Disease Control Programme under NRHM
Many disease control programmes have been subsumed under NRHM. Official statistics suggest commendable performance in some programmes but not in others. Achievements in terms of prevalence rate/cure rate/mortality are as follows:ï¿½ Good Progress
Target of overall cure rate of 85% has been achieved during the first two years of the Eleventh Plan.
In 2007ï¿½08, as against a target of 50 lakh cataract operations, 54.05 lakh operations were carried out. In the following year, 58.1 lakh cataract operations were conducted as against the target of 60 lakh.
The overall target of reducing the leprosy prevalence rate from 1.8 per 10,000 in 2005 to less than 1 per 10,000 has been achieved. As many as 510 (81 per cent) districts have achieved the target during the first two years of the Eleventh Plan.
The overall reduction was 56.52 per cent during the first two years of the Eleventh Plan. The Plan had aimed at mortality reduction by 50 per cent by 2010, and sustaining that level until 2012.
Against the target of malaria mortality reduction by 50 per cent by 2010, and an additional 10 per cent by 2012, the overall reduction was 45.22 per cent during the first two years of the Eleventh Plan.
Against the target of kala-azar mortality reduction by 100 per cent by 2010 and sustaining the elimination until 2012, the overall reduction was only 21.93 per cent during the first two years of the Eleventh Plan. A majority of the deaths due to kala-azar are from three high-focus states of Uttar Pradesh, Bihar, and Jharkhand. Their weak health infrastructure in these states is the likely cause of unsatisfactory performance.
Against the target of filaria/microfilaria reduction by 70 per cent by 2010, 80 per cent by 2012, and elimination by 2015, the overall reduction was only 26.74 per cent during the first two years of the Eleventh Plan.
Trend of Communicable Diseases in India
Rashtriya Swasthya Bima Yojana (RSBY)
Launch of the RSBY by the Ministry of Labour Employment in 2007 has been an important step in supplementing the efforts being made to provide quality healthcare to the poor and underprivileged population. It provides for ï¿½cash-lessï¿½, smart card based health insurance cover of Rs. 30000 per annum to each enrolled family, comprising up to five individuals. The beneficiary family pays only Rs. 30 per annum as registration/ renewal fee. The scheme covers hospitalization expenses (Out-patient expenses are not covered), including maternity benefit, and pre-existing diseases. A transportation cost of Rs.100 per visit is also paid. The premium payable to insurance agencies is funded by Central and State Governments in a 75:25 ratio, which is relaxed to 90:10 for the North-East region and Jammu and Kashmir. The maximum premium is capped at Rs.750 per insured family per year.
RSBY was originally limited to Below Poverty Line (BPL) families but was later extended to building and other construction workers, MGNREGA beneficiaries, street vendors, beedi workers, and domestic workers. The scheme is currently being implemented in 24 States/UTs. About 3.3 crore families have been covered as on date and 43 lakh persons have availed hospitalisation under the scheme till November 2012.
Key feature of RSBY
It provides for private health service providers to be included in the system, if they meet certain standards and agree to provide cashless treatment which is reimbursed by the insurance company. This has the advantage of giving patients a choice between alternative service providers where such alternatives are available. Several State Governments (such as those of Andhra Pradesh and Tamil Nadu) have introduced their own health insurance schemes, which often have a more generous total cover.
Written by princy