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LATEST NEWS UPDATES | Free childbirth services elude poor -GS Mudur

Free childbirth services elude poor -GS Mudur

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published Published on Jul 8, 2016   modified Modified on Jul 8, 2016
-The Telegraph

New Delhi: Free health-care services during childbirth remain a pipe dream for most of India's poor, whether it relates to diagnostic tests, medicines, transport or even food, despite the Union health ministry launching a "free entitlements" programme five years ago.

The families of most women who seek childbirth in government hospitals are forced to pay for supposedly "free" services, at times experiencing catastrophic expenditures likely to accentuate their poverty, two independent investigations by public health and social science experts have found.

A study of more than 14,400 deliveries through government or private clinics across the country during a six-month period has found that only 19 women had to pay nothing for childbirth. All the rest had to pay at various points during maternity care, with their bills touching an average of Rs 15,000.

"Private health care pushes up the average but the free entitlements that women should receive in government clinics either aren't sufficient or aren't available throughout the maternity period," said Srinivas Goli, an assistant professor at the Jawaharlal Nehru University, New Delhi, who led the study.

The health ministry had about a decade ago launched the Janani Suraksha Yojana (JSY) that promises each woman who seeks institutional delivery a sum of Rs 1,400.

In 2011, the ministry launched the Janani Shishu Suraksha Karyakaram (JSSK) that promises women seeking childbirth in government institutions benefits such as cashless delivery, free C-section surgeries when necessary, free diagnosis and medicines, free food during stay in the health-care institution, and free transport.

Goli and his colleagues from collaborating academic institutions in Odisha and Australia have found that the cost of delivery itself was on average about Rs 9,000. Their findings have been published in the research journal PLOS One.

"The JSY scheme has drawn more and more women to institutions for deliveries," Goli said.

The number of JSY beneficiaries rose from about 740,000 women in 2005-06 to about 11 million by 2009, but the findings suggest that poor households continue to face significant expenditures despite the JSY and JSSK.

The second analysis was conducted across four states - Bengal, Jharkhand, Odisha and Uttar Pradesh - during 2014 and 2015. It found that households seeking childbirth services in government clinics had to make significant expenditures while trying to access free entitlements under the JSSK scheme.

"Over the past two years, we found pretty much the same thing we observed in 2009 - spending by families for childbirth has not stopped," said Jashodara Dasgupta, senior advisor with Sahayog, an NGO tracking the quality of maternal health care available in government clinics for over a decade.

"They have to pay either for services not available or have to pay money to access what should be free for them --- whether an ambulance for transport or registration for the delivery itself."

During a 16-month period spanning 2012 and 2013, Sahayog, working with grassroots women's groups in the villages of Uttar Pradesh, had used a toll-free telephone hotline to document 873 complaints of "informal payment demands" by health-care providers.

"We need to build strong public counter pressure, and inform and organise women and their households to demand their entitlements and complain to medical officers when demands for payment are made," Dasgupta said.


The Telegraph, 8 July, 2016, http://www.telegraphindia.com/1160708/jsp/nation/story_95451.jsp#.V39I_qI1t_k


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