Kerala will soon have Janani-Shishu Suraksha Karyakram (JSSK), a Union Ministry of Health and Family Welfare (Mohfw) initiative, which ensures absolutely free maternal and neonatal services including Caesarean section deliveries and all possible out-of-pocket medical expenses that childbirth brings.

The new initiative, a supplementary to the existing cash-assistance scheme Janani Suraksha Yojana (JSY), was formally launched last month.

Under the JSSK, pregnant women will be provided cashless services in normal delivery cases, Caesarean operations and neonatal care (up to 30 days after birth) in government health institutions, both in urban and rural areas. The aim is to boost institutional deliveries, so as to bring down maternal mortality rate.

“JSSK had been envisaged for the entire country but in Kerala, the only hitch was that the amount set aside for providing free transportation was not enough. The matter was taken up with the Mohfw and it has been sorted out now. It is not finalised yet, but we are thinking about a special fleet of ambulances for JSSK, on the lines of the 108 service, which would be funded by the NRHM,” a high-level official in the department told The Hindu .

Pregnant women who deliver in the government hospitals or in specially accredited private hospitals are now being paid Rs.700 in Kerala under the Janani Suraksha Yojana.

JSSK has been conceived with the aim of providing quality post-natal care for women, as most of the maternal deaths occur during this period.

As per the scheme, all services for pregnant women reaching a hospital will be free – this includes free drugs and consumables, food and stay in hospitals, blood transfusion services if required, and totally free transport services from home to the hospital and back.

Ambulance service

“The primary aim of the new initiative is to ensure that there is no out-of-pocket expenditure for a pregnant woman coming to a healthcare institution for delivery, either by way of transportation charges or hospital charges for investigations like ultrasound scan. Once the transportation component is worked out, a pregnant woman anywhere in the State should be able to call for an ambulance for going to the hospital for delivery and back,” a senior Health official said.

Kerala has the lowest maternal mortality rate in the country at 81 (per one lakh live births), as against the national MMR of 212.

However, in a State with almost 100 per cent institutional deliveries, the maternal mortality rate should be much lower, public health experts say.

A significant number of maternal deaths in the State continue to be in hard-to-access tribal hamlets in districts like Wayanad.

The question is whether any of the schemes like JSSK or JSY will benefit mothers in the tribal areas, who continue to be marginalised and are often neglected by the health care delivery system.

The scheme aims to bring down mortality rate by encouraging institutional deliveries

source: http://www.TheHindu.com / Home> National> Kerala / by C. Maya / Thiruvananthapuram, July 10th, 2012