Chiranjeevi Yojana: A Comprehensive Health Insurance Scheme for All

Chiranjeevi Yojana: A Comprehensive Health Insurance Scheme for All Healthcare is a fundamental right, yet access to affordable and quality medical services remains a challenge for millions of people. Recognizing this, the Government of Rajasthan introduced the Chiranjeevi Yojana, a health insurance scheme aimed at providing financial protection to the underprivileged sections of society. This initiative stands as a crucial step towards achieving universal healthcare in India, ensuring that even the most vulnerable citizens can receive the necessary medical attention without worrying about financial strain.

Overview of Chiranjeevi Yojana

Launched in May 2021 by the Rajasthan government under the leadership of Chief Minister Ashok Gehlot, the Mukhyamantri Chiranjeevi Swasthya Bima Yojana is a health insurance scheme that offers coverage of up to ₹10 lakh annually to each enrolled family. The program aims to provide free treatment for various diseases and surgeries, with a particular focus on ensuring that healthcare facilities reach the rural and economically weaker sections of society.

The scheme covers over 1,500 diseases, including serious ailments like cancer, heart diseases, and kidney failures, as well as treatments like dialysis, organ transplants, and emergency surgeries. The objective is to provide financial security to families, so they do not fall into the trap of debt while paying for healthcare services.

Key Features

Annual Health Coverage: Each enrolled family receives an insurance cover of ₹10 lakh, which includes all major and minor medical treatments.

Cashless Treatment: The Chiranjeevi Yojana provides cashless treatment in both government and empaneled private hospitals across the state.

Inclusive Eligibility: The scheme targets BPL (Below Poverty Line) families, small farmers, contract laborers, and other vulnerable groups. Families already covered under the National Food Security Act and the Socio-Economic Caste Census (SECC) are automatically eligible.

Wide Range of Covered Treatments: Over 1,500 different medical conditions are covered under the scheme, from minor surgeries to high-cost treatments like chemotherapy, dialysis, and critical care.

Empaneled Hospitals: Both public and private hospitals are included in the empanelment list, offering beneficiaries the choice of where they want to receive treatment.

Chiranjeevi Yojana - An Introduction

Chiranjeevi Yojana scheme proved as an exemplary scheme in the area of Public Health which has contributed significantly in improving the access to Institutional deliveries for marginalized section of the society by reducing the maternal deaths. Under the scheme, the government would enter into a contract with the private provider to cater to institutional services for both normal and complicated delivery including C-Sections operation and blood transfusion to targeted group.

Chiranjeevi Yojana launched as a one year pilot project in 09/11/20005 in five most vulnerable districts (Banaskantha, Dahod, Kutch, Panchmahal and Sabarkantha) covering below poverty line families.
Considering the success of the pilot project this scheme was scaled up to the entire state since 08/09/2006.
Since 26/03/2007 APL-Non Income Tax Paying families are also incorporated in beneficiary criteria.
BPL and tribal women (whosoever choose to deliver in Chiranjeevi Hospital) are identified during their ante natal care by ANM/FHW and are given an application form for registration in the scheme during birth microplan preparation in Mamta Diwas. In absence of BPL card and tribal certificate, authorization by local recognized authority is also considered. The field workers also explain to pregnant mothers benefits/services which they can avail under the scheme. At the time of delivery, the women goes to previously identified empanelled doctors, gets the delivery done free of charge. She also receives transportation charges from the doctor.
Package of the Scheme:
To develop the costing of the services, the government had carried out consultation with SEWA Rural (an NGO providing health services), individual specialist and Federation of Obstetric and Gynecological Societies of India (FOGSI) representatives of the state to arrive at a uniform fee that could be charged for normal, complicated and as well as C-Section cases to design the package for 100 deliveries. Initial package of Rs. 1,85,000 for 100 deliveries, which was modified by Govt. Resolution No.: FPW/102013/73/B-1 dated 29/07/2013, now revised package of 100 deliveries is Rs. 3,80,000. In Chiranjeevi Yojana, there is provision of Rs. 2500/- per Caesarian Section if enrolled Private gynecologists conduct Caesarian Section in Government health facility.
Selection criteria for private obstetricians for enrolment under the scheme:
  • Doctor must be having post-graduate qualification in Obstetrics and Gynecology.
  • Must have his / her own hospital - preferably minimum of 15 beds.
  • Must have labor room and operating room.
  • Must be able to access blood in emergency situation.
  • Must be able to arrange for anesthetists and do emergency surgery.
  • Facility should be preferably accredited for sterilization procedures by the government.
All the available and willing obstetricians are to be included in the scheme.

Implementation, Monitoring & Evaluation:

As the scheme is implemented and monitored by officers and staff from the government health machinery there is no additional cost is involved. The roles and responsibilities at different level are discussed below:Under the guidance of Commissioner of Health, Additional Director (Family Welfare) and State Maternal Health Program Officers have overall responsibility for planning, implementation and monitoring of Chiranjeevi Yojana.
District Development officer is responsible for overall implementation of the scheme in the district.
Chief District Health Officer (CDHO) is responsible for identification and enrolment of the Obstetricians, orientation about the scheme and coordination.
The RCH Officer (RCHO) and District Project Coordinator (DPC) are responsible for payment to the Chiranjeevi doctors and report collection.

