NEW DELHI :
In Muzaffarpur, the ground zero of the encephalitis epidemic in Bihar, patients flock to state-run Sri Krishna Medical College and Hospital (SKMCH) for treatment, though 27 other facilities in the district offer free hospitalization under the government’s Ayushman Bharat health insurance scheme.
Till Thursday, the state recorded at least 185 encephalitis deaths, with 132 in Muzaffarpur alone. This is followed by 20 in Vaishali, 12 in Motihari, eight in Begusarai, nine in Samastipur, and one each in Arrah, Sheohar, Purnia, and Siwan.
Out of the 28 medical facilities in Muzaffarpur empanelled under Ayushman Bharat—Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), 18 are state-run and the remaining 10 private. Of the 18 public health institutions, five are community health centres (CHCs), 10 are primary health centres (PHCs), one is a single-specialty hospital, while two are multi-specialty hospitals, including SKMCH and a referral hospital. Out of the 10 private hospitals, six provide tertiary care but do not have patients exhibiting symptoms of acute encephalitis syndrome (AES).
This is because many patients are under the impression that only SKMCH provides free treatment, said Shailesh Kaushik of the Bihar state health department.
“We have issued more than one lakh Ayushman Bharat cards to people in Muzaffarpur. We are trying to spread awareness about the scheme so that patients can also go to private hospitals. People have this preconceived notion that only SKMCH is providing free treatment. The treatment is completely free in all the CHCs, PHCs, private hospitals and the referral hospital. They all are also trying to help the patients, provided they go there for treatment," said Kaushik.
The Ayushman Bharat scheme provides health coverage of up to ₹5 lakh per family per year for secondary and tertiary hospitalization to around 107.4 million poor and vulnerable families, which translates to approximately 500 million beneficiaries.
However, till 18 June this year, only 39,943 claims were filed in Bihar for availing treatment under the scheme and nearly ₹34. 6 crore were disbursed for the scheme in all of Bihar, according to National Health Authority data.
“In the area, the facilities are the best at SKMCH. The other hospitals have also qualified the minimum criteria for empanelment, so they can also provide treatment. We are trying to get in touch with the state government to make full use of the scheme," said Indu Bhushan, chief executive officer of AB-PMJAY.
“AES can easily be managed at a PHC, CHCs or a normal referral hospital by glucose doses and giving good food. However, when the condition of a child deteriorates, the child needs tertiary care. As PHCs and CHCs can only give primary treatment and are not equipped to handle critical patients, there is a concentration of patients at SKMCH. The state government should ensure that the child gets treatment as soon the symptoms are seen. We are in conversation with the state government about tackling the problem," said Bhushan.
The NHA recently wrote to the state health agency (Bihar) to ensure that patients suffering from AES disease are able to avail of PMJAY services. “Ayushman Bharat covers treatment for AES and viral encephalitis as part of its medical packages. We have requested the authorities to map the prevalence and effects of such diseases in the state," said Bhushan.
Launched in September 2018, Ayushman Bharat is a centrally sponsored scheme, with the funding shared between the Centre and state governments. It covers poor and vulnerable families based on deprivation and occupational criteria according to the census database.
The social audit of families of children admitted with AES done by the Bihar government recently revealed that around three fourth of them are below poverty line.