Indo-German Social Security Programme

Programme description

Title: Indo-German Social Security Programme
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Country: India
Lead executing agency: Ministry of Health & Family Welfare and Ministry of Labour & Employment, Government of India; Department of Labour, State Government of Karnataka
Overall term: 2011 to 2017

India. A family with a smartcard for cash-free treatment in hospital. © GIZ

Context

More than 400 million people – over 90% of India’s labour force – are employed as daily wage labourers without contracts, as independent smallholder farmers or as traders. The majority of these informally employed people have no access to appropriate social security. As a result, any unforeseen expenses and income losses due to illness, accidents or death of the primary earner, or simply because of old age, usually plunge families deeper into penury. Though there are various social security programmes offered by India’s central and state governments, they are often difficult to access for workers in the unorganised sector, and frequently they are poorly coordinated and administered.

Objective

The social security system for informal workers and their families has improved.

Approach

The Indo-German Social Security Programme (IGSSP) provides policy advice, strengthens the capacities of ministries and other stakeholders, develops training materials, carries out evaluations, offers  IT advice, and develops monitoring instruments and information campaigns for informal workers.

IGSSP comprises three components:

  1. The design and introduction of national health insurance for the poor
  2. The convergence and improved coordination of different social security schemes
  3. The establishment of Single Window Service Centres (SWSCs) to provide informal workers with better access to social security benefits.

The programme’s main partners are:

  • Ministry of Health & Family Welfare (MoHFW). The programme advises the MoHFW on the implementation of Rashtriya Swasthya Bima Yojana (RSBY), a social health insurance scheme for India’s poor. A biometric chip card (RSBY smartcard) enables families enrolled in the scheme to easily identify themselves and receive cashless treatment in public and private hospitals.
  • IGSSP also supports the MoHFW in the design and rolling out of a new National Health Protection Scheme (NHPS) which will replace RSBY. The number of beneficiaries is to be increased significantly, and the quality and range of health services for the poor is to be improved.
  • Ministry of Labour & Employment (MoLE). The programme works with the MoLE to develop IT-based systems for the convergence of social security schemes offered by different ministries.
  • Department of Labour (DoL) of the Government of Karnataka. The programme supports the DoL in the establishment of 1,200 Single Window Service Centres in Karnataka. These centres advise informal workers and their families about their entitlements in the various social security schemes and help them with enrolment and application procedures.
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Results

Scaling-up of India’s national health insurance. RSBY has become one of the world’s largest health insurance schemes in terms of the number of beneficiaries. In March 2016, over 41 million poor households with approximately 125 million members were enrolled in the scheme.

Better access to health care for the poor. RSBY has so far covered 11.8 million hospitalisations in more than 10,000 empanelled hospitals.

Improved medical coverage for women. The percentage of women insured under RSBY rose from 41 to 49 per cent in a period of four years.

Lower out-of-pocket expenditure for hospital treatment. Independent evaluations show that families covered under RSBY have lower out-of-pocket expenditure on inpatient care.

Secure biometric authentication of beneficiaries using the RSBY smartcard. Using innovative technologies, entitlement to health care can be easily verified and electronically processed. This has improved the efficiency of government programmes and made them more inclusive.

Trained personnel to support government agencies. GIZ and its RSBY Professional Programme provide training for managers and specialists implementing RSBY. These personnel are placed within the federal state agencies responsible for managing RSBY.

Establishment of Single Window Service Centres (SWSCs). The Government of Karnataka is opening around 1,200 SWSCs in all 30 districts of the state following a successful pilot phase in which IGSSP demonstrated the benefits of such centres for informal workers. In addition, the Government of Karnataka plans to open more than 2,000 service centres covering all villages of the state. These centres are mandated to provide services in the areas of social protection, document certification, and updating of residents’ data.

Improved livelihoods for the elderly. IGSSP, together with the non-governmental organisation HelpAge India, has set up more than 900 elderly self-help groups (ESHGs) with a total of 12,400 members in the state of Bihar. The initiative aims to enhance the incomes of its members through savings schemes and by providing training and seed capital for self-employment. 

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The groups have disseminated information on government schemes for the elderly and also acted as pressure groups within their local communities and vis-à-vis the government. The Ministry of Rural Development (MoRD) has adopted the concept of ESHGs under its National Rural Livelihoods Mission, and five states have decided to implement this unique model of self-help for the elderly.