Benefits of the scheme:
It is considered very successful as large numbers of obstetrician/ gynecologist have joined it and many poor women have benefited through delivery at a facility managed by qualified obstetrician/gynecologist as compared to previous option i.e. home deliveries This scheme empowers the poor in several ways:It provides them entitlement for free delivery care in private sector.
It provides immediate access to Emergency Obstetric Care (EmOC) when needed.
Reduction in out of pocket expenditure.
It also provides them choice of several providers nearby from which they can choose from.
It also shows that it is possible to develop large scale partnership with private sector to provide skilled birth attendance and EmOC to poor women at a relatively small expenditure.
The Chiranjeevi scheme is now linked with Emergency Management and Research Institute (EMRI) services for elimination of transportation time delay. EMRI is providing free ambulance services to all sections of the society in entire Gujarat state.
Bal Sakha Yojana is now linked with Chiranjivi Yojana. It is a scheme to provide treatment by private pediatrician to children aged up to 1 month.
Impact of Chiranjeevi Yojana:Exponential rise in Institutional Deliveries: The State has experienced a constant rise in the trend of Institutional Deliveries over the years and a consequent decrease in the trend of Home Deliveries. In the year 2005-06 rate of institutional delivery was 63.24 % which reached to 99% by March-2018.
Decline in Maternal Mortality Ratio & Infant Mortality Rate:
MMR:
Year(2001-03)(2004-06)(2007-09)(2010-12)(2011-13)(2014-16)(2015-17)
MMR1721601481221129187
IMR:
Year200520062007200820092010
IMR545352504844
Year20102011201220132016
IMR4441383630
Source: Sample Registration Survey
The scheme was evaluated by UNFPA and IIM Ahmedabad and they have given favorable comment.
In the Study "Directory of Innovations Implemented in the Health Sector” supported by Department for International Development quoted- Several States have adopted the JSY/Chiranjeevi model to further provide services in areas not covered by JSY or to boost the gains from JSY, including Saubhagyawati Scheme (Uttar Pradesh), Janani Suvidha Yojana (Haryana), Janani Sahyogi Yojana (Madhya Pradesh), Ayushmati Scheme (West Bengal), Chiranjeevi Yojana (Assam), and Mamta Friendly Hospital Scheme (Delhi).Click here to View Details of Chiranjeevi Yojana(File Size:70KB)
You Can also Refer
Government ResolutionsGR on 'Chiranjeevi Yojana' for reducing Mother and Child Mortality Rate-29-07-2013(File Size:2.41MB)
GR on 'Chiranjeevi Yojana' for reducing Mother and Child Mortality Rate-17-08-2010(File Size:1.05MB)
GR on 'Chiranjeevi Yojana' for reducing Mother and Child Mortality Rate-26-03-2007(File Size:136KB)
GR on 'Chiranjeevi Yojana' for reducing Mother and Child Mortality Rate-08-09-2006(File Size:2.29MB)
GR on 'Chiranjeevi Yojana' for reducing Mother and Child Mortality Rate-09-11-2005(File Size:174KB)
GR on 'Guideline for Chiranjeevi Yojana and Bal Sakha Yojana'(File Size:871KB)

How to Apply for Chiranjeevi Yojana

The process for enrolling in the Chiranjeevi Yojana is simple and accessible to the eligible population. Here's a step-by-step guide:

Online Registration: Families can register through the official portal of the Rajasthan Government (https://health.rajasthan.gov.in/). The portal provides a user-friendly interface for people to submit their personal details and required documentation.

Offline Registration: For those who are not comfortable with the online process, offline registration can be done at e-Mitra centers across the state. These centers assist with filling out forms and submitting documents.

Verification Process: After registration, the information provided is verified by government officials to ensure that only eligible families are enrolled.

Issuance of Health Cards: Once approved, beneficiaries receive a health card that can be used to avail of the scheme's benefits at any empaneled hospital.

Benefits of the Chiranjeevi Yojana

Financial Security: The scheme reduces the financial burden on low-income families, who often face difficulties in paying for medical treatments. The annual cover of ₹10 lakh is sufficient for most critical treatments and surgeries.

Wide Reach: With a vast network of empaneled hospitals, including both government and private institutions, beneficiaries have greater access to healthcare services.

Improved Health Outcomes: By ensuring that vulnerable populations can access timely and quality healthcare, the scheme is expected to lead to improved health outcomes across the state, especially in rural areas.

Poverty Reduction: One of the major causes of poverty in India is healthcare expenditure. By providing free treatment to low-income families, the Chiranjeevi Yojana prevents families from slipping further into poverty due to medical expenses.

Challenges and Criticisms

While the Chiranjeevi Yojana is undoubtedly a significant step towards universal healthcare in Rajasthan, it is not without challenges. Some of the main concerns include:

Awareness and Accessibility: Despite the government's efforts, many eligible families in rural areas are still unaware of the scheme. There is a need for more aggressive awareness campaigns to ensure that no one is left out.

Quality of Care: Although the scheme covers a wide range of treatments, there have been concerns about the quality of care provided in some empaneled private hospitals. The government must ensure strict monitoring of these hospitals to maintain standards.

Funding: As with any large-scale welfare program, ensuring sustained funding can be a challenge. The government needs to ensure that there are no delays in reimbursements to hospitals, which could otherwise affect the smooth functioning of the scheme.

Future Prospects

The Chiranjeevi Yojana is expected to evolve and expand in the coming years, with a focus on improving accessibility, increasing the number of empaneled hospitals, and addressing the challenges faced by beneficiaries. The Rajasthan government has expressed a commitment to improving healthcare infrastructure and ensuring that the scheme benefits all eligible citizens.

The Chiranjeevi Yojana is a revolutionary step towards ensuring healthcare equity in Rajasthan. By offering comprehensive health insurance to millions of people who cannot afford private healthcare, the government has taken a significant step towards achieving its goal of universal health coverage. However, continued efforts are needed to address the challenges and ensure that the scheme reaches its full potential. As the scheme progresses, it is set to serve as a model for other states in India to follow in their quest for inclusive healthcare.