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
3SIHFW: an ISO 9001:2008 certified Institution
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
4SIHFW: an ISO 9001:2008 certified Institution
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
5SIHFW: an ISO 9001:2008 certified Institution
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
6SIHFW: an ISO 9001:2008 certified Institution
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
7SIHFW: an ISO 9001:2008 certified Institution
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.
8SIHFW: an ISO 9001:2008 certified Institution
• 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
9SIHFW: an ISO 9001:2008 certified Institution
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
10SIHFW: an ISO 9001:2008 certified Institution
• 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
11SIHFW: an ISO 9001:2008 certified Institution
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
12SIHFW: an ISO 9001:2008 certified Institution
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
13SIHFW: an ISO 9001:2008 certified Institution
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
14SIHFW: an ISO 9001:2008 certified Institution
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
15SIHFW: an ISO 9001:2008 certified Institution
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.
16SIHFW: an ISO 9001:2008 certified Institution
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
17SIHFW: an ISO 9001:2008 certified Institution
• 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
19SIHFW: an ISO 9001:2008 certified Institution
• 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
20SIHFW: an ISO 9001:2008 certified Institution
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
22SIHFW: an ISO 9001:2008 certified Institution
Status of Blood Banks & Blood Storage CentersBlood Storage Centers
23SIHFW: an ISO 9001:2008 certified Institution
Operationalising List of Blood Banks
Source:-DM&HS Rajasthan
24SIHFW: an ISO 9001:2008 certified Institution
Operationalising List of Blood Storage CentersStorage Centers
Source:-DM&HS Rajasthan
25SIHFW: an ISO 9001:2008 certified Institution
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
26SIHFW: an ISO 9001:2008 certified Institution
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
27SIHFW: an ISO 9001:2008 certified Institution
• 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
28SIHFW: an ISO 9001:2008 certified Institution
Source:-G.O ,DM&HS Rajasthan
District Wise List of Functional 108 A b lAmbulances
29SIHFW: an ISO 9001:2008 certified Institution
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
30SIHFW: an ISO 9001:2008 certified Institution
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
31SIHFW: an ISO 9001:2008 certified Institution
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
32SIHFW: an ISO 9001:2008 certified Institution
• 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
34SIHFW: an ISO 9001:2008 certified Institution
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
41SIHFW: an ISO 9001:2008 certified Institution
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)
Ajmer Bikaner Bharatpur Jaipur Jodhpur Kota Udaipur
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
44SIHFW: an ISO 9001:2008 certified InstitutionSource:-DM&HS Rajasthan ( From April 1- July 15,2012)
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
45SIHFW: an ISO 9001:2008 certified InstitutionSource:-DM&HS Rajasthan ( From April 1- July 15,2012)
No. of Women Received Free Foodo o o e ece ed ee ood
42620
29340
38956
29340
1874622581
26784
18789
Ajmer Bikaner Bharatpur Jaipur Jodhpur Kota UdaipurAjmer Bikaner Bharatpur Jaipur Jodhpur Kota Udaipur
46SIHFW: an ISO 9001:2008 certified InstitutionSource:-DM&HS Rajasthan ( From April 1- July 15,2012)
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
Ajmer Bikaner Bharatpur Jaipur Jodhpur Kota Udaipur
47SIHFW: an ISO 9001:2008 certified InstitutionSource:-DM&HS Rajasthan ( From April 1- July 15,2012)
No. of Women Received Free Bloodo o o e ece ed ee ood3416 3495
2289
1297 1221759
1221
554
Ajmer Bikaner Bharatpur Jaipur Jodhpur Kota UdaipurAjmer Bikaner Bharatpur Jaipur Jodhpur Kota Udaipur
48SIHFW: an ISO 9001:2008 certified InstitutionSource:-DM&HS Rajasthan ( From April 1- July 15,2012)
Zone Wise status of RJSSY for Sick NewbornRJSSY for Sick Newborn
49SIHFW: an ISO 9001:2008 certified Institution
No. of Newborns Received Free M di iMedicines
1704417044
12958
6364
85707190
63644241 4410
Ajmer Bikaner Bharatpur Jaipur Jodhpur Kota UdaipurAjmer Bikaner Bharatpur Jaipur Jodhpur Kota Udaipur
50SIHFW: an ISO 9001:2008 certified InstitutionSource:-DM&HS Rajasthan ( From April 1- July 15,2012)
No. of Newborns Received Free Lab T tTest
6527
4072
25701988
565
1841
2570
Ajmer Bikaner Bharatpur Jaipur Jodhpur Kota Udaipur
565439
Ajmer Bikaner Bharatpur Jaipur Jodhpur Kota Udaipur
51SIHFW: an ISO 9001:2008 certified InstitutionSource:-DM&HS Rajasthan ( From April 1- July 15,2012)
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
Ajmer Bikaner Bharatpur Jaipur Jodhpur Kota Udaipur
52SIHFW: an ISO 9001:2008 certified InstitutionSource:-DM&HS Rajasthan ( From April 1- July 15,2012)
No. of Newborns Received Free Bl dBlood
394
130130
39
123
34
Ajmer Bikaner Bharatpur Jaipur Jodhpur Kota Udaipur
3 0
Ajmer Bikaner Bharatpur Jaipur Jodhpur Kota Udaipur
53SIHFW: an ISO 9001:2008 certified InstitutionSource:-DM&HS Rajasthan ( From April 1- July 15,2012)
Thank You
For more details log on towww.sihfwrajasthan.com
or contact : Director-SIHFW on
[email protected]@yahoo.co.in
54SIHFW: an ISO 9001:2008 certified Institution
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