Lok Sabha Question No. 1767 (UNSTARRED), answered on 2016-11-25
Subject: Welfare Schemes for Pregnant Women
Ministry: HEALTH AND FAMILY WELFARE
Asked by: RADHESHYAM BISWAS

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

LOK SABHA UNSTARRED QUESTION NO. 1767 TO BE ANSWERED ON 25 TH NOVEMBER, 2016

## WELFARE SCHEMES FOR PREGNANT WOMEN

## 1767. SHRI RADHESHYAM BISWAS:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) the details of schemes/ programmes that are in force for the welfare of pregnant women and children in the country;
- (b) the funds allocated, sanctioned and released for the last three years, State/UT - wise;
- (c)  whether  the  schemes/programmes have  achieved  in  reducing  the  death  rate  of pregnant women and child, if so, the details thereof; and
- (d) whether the Union Government has taken any steps to ensure proper implementation of the schemes/programmes in rural areas, if so, the details thereof ?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI FAGGAN SINGH KULASTE)

- (a): Government of India has implemented various schemes for pregnant women and chi ldren in the country and the same are placed below:
- Janani Suraksha Yojana (JSY) was launched in April 2005, with the objective of reducing maternal and neonatal mortality by promoting institutional delivery among pregnant wo by providing incentive to all BPL/SC/ST pregnant women delivering in Government health facilities/accredited  private  institutions  in  both  High  performing  State  (HPS)  an Performing State (LPS) regardless of age of mother and number of children.
- Janani Shishu Suraksha Karyak aram (JSSK) has been launched on 1 st June, 2011, which entitles all pregnant women delivering in public health institutions to absolutely fre expense delivery including Caesarean section.  The initiative stipulates free drugs, dia blood an d diet, besides free transport from home to institution, between facilities in referral and drop back home.  Similar entitlements have been put in place for all sick accessing public health institutions for treatment.
- The  Pradhan  Mantri Surakshit  Matritva  Abhiyan(PMSMA) has  been  launched  by  the Ministry of Health & Family Welfare (MoHFW), Government of India to provide fixed - day assured, comprehensive and quality antenatal care universally to all pregnant women o 9th of every month. As part of the Abhiyan, a minimum package of antenatal care services would be provided to pregnant women in their 2nd / 3rd trimesters, by OBGY specialis Radiologist/  Physicians  at  government  health  facilities,  with  support  from  private doctors to supplement the efforts of the government.
- Rashtriya  Bal  Swasthya  Karyakram  (RBSK) has  been  launched  to  provide  child  health screening and early interventions services by expanding the reach of mobile health te block level. These teams also carry out screening of all the children in the age group 0 -6 years enrolled at Anganwadi Centres at least twice a year. RBSK covers 30 common heal conditions.
- In order to increase awareness about the use of ORS and Zinc in diarrhoea, an Intensified Diarrhoea  Control  Fortnight  (IDCF) is  being  observed  during  July -August,  with  the ultimate  aim  of  'zero  child  deaths  due  to  childhood  diarrhoea'.  During  fortnight  health workers visited the households of under five children, conducted community level aware generation activities and distributed ORS packets to the families with children under fi of age. Around 1.9 crore and 6.34 Crore Under - five children were reached by ASHAs during IDCF 2014 and 2015 respectively and prophylactic ORS packets were distrib ut d to them with counselling for care during diarrhoea.
- National  Deworming  Day  (NDD): Ministry  of  Health  &  Family  Welfare  had  adopted  a single  day  strategy  called  National  Deworming  Day  (NDD)  in  2015  to  combat  Soil Transmitted  Helminths  (STH)  infections in  the  children.  During  NDD,  a  single  dose  of Albendazole is administered to the children by school teachers and anganwadi workers.
- Government of India is implementing the Rashtriya Kishor Swasthya Karyakram. The salien features of the various interventi ons u der RKSK  are as follows :
-  Weekly  Iron  Folic  Acid  Supplementation  programme : The  objective  of  the programme is to reduce the prevalence and severity of anaemia in adolescent populatio (10 - 19  years). The programme covers adolescent girls and boys enrolled in 6th to 12th class  in  government/government  aided/municipal  schools  and  out  of  school  adolesce girls.  Under the programme supervised WIFS are given to these adolescent girls and using fixed day approach and biannual deworming for control of helminthic infestation. The adolescents are screened for moderate/severe anaemia and are referred to approp health facilities. Nutrition Health Education is also imparted to the adolescents b nodal teache rs.
-  Scheme  for  Promotion  of  Menstrual  Hygiene: The  scheme  aims  at  increasing  the awareness regarding hygiene practices during menstruation, increased access to and u hygienic products during menstruation and disposal of such products in environmentally friendly manner among adolescent girls living rural areas.
-  Peer Education: The programme aims to ensure that adolescents between the age of 10 -19  years  benefit  from  regular  and  sustained  peer  education  thus  improving  life  s knowledge and aptitude on key focused areas.
-  Adolescent Friendly Health Clinics: At AFHCs with the presence of trained service providers counselling and curative services ( information, commodities and services provided at primary, secondary and tertiary levels of care with due referral linkage

