Equity Impacts of a Targeted Health Insurance Programme: New Evidence from India’s Rashtriya Swasthya Bima

Aims & Objectives: This study appraised the possible impact of RSBY, launched in 2008, on better health equity by increasing the utilization of healthcare services and reducing the risks of financial impoverishment. It undertook the following activities to

• Assess the current health status of low income communities;
• Examine the utilization of healthcare services with special focus on the type of healthcare provider’s viz. public, private and informal;
• Estimate the reasons behind high household healthcare expenditure;
• Check the source of health expenditure, separately for each morbidity and illness;
• Assess the awareness, coverage and utilization of RSBY scheme besides experiences during enrolment and utilization processes;
• Evaluate the facilities and services provided during hospitalization under the RSBY scheme and
• Adjudge the reduction in high expenditures and risks of further impoverishment among the poor households.

Methodology: Identifying poor localities and households across 10,000 households (screened from 52 Jhuggi-Jhopri clusters), this study surveyed 3,350 households.

Findings: The main findings including societal/policy implications were:

• Prevalence of morbidities and illness was much higher in these low income communities than the general population;
• For all type of morbidities and illness, savings were the major source, followed by borrowings from friends and other family members;
• Almost 38% of the total households had heard about the RSBY scheme;
• Roughly 12% eligible households utilized RSBY scheme in the last one year with significant differentiation by background variables and

Recommendation:

• Delhi government should support the scheme to help the urban poor to reduce the probability of households falling into severe poverty trap due to excessive healthcare expenses.