Accessing medical benefits under ESI Scheme: A demand-side perspective

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.