India: Social health protection

Context

Each year, unforeseen expenditure and loss of income as a result of illness push up to 60 million Indian citizens to the brink of poverty. In order to improve health care for its citizens and lay the foundations for universal social protection in the event of illness (universal health coverage, UHC), the Indian Government has introduced a series of state social security benefits. On behalf of the German Federal Ministry for Economic Cooperation and Development (BMZ), the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH has already advised the Indian Ministry of Health and Family Welfare on introducing the health insurance scheme Rashtriya Swasthya Bima Yojana (RSBY) in an earlier project. 

The new programme follows on from the success already achieved and the findings gained to date. It advises the ministry and the newly founded National Health Authority on implementing and improving Pradhan Mantri Jan Arogya Yojana (PM-JAY), the national health insurance scheme created in the second half of 2018.

Objective

The implementation structures and processes of the national health insurance scheme PM-JAY in India have improved. As a result, the country is in a better position to ensure universal health coverage. The Indian Government has laid the foundations for improving the quality of health care for 500 million people.

Approach

PM-JAY, a health insurance scheme funded entirely by the government, plays an important role in the Indian Government’s objective of providing citizens with social health protection. PM-JAY provides cashless hospitalisation for more than 500 million vulnerable people and their families, and is accessible via a network of  public and private hospitals. The risk of poverty for families on low incomes is therefore lower because they are not reliant on their own financial reserves to pay for health services. In this way, India is contributing to implementing the 2030 Agenda for Sustainable Development.

The objective of the programme is to improve the availability and quality of health care provided by PM-JAY. To achieve this, it conducts evaluations, provides IT advisory services and develops monitoring instruments. It aims to align the different health insurance systems in the various Indian federal states. 

At central government and federal state level, the programme promotes the Indian partners through training seminars, upskilling measures and by deploying experts. In addition, it advises on quality standards and on costing the service packages. Offering high-quality health care services under PM-JAY needs to be particularly attractive for private hospitals – firstly, so that they can be comprehensively incorporated into the insurance network and secondly, so that poor citizens too can be treated in private clinics.

To promote health care in India in the course of the COVID-19 pandemic, the programme is supporting the government in implementing additional measures. The objective of these measures is to increase COVID-19 testing and treatment measures conducted by technical experts across the different regions. The programme is focusing in particular on India’s northern federal states, where the health care system is under great strain owing to the large number of migrant workers returning from urban areas.