Lok Sabha Question No. 144 (UNSTARRED), answered on 2017-12-15
Subject: Maternal Deaths
Ministry: HEALTH AND FAMILY WELFARE
Asked by: SANJAY JAISWAL

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

## LOK SABHA UNSTARRED QUESTION NO. 144 TO BE ANSWERED ON   15 TH DECEMBER, 2017

## MATERNAL DEATHS

## 144. DR. SANJAY JAISWAL:

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

- (a) whether the Government has identified primary causes for maternal deaths;

(b) if so, the details thereof along with the details of maternal deaths during the last three years, State and year - wise;

(c) whether the  Government  has noticed that Anaemia is one of the reasons behind maternal deaths; and

(d) if so, the details thereof along with the steps taken/being taken by the Government to reduce maternal deaths in the country?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

(a) to (c):Government has identified primary causes for maternal deaths . As per the RGI -SRS  Report  (2001 - 2003)  the  identified  primary  causes  of  maternal  deaths  are  haemorrhag (38%),  sepsis  (11%),  abortion - (8%),  hypertensive  disorders - (5%),  obstructed  labour  (5%), other conditions (ectopic pregnancy, severe anaemia, embolism ) tc (34%).

According  to  RGI - SRS,  the  latest  data  on  maternal  deaths  in  the  country  has  bee released in the year 2011 - 13. The details are placed at Annexure.

(d): Under  the  National  Health  Mission  (NHM),  the  steps  taken  to  tackle  anaemia  and reducematernal deaths are as follows:

- Ministry of Health and Family Welfare in 2013 launched 'National Iron plus Initiative' as a comprehensive strategy to combat the public health challenge of Iron Defici Anemia prevalent across the life cycle. There are a ge specific interventions with Iron and Folic Acid Supplementation and Deworming for improving the hemoglobin levels and reducing the prevalence of anemia for all age groups, that is children 6 - 59 months, 5 -10 years, adolescent girls and boys (10 - 19 year s), pregnant and lactating women and women in reproductive age group (15 -45 years).
- Universal screening of pregnant women for anemia is a part of ante - natal  care and all pregnant  women  are  provided  iron  and  folic  acid  tablets  during  their  ante - natal  visits through the existing network of sub - centers and primary health centers and other he al facilities  as  well  as  through  outreach  activities  at  Village  Health  &  Nutritio (VHNDs).  These women are also counselled for dietary habits.
- Pradhan  Mantri  Surakshit  Matritva  Abhiyan  (PMSMA)  has  been  recently  launched  to focus  on  conducting  spe cial  ANC  check  up  on  9th  of  every  month  with  the  help  of Medical officers/ OBGYN to detect and treat cases of anemia.
- Health  management  information  system  &  Mother  Child  tracking  system  is  being implemented      for  reporting  and  tracking  the  cases  of  anemic and  severely  anemic pregnant women.
- Every pregnant woman is provided with about 360 tablets of iron and folic acid to the  ante  natal  and  post -natal  period.  Pregnant  women,  who  are  found  to  be  clinically anemic, are given additional tablet for takin g two tablets daily.
- To address anaemia due to worm infestation, deworming of pregnant women is done afte first trimester preferably in second trimester of pregnancy.
- Operationalization of   Blood Bank in District Hospitals and Blood Storage Unit in district  facilities  such  as  Sub - Divisional  Hospital/  Community  health  Centers  is  being taken up to tackle complications due to severe anemia etc.
- To  tackle  the  problem  of  anemia  due  to  malaria  particularly  in  pregnant  women  a children,  Long  Lasting  In secticide  Nets  (LLINs)  and  Insecticide  Treated  Bed  Nets (ITBNs) are being distributed in endemic areas.
- Health and nutrition education through IEC & BCC to promote dietary diversificati inclusion of iron folate rich food as well as food items that prom otes iron absorption.
- MCP Card and Safe Motherhood Booklet is being distributed to the pregnant women fo educating them on dietary diversification and promotion of consumption of IFA.
- Information,  Education  and  Communication  (IEC)  material  in  the  for m  of  posters, hoardings, wall - writings and audio - visuals have been developed to promote prevention of anemia.
- Videos and job - aids for nutrition and health education have also been disseminated to States/UT.
- Janani Shishu Suraksha Karyakaram (JSSK) has been launched on 1st June, 2011, which entitles all pregnant women delivering in public health institutions to absolutely no  expense  delivery  including  Caesarean  section.    The  initiative  stipulates  free diagnostics,  blood  and  di et,  besides  free  transport  from  home  to  institution,  betwee facilities in case of a referral and drop back home.  Similar entitlements have bee place for all sick infants accessing public health institutions for treatment.
- Engagement  of  more  th an  9  lakhs  Accredited  Social  Health  Activists  (ASHAs)  to generate demand and facilitate accessing of health care services by the community.

(Source: RGI -SRS 2011-13 bulletin)

## Annexure

| State                      |   Maternal Mortality Ratio (MMR) (Maternal deaths per 1,00,000 live births) |
|----------------------------|-----------------------------------------------------------------------------|
| INDIA                      |                                                                         167 |
| Assam                      |                                                                         300 |
| Bihar                      |                                                                         208 |
| Madhya                     |                                                                         221 |
| Orissa                     |                                                                         222 |
| Rajasthan                  |                                                                         244 |
| Uttar Pradesh/ Uttarakhand |                                                                         285 |
| Andhra                     |                                                                          92 |
| Karnataka                  |                                                                         133 |
| Kerala                     |                                                                          61 |
| Tamil                      |                                                                          79 |
| Gujarat                    |                                                                         112 |
| Haryana                    |                                                                         127 |
| Maharashtra                |                                                                          68 |
| Punjab                     |                                                                          17 |
| West                       |                                                                          33 |
| Other states)              |                                                                         188 |