(b): the details of the  funds  approved  and utilized  for Mat ernal health & Child health  for the last  three years  State/ UT - wise  is placed at Annexure - I & Annexure- II respectively.

- As per the latest RGI - SRS Report (2011 - 13); the MMR of India has declined from 254 in 2004- 06  to  167  per  100,000  live  births  in  2011 - 13.  This  translates  into a  reduction of absolute numbers of maternal deaths from approximately 67000 to 44,000 per year.
- The annual decline in MMR has been 6.2% during 2011 - 13 to 2010 - 12 as compared to the  annual  decline  of  5.7%  during  2007 - 09  to  2010 - 12.  Assuming,  the  same  pace  of decline continues, India's MMR is likely to reach the MDG - 5 target of 139/ lakh live births by 2015.
- The Under -5 Mortality Rate of the country has reduced from 52 per 1,000 live birth 2012 to 45 per 1,000 live births in 2014.
- (d): The implementation and progress of the various schemes and  programs are  reviewed at the national level through a number of review mechanisms and surveys:
- i)  Hon'ble  Prime  Minister has  recently  reviewed  the  progress  on  Infant  Mortality  Rate  and Maternal Mortality Ratio in Empowered Action Group States (Bihar, Chhattisga rh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttar Pradesh, Uttarakhand) & Assam through PRAGATI -the ICT - based, multi - modal platform for Pro -Active Governance and Timely Implementation.
- ii)  Meetings  of Central  Council  of  Health  &  Family  Welfare  ar e  held under  the chairpersonship of Union Minister of Health & Family Welfare to review progress under NH with State Health Ministers.
- iii) Annual Common Review Missions -Common Review Missions (CRMs) are conducted on an annual basis to review the progress of various schemes under NHM.

## iv) Surveys:

- RGI  provides  information  on  indicators  such  as  IMR,  MMR,  Under  five  mortality  rate  e through the Sample Registration Syste m  (SRS)
- District  Level  Household  Survey  (DLHS) -provides  district  level  estimates  on  health indicators  to  assist  policy  makers  and  program  administrators  in  decentralized  pla monitoring and evaluation.
- National Family Health Survey (NFHS) provides state and national information for India on fertility, infant and child mortality, the practice of family planning etc
- Rapid Survey on Children conducted by UNICEF
- v)  Reviews  of  various  programmes  under  the  National  Health  Mission  are  also  conducted R egional  level  review  meetings,  National  Programme  Coordination  Committee meetings held at National level to discuss State programme implementation plans etc.
- vi) Video Conferences are conducted at regular intervals with State Health Secretaries/ S Mi ssion  Directors  under  the  chairpersonship  of  senior  officials  in  the  Ministry  to  re progress
- vii)  Regular  integrated  monitoring  visits from  the  MoHFW  &  National  Health  Systems Resource Centre (NHSRC) to States and from States to districts & blocks.

