Abstract
The ILO in India, through the ILO-ESIS project, has been providing technical support to the Employees’ State Insurance Corporation (ESIC) to strengthen its health services while increasing coverage and financial protection of working people in India. As part of this project, based on inputs from organizations of employers and workers, the ILO has carried out the present study titled, “Accessing Medical Benefits Under ESI Scheme: A Demand-side Perspective” in 2020-21. The present study brings together comprehensive primary evidence from four states of India, Jharkhand, Haryana, Tamil Nadu, and Rajasthan. It is supplemented by an analysis of relevant secondary data, to identify obstacles and incentives faced by beneficiaries in accessing ESIS services. The evidence in this study captures the health-seeking behaviour of beneficiaries as well as awareness and attitude of the insured persons and employers registered with the ESIS. The findings of this study underscore differential experiences and perceptions of beneficiaries in diverse implementation context of four states of India. The study highlights that while the ESIS beneficiaries appreciate the extensive benefit package, especially the medical benefits, there is still substantial scope of strengthening the effectiveness of the service delivery. At the same time, the beneficiaries themselves would gain from stronger awareness of their entitlements under ESIS. An important area of focus for increasing overall service utilization would be the provision of primary healthcare services. ESIS offers better financial protection than other similar schemes in India. However, it can contribute in a much larger way to India’s goal of Universal Health Coverage by increasing out-patient and in-patient healthcare service utilization at its facilities. One way to do this, as the study indicates, would be to actively track and improve the levels of beneficiary satisfaction.