Lok Sabha Question No. 1044 (UNSTARRED), answered on 2017-07-21
Subject: IMR and MMR
Ministry: HEALTH AND FAMILY WELFARE
Asked by: BHARATI DHIRUBHAI SHIYAL, RAJESHBHAI NARANBHAI CHUDASAMA, B.N. CHANDRAPPA, NALIN KUMAR KATEEL

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

## LOK SABHA UNSTARRED QUESTION NO. 1044 TO BE ANSWERED ON 21 ST JULY, 2017

## IMR AND MMR

## 1044. DR. BHARATIBEN D. SHYAL: SHRI RAJESHBHAI CHUDASAMA: SHRI B.N. CHANDRAPPA: SHRI NALIN KUMAR KATEEL:

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

(a) the present status of Infant Mortality Rate (IMR) and Maternal Mortality Rate (MMR) in the country including Delhi;

(b) whether there is any policy or action plan to tackle the high IMR and MMR in the country including Delhi and if so, the details thereof, if not, the reasons therefor;

- (c)  whether  the  Government  intends to  start  awareness  campaign  about  maternal health programmes especially  for  below poverty  line  sections,  if  so,  the  details thereof,  if  not,  the reasons therefor;
- (d) whether the Government intends to provide health packages for the pregnant women and newborn  children  relating  to the  vulnerable  population,  if  so, the  details thereof,  if  not,  the reasons therefor;
- (e) whether the Government has made any significant achievement in this regard during the last three years and the current year, if so the details thereof; and

(f) whether the Government has set any time line to achieve its target for reduction in IMR and MMR and, if so the details thereof?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

(SHRI FAGGAN SINGH KULASTE)

(a): As per the latest report of the Registrar General of India - Sample Registration System (RGI- SRS), Infant Mortality Rate (IMR) at national level is 37 per 1000 live births in 2 Maternal Mortality Ratio (MMR) at national level is 167 per 100,000 live births for the period of 2011- 13.

The IMR of Delhi is 18 per 1000 live births (SRS, 2015) whereas SRS 2011 - 13 does not provide the MMR of NCT of Delhi.

(b ) : Government  of  India  has  adopted  the  Reproductive,  Maternal,  Newborn,  Child  and Adolescent Health Strategy (RMNCH+A) to improve maternal and child health outcomes. The RMNCH+A strategy recognize that child health and survival is inextricably linked to wome n's health across all life stages.

Under National Health Mission, the following interventions are being implemented to re infant and maternal mortality all across the country including NCT of Delhi:

