1. 1 Results Background RSBY – What is the Scheme?
Debashish Kundu1, V Katre2, K Dhillon3, T K Agrawal3, S Srinath4, K Khaparde1, S Chandra1, A Sreenivas1
1 World Health Organization Country Office For India, New Delhi; 2 Rashtriya Swasthya Bima Yojna (RSBY), State Nodal Agency, Directorate of Health Services, Raipur, Chhattisgarh, India; 3 Directorate of Health Services, Raipur, Chhattisgarh, India; 4 International Union against Tuberculosis and Lung Diseases, New Delhi, India.
The authors acknowledge the support of RSBY State Nodal Agency in Chhattisgarh, Central TB Division, The Union, WHO-India, all study participants and staff of the Chhattisgarh State Health Directorate for their support and cooperation
RSBY MDR-TB PACKAGE DETAILS IN SCHEME YEAR 4
Background
India: Estimated 2 – 2.5 Million Annual Incidence of TB cases
Tuberculosis (TB) is a disease of poverty
In many high burden countries, TB patients incur huge expenditure for diagnosis and treatment of TB
The economic burden imposed by TB disease on individuals and families can be reduced through a well designed and implemented social health insurance scheme
National Programmatic Management of Drug Resistant TB (PMDT) Guidelines gives emphasis to the provision of –
Hospitalization of the DR-TB Patient at the DR-TB Centre
Clinical investigations for pre-treatment evaluation.
Ancillary drugs for management of adverse drug reactions
In case a patient refuses admission at the DR-TB Center and to encourage involvement of private sector, alternative local arrangements needs to be undertaken.
The state of Chhattisgarh in central India (population 25 million) has 80% of the population living in rural areas and 30% considered ‘tribal
* Only MDR-TB Diagnosed patient from a RNTCP recognised Laboratory
RSBY – What is the Scheme?
Rashtriya Swasthya Bima Yojna (RSBY), is a social health insurance mechanism in India (Cashless, Paperless and Portable Scheme through Smart Cards)
RSBY provides health insurance coverage and protection :
1. To people Below the Poverty Line (BPL)
2. To fund medical treatment upto 600 US $ annually
3. For five enrolled members in a family
4. 20 US $ towards transportation expenses in a year (2 USD Per Visit) ’.
Results
Table 1: Status of uptake of claims by Tuberculosis Patients in RSBY
Intervention and Response
Discussions
The innovative RSBY MDR-TB package is a step towards attainment of health equity, improving access to the nearest health facilities, empanelled in RSBY.
Synergy with RSBY broadens scope of uptake of standardized services both from the private and public establishments, free of cost, reducing ‘out of pocket expenditure’, which was earlier untapped by the National TB Programme.
Hospitals empanelled under RSBY are electronically enabled and connected to the server at the district level, ensures smooth data flow regarding service utilization.
Empowers Drug Resistant TB Patients to avail cashless, paperless and portable transactions as per his choice in any RSBY empanelled hospital across Chhattisgarh.
Awareness on RSBY MDR-TB Package is essential to improve it’s utilisation.
Recommendations for the TB Programme
In order to address the social protection component of post 2015 Stop TB strategy, mechanisms emphasizing collaboration with existing social health insurance schemes like RSBY needs to find weightage in the national policy framework for TB control. 1