Transgender social inclusion and equality is a pivotal path to developing the community, which will not only help gain community trust but shall also provide equity in health care services and reduce the social stigma attached to it.
To run a universal health coverage (UHC) programme successfully, inclusivity is key. This aim was bolstered when Prime Minister Narendra Modi launched the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) on September 23, 2018. As we celebrate four years of AB PM-JAY, we will also recognise a landmark addition to the world’s biggest public health assurance scheme: The extension of benefits under AB PM-JAY to the transgender community through a collaboration between the National Health Authority (NHA, ministry of health and family welfare) and the ministry of social justice and empowerment under the Support for Marginalised Individuals for Livelihood and Enterprise (SMILE). This is in continuation of the objectives of the AB PM-JAY scheme for fostering equity and inclusivity in the delivery of health care services.
As per the 2011 Census, the transgender community has 487,803 members. To date, 8,172 certificates have been issued. Many more certificates will be issued in the days to come. (Getty Images/iStockphoto)
Through this collaboration, any individual holding a transgender certificate, issued by the National Portal for Transgender Persons, can avail of the health care benefits with dignity and self-reliance at any AB PM-JAY-empanelled hospital.
As per the 2011 Census, the transgender community has 487,803 members. To date, 8,172 certificates have been issued. Many more certificates will be issued in the days to come. However, transgender people have not been able to avail the benefits of health insurance schemes for various procedures such as facilitating gender-reaffirmation surgeries. In many instances, individuals undergoing such operations did so at their own risk, without any accountability from health facilities.
To enable individuals from the transgender community to lead a healthy life, the scheme will provide various services free of cost at empanelled hospitals. Apart from the treatment packages covered under AB PM-JAY, around 50 more packages have been defined specifically for the transgender community, including packages on sex reassignment surgery (SRS). The construct of the packages includes genital surgeries, hormone therapy, laser therapy, and follow-up packages for certain procedures to ensure the continuum of care for transgender persons. Additionally, health facilities that specialise in providing SRS have been identified and will be empanelled to give a bigger network for availing health benefits. The AB PM-JAY scheme simultaneously fulfils its primary objective of significantly reducing out-of-pocket expenditure (OOP) of beneficiaries and rapidly expanding its reach of providing health care benefits to people across rural and urban areas.
Since its implementation, AB PM-JAY has expanded its footprint across the country. As of August 29, 189 million beneficiaries have been enrolled under the scheme and provided with Ayushman cards. In addition, approximately 37.8 million hospital admissions have been authorised, with hospitalisation expenses of over ₹45,000 crore, under the scheme through a network of 25,000 hospitals.
AB PM-JAY also envisages the integration and consolidation of the insurance landscape in India. Henceforth, after the launch of AB PM-JAY, NHA started the convergence of health insurance/assurance programmes through the NHA IT platform, creating an ecosystem catering to different beneficiary categories like ESIS, Ayushman CAPF, BoCW, CGHS and PM CARES for children schemes.
With its vision of inclusivity and health care for all, NHA has embarked on its journey to help the communities which require the utmost attention. This momentous programme will be a significant step in that direction. Transgender social inclusion and equality is a pivotal path to developing the community, which will not only help gain community trust but shall also provide equity in health care services and reduce the social stigma attached to it.
RS Sharma is chief executive officer, National Health Authority The views expressed are personal
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