Understanding the use of India's National Health Insurance Scheme for family planning and reproductive health services in Uttar Pradesh.

Abstract

India's National Health Insurance Scheme, Rashtriya Swasthya Bima Yojana (RSBY), expands health services to families living below the poverty line by enrolling them into the scheme through selected health facilities. Use and reasons for nonuse of RSBY for family planning (FP) and reproductive health (RH) services have not been explored previously. This cross-sectional study explored the use of RSBY for FP/RH services at private health facilities, knowledge of FP/RH service availability, and factors influencing knowledge among RSBY enrolled families. A total of 726 women and 640 men from enrolled families living in 3 cities of Uttar Pradesh, India, were interviewed. Use of FP/RH services at private hospitals enrolled in the RSBY was 2%. Nearly 20% of respondents used FP or delivery services from unenrolled private hospitals but could have accessed these services through the scheme. Over 75% of respondents were unaware of FP/RH service availability through RSBY. Respondents with some education were more likely to have this knowledge, while poorer families were less likely to have this knowledge. Findings suggest that for RSBY to reach the most vulnerable families, efforts need to be made to better educate enrolled families about their entitlements and benefits of the scheme.