## Annexure - 1 Statement showing details of SPIP Approval Vs Expenditure for the component Maternal Health under RCH Flexible Pool for FY 2013 - 14 to 2015 -16

Rs. In crore

| S.No.                    | State                     | 2013-14        | 2013-14     | 2014-15        | 2014-15     | 2015-16        | 2015-16     |
|--------------------------|---------------------------|----------------|-------------|----------------|-------------|----------------|-------------|
| S.No.                    | State                     | SPIP Approvals | Utilization | SPIP Approvals | Utilization | SPIP Approvals | Utilization |
| A. High Focus States     |                           |                |             |                |             |                |             |
| 1                        | Bihar                     | 577.99         | 432.36      | 535.86         | 362.54      | 426.55         | 379.30      |
| 2                        | Chattisgarh               | 116.44         | 65.20       | 84.55          | 64.59       | 89.56          | 75.60       |
| 3                        | Himachal Pradesh          | 10.04          | 21.41       | 18.86          | 18.02       | 18.47          | 23.72       |
| 4                        | Jammu & Kashmir           | 42.63          | 54.79       | 57.11          | 45.26       | 60.99          | 53.19       |
| 5                        | Jharkhand                 | 140.96         | 103.54      | 150.55         | 107.37      | 165.91         | 111.64      |
| 6                        | Madhya Pradesh            | 320.87         | 298.01      | 290.97         | 267.22      | 296.15         | 295.97      |
| 7                        | Orissa                    | 165.96         | 147.24      | 139.54         | 124.38      | 151.06         | 137.05      |
| 8                        | Rajasthan                 | 345.05         | 270.84      | 337.00         | 301.80      | 345.27         | 270.37      |
| 9                        | Uttar Pradesh             | 702.28         | 603.50      | 713.89         | 575.15      | 698.82         | 515.14      |
| 10                       | Uttarakhand               | 33.78          | 34.67       | 39.43          | 38.96       | 45.49          | 43.10       |
|                          | Sub Total                 | 2,456.01       | 2,031.56    | 2,367.77       | 1,905.30    | 2,298.27       | 1,905.09    |
| B. NE States             |                           |                |             |                |             |                |             |
| 11                       | Arunachal Pradesh         | 4.52           | 3.01        | 5.73           | 2.63        | 6.20           | 3.62        |
| 12                       | Assam                     | 166.22         | 136.42      | 220.29         | 137.47      | 160.79         | 177.17      |
| 13                       | Manipur                   | 7.14           | 4.87        | 9.49           | 7.08        | 8.59           | 9.32        |
| 14                       | Meghalaya                 | 6.86           | 1.11        | 10.84          | 5.80        | 12.16          | 11.07       |
| 15                       | Mizoram                   | 4.28           | 3.48        | 4.70           | 1.67        | 5.67           | 1.37        |
| 16                       | Nagaland                  | 7.04           | 5.15        | 7.37           | 2.58        | 5.52           | 1.87        |
| 17                       | Sikkim                    | 1.87           | 1.65        | 1.47           | 1.50        | 1.52           | 1.54        |
| 18                       | Tripura                   | 12.45          | 10.55       | 16.81          | 11.76       | 14.51          | 12.56       |
|                          | Sub Total                 | 210.38         | 166.24      | 276.69         | 170.49      | 214.97         | 218.52      |
| C. Non-High Focus States |                           |                |             |                |             |                |             |
| 19                       | Andhra Pradesh            | 138.31         | 49.46       | 82.40          | 68.29       | 69.09          | 67.20       |
| 20                       | Goa                       | 1.99           | 1.27        | 79.63          | 39.79       | 2.84           | 0.47        |
| 21                       | Gujarat                   | 64.24          | 61.25       | 2.58           | 0.96        | 84.51          | 77.09       |
| 22                       | Haryana                   | 30.96          | 29.00       | 74.81          | 68.91       | 34.05          | 21.44       |
| 23                       | Karnataka                 | 112.21         | 86.78       | 33.75          | 28.16       | 122.48         | 96.88       |
| 24                       | Kerala                    | 37.81          | 49.85       | 115.60         | 83.51       | 37.63          | 34.78       |
| 25                       | Maharashtra               | 181.79         | 115.94      | 37.42          | 36.74       | 173.17         | 121.46      |
| 26                       | Punjab                    | 37.24          | 29.23       | 195.39         | 144.09      | 43.30          | 40.57       |
| 27                       | Tamil Nadu                | 160.96         | 127.67      | 36.83          | 40.09       | 138.46         | 120.88      |
| 28                       | Telangana                 | -              | -           | 172.49         | 187.08      | 53.96          | 42.90       |
| 29                       | West Bengal               | 237.52         | 152.79      | 262.98         | 215.60      | 251.64         | 217.37      |
|                          | Sub Total                 | 1,003.02       | 703.23      | 1,093.89       | 913.24      | 1,011.12       | 841.05      |
| D. SmallStates/UTs       |                           |                |             |                |             |                |             |
| 30                       | Andaman & Nicobar Islands | 1.07           | 0.61        | 0.45           | 0.47        | 0.52           | 0.09        |
| 31                       | Chandigarh                | 0.06           | 0.06        | 0.07           | 0.08        | 1.78           | 1.43        |
| 32                       | Dadra & Nagar Haveli      | 0.42           | 0.47        | 1.37           | 0.51        | 0.98           | 0.83        |
| 33                       | Daman & Diu               | 0.16           | 0.16        | 0.20           | 0.20        | 0.14           | 0.04        |
| 34                       | Delhi                     | 8.11           | 3.36        | 10.02          | 3.63        | 8.36           | 2.66        |
| 35                       | Lakshadweep               | 0.20           | 0.11        | 0.23           | 0.22        | 0.23           | 0.10        |
| 36                       | Puducherry                | 5.69           | 2.83        | 3.90           | 2.61        | 3.08           | 1.39        |
|                          | Sub Total                 | 15.71          | 7.60        | 16.24          | 7.73        | 15.09          | 6.55        |
|                          | Grand Total               | 3,685.12       | 2,908.64    | 3,754.58       | 2,996.75    | 3,539.45       | 2,971.20    |

