MP Nishulk Dialysis Yojana (Free Dialysis Services, Madhya Pradesh)

What is MP Nishulk Dialysis Yojana?

MP Nishulk Dialysis Yojana is the popular name for the free haemodialysis service that the Madhya Pradesh Public Health and Family Welfare Department runs through the National Health Mission (NHM), Madhya Pradesh. The service exists because maintenance dialysis is both unavoidable and ruinously expensive for a patient with end-stage kidney disease, a person on thrice-weekly dialysis needs more than 150 sessions a year, every year, for life.

According to NHM Madhya Pradesh, the state operates a "Dialysis Seva" initiative under its Non-Communicable Diseases programme and publishes a downloadable list of operational dialysis centres on nhmmp.gov.in. The national framework behind it is the Pradhan Mantri National Dialysis Programme (PMNDP), introduced in 2016 as part of the National Health Mission to put a dialysis unit in every district hospital in the country.

In Madhya Pradesh, many of these units are run on a public-private partnership (PPP) basis: the government provides the space, water treatment and power, and a contracted operator provides the machines, the technicians and the consumables, paid per session by the state. For the patient the arrangement is invisible and the session is cashless.

Two things are worth understanding at the outset:

• This is a service, not a cash benefit. No money is transferred to the patient. The benefit is the treatment itself, delivered free.
• There is no online application form. Dialysis begins on clinical indication. A doctor decides you need it, and registration follows.

What does the free dialysis service actually cover?

At a government dialysis unit operating under the programme, the following are provided without charge to an eligible patient:

• The haemodialysis session itself, on the schedule prescribed by the treating doctor.
• The dialyser, tubing and other consumables used in the session.
• Dialysis-related medicines administered during the session, such as heparin and erythropoietin where the local protocol provides for it.
• The machine time and technician support, with separate machines maintained for hepatitis-positive patients.

What is normally not covered by the dialysis programme itself is the surgery to create vascular access such as an AV fistula, transport to the centre, and treatment of unrelated conditions. Those are handled either through the ordinary free-care route of the government hospital or through the Ayushman package. Ask the unit exactly what falls inside the free package at your hospital before the first session, and get it in writing on the patient card.

Who is eligible for free dialysis in Madhya Pradesh?

You can register if:

• You are a resident of Madhya Pradesh and can show a residence proof.
• A government hospital physician or nephrologist has certified that you need maintenance haemodialysis. This is the primary and non-negotiable criterion.
• You complete the pre-dialysis workup: creatinine, urea, kidney ultrasound and hepatitis B, hepatitis C and HIV screening.
• You carry the identity documents the unit asks for, normally Aadhaar and, in Madhya Pradesh, the Samagra ID.

You are not eligible or cannot be registered if:

• No treating doctor has indicated dialysis. The unit will not start dialysis on patient request alone.
• The patient's condition requires a facility the unit does not have, for example intensive-care-level support or paediatric dialysis where the district unit is not equipped. Such cases are referred upward to a medical college hospital rather than refused.
• The applicant fails the means test where the district applies one. The PMNDP guidelines are framed around poor and below-poverty-line patients; some districts ask for a BPL card or an income certificate and exclude serving government employees and pensioners above a stated pension. Because practice varies district to district, confirm at your own hospital rather than assuming.
• The patient is already covered for the same treatment under an employer health scheme that reimburses dialysis, in which case the hospital may route the claim through that scheme.

If a district unit turns a patient away for want of a slot rather than on eligibility, the correct response is to ask for the referral in writing to another operational unit from the NHM centre list.

What documents are needed to register for dialysis?

How to apply for free dialysis in Madhya Pradesh

1. Consult a doctor at a government hospital, the district hospital, civil hospital or medical college nearest you. Carry all previous kidney reports.
2. Complete the tests the doctor orders, typically serum creatinine, blood urea, a kidney ultrasound and the mandatory hepatitis B, hepatitis C and HIV screening. These tests are done free in the government hospital.
3. Get the written referral to the dialysis unit once the physician or nephrologist confirms that maintenance haemodialysis is needed. Ask for the prescribed frequency to be written on the referral.
4. Register at the dialysis unit with the referral, the reports, Aadhaar, residence proof and photographs. The unit opens a patient file and issues a dialysis card.
5. Take the allotted slot. Units run in shifts and allot a fixed day-and-time slot for each patient. Some units confirm the appointment by SMS.
6. Attend every scheduled session and get the card stamped. Missing sessions without informing the unit can cost you the slot, which is then given to a waiting patient.
7. Repeat the screening tests periodically as the unit directs, usually every three to six months.

Find the nearest operational unit from the list of operational dialysis centres published on nhmmp.gov.in before you travel, because units are added and occasionally suspended for maintenance.

How do I check whether my district has a dialysis unit?

Open nhmmp.gov.in and download the list of operational dialysis centres from the NCD section. The list names the hospital and district for each unit. If your district hospital is on the list but the unit is not functioning when you arrive, raise it with the Civil Surgeon and record a complaint on CM Helpline 181, the machines and consumables are contracted for and a prolonged shutdown is a contract failure, not a normal state of affairs.

Patients holding an Ayushman Nirogayam / PM-JAY card have a second route. Dialysis is a listed package under PM-JAY, so an empanelled private hospital can treat you cashless against the card. Where the government unit near you is full, this is frequently the faster option.

Why do dialysis registrations run into problems?

• No slot available. The commonest problem. Units run at capacity and a new patient waits. Ask for a written referral to another listed unit.
• Incomplete viral screening. A unit will not start dialysis until hepatitis B, hepatitis C and HIV status is known, because positive patients must be dialysed on dedicated machines.
• No vascular access. A patient sent for dialysis without an AV fistula or a catheter has to have access created first, which is a separate procedure and a separate wait.
• Means-test documents missing in districts that apply one — a ration card or income certificate that the patient did not bring.
• Machine or reverse-osmosis plant down, which suspends sessions at that unit until repaired.
• Patient shifted districts without transferring the file, so the new unit has no record of the treatment history.

Where do I complain about free dialysis in Madhya Pradesh?

• Civil Surgeon-cum-Hospital Superintendent of the district hospital; first authority for a refusal, a charge levied, or a non-functioning machine.
• Chief Medical and Health Officer (CMHO) of the district. The next level.
• CM Helpline 181. The Madhya Pradesh grievance line for every state scheme; it issues a complaint number you can follow up on.
• Health helpline 104, for information about services and facilities.
• Directorate of Public Health and Medical Education, health.mp.gov.in, the department that oversees hospital administration in the state.

A patient should never be asked to pay for a session, a dialyser or tubing at a unit running under the National Health Mission. If money is demanded, pay nothing and complain the same day with the name of the person who asked.