Janani Shishu Suraksha Karyakram: Why You Get Denied Free Care and How to Fix It

Why Janani Shishu Suraksha Karyakram entitlements get denied

Janani Shishu Suraksha Karyakram is not a scheme you apply to and get rejected from, it is an automatic, no-form entitlement at public health institutions. So a "rejection" here means being wrongly charged or denied free care that you are legally owed. The Janani Shishu Suraksha Karyakram pillar covers the full list of free services; this article covers the situations where those free services are refused and exactly how to fix each one.

Because there is no application, the failure points are practical and on-the-spot: wrong facility type, informal charges, transport that never arrives, or confusion with the cash scheme.

Reason 1: You went to a private hospital

Why it happens: Janani Shishu Suraksha Karyakram entitlements apply only at public health institutions; sub-centres, PHCs, CHCs, district hospitals and medical college hospitals. A private hospital or nursing home cannot process the entitlement, so you pay full price.

The fix: Deliver at a designated public facility. If you have already been referred to a private facility, that referral is only free if it is a public-to-public referral or a specific empanelled arrangement. Ask your ASHA which public institution is your designated delivery point before labour begins.

Reason 2: You were asked to pay or buy medicines outside

Why it happens: Some facilities still demand user charges or ask families to buy drugs, gloves or consumables from an outside chemist. This directly violates the entitlement — the scheme exists to eliminate exactly this out-of-pocket spending.

The fix: Refuse the demand and escalate the same day. Ask the ward in-charge to record the demand in writing, then take it to the medical superintendent or the facility's grievance officer. Call your state's 104 health helpline to lodge a complaint. Free drugs, consumables, diagnostics (including blood tests, urine tests and ultrasonography), blood and diet are all part of the entitlement.

Reason 3: Free diet was cut short

Why it happens: Families are sometimes told to arrange their own food. Under the scheme, free diet is provided for up to 3 days after a normal delivery and up to 7 days after a caesarean section during the hospital stay.

The fix: Point to the 3-day and 7-day norm and ask the ward in-charge to provide the diet. Escalate to the medical superintendent if refused.

Reason 4: Transport was refused or never came

Why it happens: Free transport is owed in all three directions: home to institution, facility-to-facility on referral, and drop back home, usually through the 102 patient transport service. It is often denied for the drop-back leg, or the ambulance simply does not arrive.

The fix: Call 102 directly, or ask your ASHA to arrange it. On referral, insist on free referral transport and carry the referral slip. On discharge, claim the free drop back home. If transport fails, note the date and time and report it on the 104 helpline.

Reason 5: Care refused for missing documents

Why it happens: Registration counters sometimes demand an Aadhaar card, MCP card or ANC slip before treating a woman in labour.

The fix: None of these is mandatory for emergency care. Care cannot be refused for a missing MCP card or Aadhaar. Carry the MCP card if you have it because it speeds up tracing your antenatal record, but a woman in labour must be attended regardless.

Reason 6: You expected a cash payment

Why it happens: Many families confuse this scheme with a cash benefit. Janani Shishu Suraksha Karyakram pays no money to the beneficiary; it removes charges.

The fix: For cash assistance linked to institutional delivery, apply separately under Janani Suraksha Yojana, which pays into the mother's bank account. A woman delivering in a public facility can claim both at once.

How to escalate a denial

1. Ask the ward in-charge to record the demand for payment in writing.
2. Escalate to the medical superintendent or the facility grievance officer the same day.
3. Call the 104 health helpline of your state to lodge a formal complaint.
4. Ask your ASHA to raise it with the block medical officer.

Any demand for payment at a public health institution for delivery, newborn care, drugs, tests, blood, diet or transport is a violation of the entitlement and should be reported, not paid.