate the names, addresses,

e-mails, telephones, mobiles and fax numbers ofgrievance redressal authorities at state, districtlevel & public domainS t h l d k ti / l i t b t• Set up help desks, suggestion / complaint box atGov. facilitiesW kl fi d t h f ti th• Weekly fixed two hours for meeting thecomplainants & redressing their grievances

• Take action on the grievances within a suitable• Take action on the grievances within a suitabletimeframe & communicate to the complainants

• Maintain proper record• Maintain proper record


Funds (as approved under PIP 2012 13)2012-13)

• Drugs and consumablesDrugs and consumables– For normal deliveries – Rs. 1200 lakhs– For complicated deliveries – Rs. 1080 lakhsp– For caesarean deliveries – Rs. 900 lakhs– For sick newborn – Rs. 120 lakhs

• Diagnostics– For pregnant women – Rs. 2400 lakhs– For newborns – Rs. 9 lakhs

• Blood Transfusion– For pregnant women – Rs. 150 lakhs– For newborns – Rs. 20 lakhs


• Diet– For normal deliveries – Rs. 1468.80 lakhs– For caesarean deliveries – Rs. 214.20 lakhs

• Free referral transport– For pregnant womenp g

• From home to institution – Rs. 1375 lakhs• From institution to home – Rs. 1625 lakhs• Referral to higher facility and drop back – Rs. 450

lakhsF i k b– For sick newborn• Mildly sick – Rs. 300 lakhs

S l i k R 60 l kh• Severely sick – Rs. 60 lakhs33SIHFW: an ISO 9001:2008 certified Institution

Monitoring and Follow Upg p

• At National -NHSRC, MHD & MoHFW GoI

• At State &District Level-State & District Nodal

officerofficer


Status of RJSSY


RJSSY: PerformanceS.No

Services No. of beneficiaries (Sept 12, 2011

– March 31,

No. of beneficiaries(April 1 – July 15 2012)March 31,

2012)15 2012)

1 Total Deliveries 430235 192210

2 N f t id d f di i 753058 3058442 No. of pregnant women provided free medicine 753058 305844

3 No. of pregnant women provided free lab tests 417319 186478

4 No of pregnant women availed free hot food 516437 1978164 No. of pregnant women availed free hot food 516437 197816

5 No. of pregnant women provided free referral transport from house to health facility 227716 142684

6 No. of pregnant women provided free referral transport from health facility to house 289978 153604

7 No. of pregnant women provided free blood facility 18860 13086

SIHFW: an ISO9001: 2008 certified institution 39Source:-DM&HS

RJSSY: PerformanceS.No

Services No. of beneficiaries (Sept 12, 2011

– March 31,

No. of beneficiaries(April 1 –July 15March 31,

2012)July 15 2012)

1 No of Sick Neonates (30 days) received free medicine 132387 607771 No. of Sick Neonates (30 days) received free medicine 132387 60777

2 No. of Sick Neonates (30 days) received free lab tests 35399 18002

3 No. of Sick Neonates (30 days) received free referral transport from house to health facility 8434 2712

4 No. of Sick Neonates (30 days) received free referral transport from health facility to house 13850 5212

No of Sick Neonates (30 days) provided free blood5 No. of Sick Neonates (30 days) provided free blood facility 711 723

SIHFW: an ISO9001: 2008 certified institution 40Source:-DM&HS

ID under JSY and JSSKJ J

JSY JSSK342393

314556265711

JSY JSSK

319786 298420254779

Oct-Dec Jan-Mar Apr-June

Source: DM&HS monthly reports –data compared with ID of previous year for same quarters


Zone Wise status of fRJSSY for Pregnant Women


Total Deliveries

35528

37584

3035328640

1905022082

19073

Ajmer Bikaner Bharatpur Jaipur Jodhpur Kota Udaipur

43SIHFW: an ISO 9001:2008 certified InstitutionSource:-DM&HS Rajasthan ( From April 1- July 15,2012)


No. of Women Received free M di iMedicines

83113

58347

51619

34803

58347

25817 2937622769

Ajmer Bikaner Bharatpur Jaipur Jodhpur Kota UdaipurAjmer Bikaner Bharatpur Jaipur Jodhpur Kota Udaipur


No. of Women Received Free Lab T tTest

3884537133

2918227569

37133

14644

2025318853

Ajmer Bikaner Bharatpur Jaipur Jodhapur Kota UdaipurAjmer Bikaner Bharatpur Jaipur Jodhapur Kota Udaipur


No. of Women Received Free Foodo o o e ece ed ee ood

42620

29340

38956

29340

1874622581

26784

18789



No. of Women Received Free T t ti F ilitTransportation Facility

35 12 01

Free Transportation home to facility Free Transportation facility to home

2863

2301

0

2445

9

2499

5282

5

2447

0

2345

1 291

9

1685

3

153

4284

1822

5

1586

1

1157

9

13114



No. of Women Received Free Bloodo o o e ece ed ee ood3416 3495

2289

1297 1221759

1221

554



Zone Wise status of RJSSY for Sick NewbornRJSSY for Sick Newborn


No. of Newborns Received Free M di iMedicines

1704417044

12958

6364

85707190

63644241 4410



No. of Newborns Received Free Lab T tTest

6527

4072

25701988

565

1841

2570


565439



No. of Newborns Received Free T t ti f H t F ilitTransportation from Home to Facility

967 977Free Transportation home to facility 967

829 797

Free Transportation facility to home

542464

665642 625

227279

395375

140



No. of Newborns Received Free Bl dBlood

394

130130

39

123

34


3 0



Thank You

For more details log on towww.sihfwrajasthan.com

or contact : Director-SIHFW on

[email protected]@yahoo.co.in


Janani Shishu Suraksha Yojna (JSSY) - SIHFW) … at State Level • Issue Government order on free...

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