## Note:

- 1) SPIP stands for State Programme Impementation Plan.
- 2) The above figures is as per FMR Submitted by the States/UTs.
- 3) Above mentioned Utilization figures are as reported by States/UTs and includes expenditure against Central Release, State share & unspent balances, updated up to 31 - 03- 2016.

Annexure-II Statement showing details of SPIP Approval Vs Expenditure for the component Child Health under RCH Flexible Pool for FY 2013-14 to 2015-16

Rs. In crore

|                           |                   | 2013-14        | 2013-14     | 2014-15        | 2014-15     | 2015-16        | 2015-16     |
|---------------------------|-------------------|----------------|-------------|----------------|-------------|----------------|-------------|
| S.No.                     | State             | SPIP Approvals | Utilization | SPIP Approvals | Utilization | SPIP Approvals | Utilization |
| A. High Focus States      |                   |                |             |                |             |                |             |
| 1                         | Bihar             | 53.94          | 29.30       | 12.41          | 8.60        | 15.00          | 7.48        |
| 2                         | Chattisgarh       | 10.53          | 6.12        | 11.70          | 7.86        | 14.68          | 11.27       |
| 3                         | Himachal Pradesh  | 1.18           | 7.29        | 7.24           | 13.05       | 4.21           | 3.78        |
| 4                         | Jammu & Kashmir   | 11.93          | 4.68        | 6.48           | 4.68        | 4.88           | 4.46        |
| 5                         | Jharkhand         | 19.05          | 8.83        | 18.52          | 7.33        | 19.05          | 8.84        |
| 6                         | Madhya Pradesh    | 42.45          | 39.74       | 34.55          | 30.26       | 37.98          | 31.18       |
| 7                         | Orissa            | 11.15          | 6.22        | 15.63          | 6.68        | 13.33          | 6.98        |
| 8                         | Rajasthan         | 21.88          | 11.14       | 24.40          | 15.54       | 17.61          | 10.68       |
| 9                         | Uttar Pradesh     | 12.35          | 4.46        | 17.90          | 7.10        | 25.21          | 7.56        |
| 10                        | Uttarakhand       | 1.51           | 2.02        | 2.15           | 2.05        | 3.93           | 2.41        |
|                           | Sub Total         | 185.95         | 119.81      | 150.97         | 103.16      | 155.87         | 94.63       |
| B. NE States              |                   |                |             |                |             |                |             |
| 11                        | Arunachal Pradesh | 1.38           | 0.65        | 1.26           | 0.89        | 1.40           | 2.38        |
| 12                        | Assam             | 25.76          | 15.69       | 30.04          | 15.92       | 19.34          | 9.37        |
| 13                        | Manipur           | 0.38           | 0.75        | 1.77           | 1.64        | 1.43           | 1.09        |
| 14                        | Meghalaya         | 1.78           | 0.13        | 3.65           | 0.79        | 3.78           | 1.10        |
| 15                        | Mizoram           | 1.40           | 0.78        | 0.86           | 0.47        | 1.43           | 0.84        |
| 16                        | Nagaland          | 1.79           | 0.46        | 1.29           | 0.19        | 1.25           | 0.83        |
| 17                        | Sikkim            | 0.49           | 0.51        | 0.65           | 0.50        | 0.64           | 0.40        |
| 18                        | Tripura           | 0.58           | 0.88        | 2.56           | 1.85        | 1.67           | 1.00        |
|                           | Sub Total         | 33.56          | 19.85       | 42.08          | 22.24       | 30.94          | 17.00       |
| C. Non- High Focus States |                   |                |             |                |             |                |             |
| 19                        | Andhra Pradesh    | 21.45          | 6.05        | 12.34          | 6.77        | 11.27          | 11.09       |