- (1)Promotion  of  Institutional  deliveries  through  cash  incentive  under  Janani  Sura Yojana  (JSY)  and  Janani  Shishu  Suraksha  Karyakaram  (JSSK)  which  entitles  all pregnant  women  delivering  in  public  health  institutions  to  absolutely  free  ante - natal check - ups,delivery  including  Caesarean  section,  post - natal  care  and  treatment  of  sick infants till one year of age.
- (2)Strengthening of delivery points for providing comprehensive and quality Reproduct Maternal,  Newborn,  Child  and  Adolescent  Health  (RMNCH+A)  Ser vices,  ensuring essential  newborn  care  at  all  delivery  points,  establishment  of  Special  Newborn Units (SNCU), Newborn Stabilization Units (NBSU) and Kangaroo Mother Care (KMC) units for care of sick and small babies. Home Based Newborn Care (HBNC) is being provided  by  ASHAs  to  improve  child  rearing  practices.  India  Newborn  Action  Pla (INAP) was launched in 2014 to make concerted efforts towards attainment of the go of 'Single Digit Neonatal Mortality Rate' and 'Single Digit Stillbirth Rate', by 203 0.
- (3)Early initiation and exclusive breastfeeding for first six months and appropriate and Young Child Feeding (IYCF) practices are promoted in convergence with Ministr of  Women  and  Child  Development.  Village  Health  and  Nutrition  Days  (VHNDs)  are observed for provision of maternal and child health services and creating awarene maternal and child care including health and nutrition education. Ministry of Heal Family Welfare launched MAA -Mothers' Absolute Affection programme in August 2016 f or improvingbreastfeeding practices (Initial Breastfeeding within one hour , Exclusive Breastfeeding  up  to  six  months  and  complementary  Breastfeeding  up  to  two  years through mass media and capacity building of health care providers in health facili s well as in communities.
- (4)Universal Immunization Programme (UIP) is being supported to provide vaccination t children  against  many  life  threatening  diseases  such  as  Tuberculosis,  Diphth Pertussis,  Polio,  Tetanus,  Hepatitis  B  and  Measles.  Pentavalen t  vaccine  has  been introduced all across the country and 'Mission Indradhanush' has been launched to fully immunize children who are either unvaccinated or partially vaccinated; those that not been covered during the rounds of routine immunization for various reasons.
- (5)Name based tracking of mothers and children till two years of age (Mother and Ch Tracking  System)  is  done  to  ensure  complete  antenatal,  intranatal,  postnatal  car complete immunization as per schedule.
- (6)Rashtriya Bal Swasthya Karyakram (RBSK) for health screening, early detection of birth defects,  diseases,  deficiencies,  development  delays  including  disability  and intervention services has been Operationalized to provide comprehensive care to al children in the age g roup of 0 - 18 years in the community.
- (7)Some other important interventions are Iron and folic acid (IFA) supplementation fo prevention  of  anaemia  among  the  vulnerable  age  groups,  home  visits  by  ASHAs  to promote exclusive breast feeding and promote use of ORS and Zinc for management of diarrhoea in children.
- (8)Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) has been implemented to provide fixed - day assured, comprehensive and quality antenatal care universally to all preg women on the 9th of every mo nth.
- (9)Capacity building of health care providers: Various trainings are being conducted National Health Mission (NHM) to build and upgrade the skills of health care provi in  basic  and  comprehensive  obstetric  care  of  mother  during  pregnancy,  deliv ery  and essential newborn care.
- (10) Capacity  building  of  Graduate  doctors  in  Anesthesia  (LSAS)  and  Obstetric  Car including  C - section  (EmOC)  skills  to  overcome  the  shortage  of  specialists  in  the disciplines, particularly in rural areas.
- (11) Establishing  Maternal  and  Child  Health  (MCH)  Wings  in  high  caseload  facilities improve the quality of care provided to mothers and children.
- (12) Health  and  nutrition  education  through  Information,  Education  &  Communication (IEC) and Behaviour Change Commu nication (BCC) to promote dietary diversification, inclusion of iron folate rich food as well as food items that promotes iron absorpti
- (13) To tackle the problem of anemia due to malaria particularly in pregnant women a children,  Long  Lasting  Insectic ide  Nets  (LLINs)  and  Insecticide  Treated  Bed  Nets (ITBNs) are being distributed in endemic areas.
- (14) Safe  Motherhood  Booklet  is  being  distributed  to  the  pregnant  women  for  educati them on dietary diversification and promotion of consumption of IFA.
- (15) Low performing districts have been identified as High Priority Districts (HPDs) w entitles them to receive high per capita funding, relaxed norms, enhanced monitorin focused supportive supervisions and encouragement to adopt innovative approaches address their peculiar health challenges.

( c) : Regular Information, Education & Communication (IEC) and Behaviour Change Communication  (BCC)  for  all  pregnant  women  including  vulnerable  population  is  done including messages on early registration for ANC, reg ular ANC, institutional delivery, nutrition, and  care  during  pregnancy  are  provided.    Funds  are  being  provided  to  the  States  th Programme Implementation Plan (PIPs) for comprehensive IEC/ BCC on Maternal and Newborn health.  Standardised  IEC/BCC  packag es  have  been  prepared  at  National  level  and  have  been disseminated for adaptation by the States.

(d ) : Under  National  Health  Mission,  Government  of  India  is  providing  various  services pregnant  women  and  newborn children  including  the  vulnerable  population.  Promotion  of Institutional deliveries through cash incentive under Janani Suraksha Yojana (JSY) and Shishu  Suraksha  Karyakaram  (JSSK)  which  entitles  all  pregnant  women  delivering  in  publ health instit utions to absolutely free ante - natal check - ups, delivery including Caesarean section, post - natal care and treatment of sick infants till one year of age.

(e ) : The Infant Mortality Rate has shown decline from 42/1000 live births in 2012 to 37/ live births in 2015.

The Maternal Mortality Ratio for the period 2011 - 13 is 167 per 100,000 live births.

(f ) : Under  National Health Policy, 2017; Government of India has set targets for reducti IMR to 28 by 2019 and MMR to 100 by 2020.