"Saving the Womb"- An Initiative to address and redress malpractices in the implementation of RSBY in Samastipur, Bihar
Name of the Initiative
“Saving the Womb” - An Initiative to address and redress malpractices in the implementation of RSBY in Samastipur, Bihar
Shri Kundan Kumar, IAS, District Magistrate, Samastipur, Bihar
Project in Brief
The project aimed at addressing and redressing malpractices in the implementation of Rashtriya Swastha Bima Yojana (RSBY) in Samastipur district of Bihar. An alarmingly high percentage (61%) of hysterectomies in the district was a cause of concern. A detailed and scientific inquiry, first of its kind, conducted independently by the District Administration investigated allegations of malpractices in the implementation of RSBY. This led to revelation of physical and mental exploitation of gullible rural women by cheating them into unwanted uterus removal surgeries to make quick money.
- Action on public grievances raised by rural women, mostly in the reproductive age group, about alleged exploitation by private hospitals
- Creation of multi- tier teams at various levels to reach out to each of the beneficiaries involved
- Detailed case by case inquiry by teams of doctors and administrators.
- District level medical camp to conduct a medical inquiry on 2,606 women
- Legal and definitive action against all defaulting hospitals.
- The initiative created a lot of awareness about reproductive health care of these rural women and their vulnerability to such malpractices in the guise of social welfare schemes. It led to greater sensitisation and awareness about the scheme not only among the 5.5 lakh families living under BPL of Samastipur district but in the entire country.
- As a result of this initiative, instructions were issued to the District Magistrates (DMs) of the state to carry out similar investigations in implementation of RSBY in their districts.
- Government of India (GoI) made pre-authorization mandatory for hysterectomy of women below 40 years of age. The initiative led to a check in the wanton hysterectomy taking place across state.
- GoI introduced the categorization clause in the empanelment of hospitals to weed out clinics with substandard physical and human resources. The approval of the District Core Committee headed by the District Magistrate was made mandatory for the empanelment of health facilities under the scheme.
- The empanelment of public hospitals provided a credible alternative to the beneficiary. The empanelment of public hospitals led to flow of fund to the hospitals which was used for up gradation of infrastructure and incentivising the doctors and paramedical of the govt system
- The premium bid by the insurance providers after the initiative saw steep decline which meant saving of huge money for both the State government and GoI.
Presentation on Saving the Womb, An Initiative to address and redress malpractices in the implementation of RSBY in Samastipur, Bihar