MANUAL FOR FAMILY PLANNING INSURANCE SCHEME

MANUAL FOR FAMILY PLANNING INSURANCE SCHEME
(To be operated by Oriental Insurance Company)

Government of India, Ministry of Health & Family Welfare has published a “Manual for Family Planning Insurance Scheme”(To be operated by Oriental Insurance Company) in December,2005.

Dr. Jayalaxmi, of the Central Health Ministry handed over the said manual along with the copy of agreement with Oriental Insurance Company and other relevant papers to our FOGSI President, Dr. Duru Shah. It is not practical to publish all those(almost fifty papers) and to distribute to our more than twenty thousand FOGSI members. The manual is very important and useful document. It will help in allaying apprehension of our members while dealing with all family welfare procedures in general and sterilization operations in particular. Dr. Duru Shah therefore asked me to summarise the information given in said manual, so that it can be publish in FOGSI TIMES for the benefit of the members. I am grateful to Dr. Jayalaxmi for handing over the manual to FOGSI and to Dr. Duru Shah for asking me to summarise the same.

Summary
India is the first country that launched a National Family Planning Programme in 1952.
With a view to encourage people to adopt permanent method of Family Planning, Government has been implementing a centrally sponsored scheme since 1981 to compensate the acceptors of sterilization for the loss of wages for the day on which he/she attended medical facility for undergoing sterilization.

Under the scheme, the Central Government released funds to states and Union Territories(U.T.) at the rate of Rs. 300 per tubectomy;Rs 200 per Vasectomy and Rs 20 per IUD Insertion. The staes/U.T. had the flexilibility to decide the amount of apportionment among various components, provided minimum amount of Rs.150 was paid to the acceptors of Tubectomy/Vasectomy and Rs 60 per Tubectomy,Rs 25 per Vasectomy and Rs 20 per IUD insertion was used by the medical facility towards drugs and dressings.

In the case of EAG staes viz. Bihar,Chattisgrah, Jharkhand, Madhya Pradesh, Orissa, Rajasthan,Uttar Pradesh and Uttaranchal, the compensation package for sterilization had been raised from Rs. 300/- to Rs. 400/- per Tubectomy,Rs.200/- to Rs.400/- per Vasectomy if conducted in a public health facility or approved private sector health facility, and from Rs 20 to Rs.75 per IUD insertion, if conducted in an approved private sector health facility.
Some states/U.T. were apportioning some amount (given by center)for creating a miscellaneous purpose fund. This fund was utilized for payment of ex-gratia to the acceptor of sterilization or his/her death or incapacitation or for treatment of post operative complications attributable to the procedures of sterilization as under:
1) Rs 50,000/- per case of death
2) Rs.30,000/- per case of incapacitation
3) Rs.20,000/- per case of cost of treatment of serious post operation complication

Any liability in excess of the above limit was to be born by the state/ U.T./ NGO/ Voluntary organization concerned from their own resources.
The Honorable Supreme Court of India in its order dated 1/3/2005 in Civil Writ Petition No.209/2003(Ramakant Rai v/s Union of India) has, inter alia, and directed the Union of India & States/U.Ts for ensuring enforcement of Union Government Guidelines(therefore needless to say, that any other guidelines will not stand in the court of law).

Sterilization procedures and norms for bringing out uniformity with regard of sterilization procedures by:
1.  Creation of panel of doctors/health facilities for conducting sterilization procedures and for      conducting sterilization procedures and laying down of criteria for empanelment of laying down      of      criteria for empanelment of doctors for conducting sterilization procedures.
2. Laying down of checklist to be followed by every doctor before carrying out sterilization      procedure.The said checklist was given to Dr. P.K.Shah & he had send it to all presidents and      secretaries(it was kept on M.O.G.S & F.O.G.S.I. website)of Member Societies,it was also      given      to Dr.Pankaj Desai & he had also kept it on his website.
3.  Laying down of uniform performa for obtaining of consent of person undergoing      sterilization.(Like      Para 2, Dr. P. K. Shah & Dr. Pankaj Desai had done the needful)
4. Setting up of Quality Assurance Committee(QAC) for ensuring enforcement of pre and post      operative guidelines regarding sterilization procedures.
5.  Bringing into effect an insurance policy uniformly in all states for acceptors of sterilizations.

New Initiative: Family Planning Insurance Scheme
Under the existing Government Scheme no compensation was payable for failure of sterilization and no indemnity cover was provided to Doctors/health facilities providing professional services for conducting sterilization procedures etc.
Government has done away with ex-gratia payment because of its complicated nature and introduced present Family Planning Insurance Scheme. This scheme will not only take care of the cases of failures of sterilization, medical complications or death resulting from sterilization, but would also provide indemnity cover to the doctor/ health facility performing sterilization procedures, as follows:-

Section I

a) Death due to sterilization in hospital Rs 1,00,000/-
b) Death due to sterilization within 30 days of discharge from hospital Rs 30,000/-
c) Expenses for treatment of medical complications due to sterilization operation[(within 60 days of     operation)(to be reimbursed on the basis of actual expenditure incurred, not exceeding Rs 20,000/-)]

Section II