| 20                  | Goa                       | 0.46   | 0.15   | 7.56   | 1.18   | 0.45   | 0.09   |
|---------------------|---------------------------|--------|--------|--------|--------|--------|--------|
| 21                  | Gujarat                   | 28.00  | 16.58  | 0.70   | 0.18   | 22.47  | 17.65  |
| 22                  | Haryana                   | 5.68   | 5.61   | 21.10  | 16.78  | 6.84   | 1.02   |
| 23                  | Karnataka                 | 4.78   | 3.02   | 5.74   | 4.66   | 8.56   | 4.16   |
| 24                  | Kerala                    | 4.02   | 3.10   | 10.24  | 2.55   | 2.64   | 1.02   |
| 25                  | Maharashtra               | 17.73  | 26.57  | 1.98   | 1.58   | 12.53  | 6.20   |
| 26                  | Punjab                    | 2.95   | 0.48   | 24.08  | 13.10  | 3.61   | 3.94   |
| 27                  | Tamil Nadu                | 5.62   | 10.63  | 7.84   | 6.38   | 10.64  | 10.32  |
| 28                  | Telangana                 | -      | -      | 6.56   | 40.98  | 7.61   | 2.23   |
| 29                  | West Bengal               | 14.42  | 11.19  | 32.45  | 24.13  | 24.64  | 37.00  |
|                     | Sub Total                 | 105.10 | 83.38  | 130.60 | 118.28 | 111.27 | 94.72  |
| D. Small States/UTs |                           |        |        |        |        |        |        |
| 30                  | Andaman & Nicobar Islands | 0.06   | -      | 0.29   | 0.04   | 0.14   | -      |
| 31                  | Chandigarh                | 0.00   | 0.00   | 0.03   | 0.00   | 0.04   | 0.00   |
| 32                  | Dadra & Nagar Haveli      | 0.10   | 0.04   | 0.24   | 0.01   | 0.28   | 0.09   |
| 33                  | Daman & Diu               | -      | -      | 0.00   | 0.00   | 0.03   | 0.03   |
| 34                  | Delhi                     | 0.87   | 0.19   | 1.53   | 0.16   | 0.98   | 0.06   |
| 35                  | Lakshadweep               | 0.05   | -      | 0.15   | 0.00   | 0.21   | 0.03   |
| 36                  | Puducherry                | 0.15   | 0.06   | 0.16   | 0.09   | 0.24   | 0.00   |
|                     | Sub Total                 | 1.23   | 0.29   | 2.40   | 0.31   | 1.91   | 0.21   |
|                     | Grand Total               | 325.84 | 223.32 | 326.04 | 243.99 | 299.99 | 206.57 |

## Note:

- 1) SPIP stands for State Programme Impementation Plan.
- 2) The above figures is as per FMR Submitted by the States/UTs.
- 3) Above mentioned Utilization figures are as reported by States/UTs and includes expenditure against Central Release, State share & unspent balances, updated up to 31-03-2016.