Impact of RSBY on enrolled households: lessons from Gujarat

Introduction Launched in 2008, the Rashtriya Swasthya Bima Yojana (RSBY) insurance scheme has the mandate of improving access to quality health services of families living below the poverty line (BPL) while providing financial protection against health shocks. Four years following implementation, it is yet to find its presence in all districts of the twenty-eight States in India. Budgetary limitations, the balance between maintaining the claims ratio and sustainability, the contractual relationship between insurance companies and empanelled hospitals, and the weak monitoring system are few challenges that the scheme faces today. In this paper, we explore implementation of RSBY based on the three dimensions of universal health coverage (UHC) stated in the World Health Report 2010 i.e. “the proportion of the population to be covered” (breadth of coverage), “the range of services to be made available” (depth of coverage) and “the proportion of the total costs to be met” (height of coverage).