Assessing efforts towards universal financial risk protection in low- and middle-income countries

Study of Rashtriya Swasthya Bima Yojana (RSBY) health insurance scheme in India

Institute of Public Health, India
Institute of Public Health, India

The Indian health system has long been characterized by high out-of-pocket payments at the point of use. This inequitable form of financing in health care has two important consequences. First, it constitutes an important barrier to accessing health care. Second, for those who seek care, there is the corresponding danger of impoverishment.

In response to this situation, the Indian government has introduced various initiatives, one of them being the Rashtriya Swasthya Bima Yojana (RSBY) insurance scheme. RSBY is specifically intended for the poorest and is heavily subsidized by both the central and state governments. The enrolled families can access hospital care up to US $666 per family per year in select hospitals.

In the two years since its launch, the insurance scheme has already covered about 65 million individuals. The government hopes to cover all the estimated 300 million poor by 2012. However, data from RSBY itself show that considerable variations in performance occur from state to state.

To strengthen the effective move towards universal coverage, researchers at the Institute of Public Health (India) and the Institute of Tropical Medicine (Belgium) plan to review the RSBY program to date. The researchers seek not only to ask the ‘what’ question – what is the performance of RSBY? – but also try to understand why variations in performance exist. What is the extent of enrolment of non-enrolment in RSBY? The utilization of its services? The research team will also work to understand the reasons behind enrolment or non-enrolment, as well as utilization or non-utilisation of available services.

The results from this study will help policy-makers and managers in charge of RSBY to make appropriate mid-term corrections, and advance India’s march towards universal coverage.


Project description

Programme: Assessing efforts towards universal financial risk protection in low- and middle-income countries

Research title: Study of Rashtriya Swasthya Bima Yojana (RSBY) health insurance scheme in India

Thematic Research Area: Health Financing

Grantee Country: India

Grantee Institution: Institute of Public Health, Bangalore, India

Programme coordinator: Dr N. Devadasan

Start date: Autumn/ Winter 2010

Status of grant: Completed

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