Lok Sabha Question No. 1861 (UNSTARRED), answered on 2019-11-29
Subject: Decline in Maternal Mortality Rate
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Sanjay Haribhau Jadhav, Queen Oja, Mohanbhai Sanjibhai Delkar, Bharatiben Dhirubhai Shyal

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

LOK SABHA UNSTARRED QUESTION NO. 1861 TO BE ANSWERED ON 29 TH NOVEMBER, 2019

## DECL INE IN MATERNAL MORT ALITY RATE

## 1861. SHRI SANJAY JADHAV: SHRIMATI QUEEN OJA: SHRI MOHAN S. DELKAR: DR. BHARATIBEN DHIRUBHAI SHIYAL:

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

- (a) whether as per the data released recently by the Government, the Maternal Mortalit (MMR) has shown a decline, if so, the details thereof and the percentage of this decline;
- (b)  whether  the  Government  has  conducted  a  survey  in  this  regard  to  ascertain  the  f responsible for MMR if so, the details thereof;
- (c) the schemes formulated and operated by the Government resulting in such decline in MMR, State/UT/Districtwise including Dadar and Nagar Haveli, Marathwada district of Maharash during the last three years; and
- (d) the other steps taken by the Government to further reduce MMR?

## A NSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

## (SHRI ASHWINI KUMAR CHOUBEY)

- (a):          As  per  the  latest  report  of  Sample  Registration  System  (SRS)  released  by  R General of India (RGI), Maternal Mortality Ratio (MMR) of India has reduced by 8 points from 130, per 100,000 live births in SRS 2014 - 16 to 122 in SRS 2015 - 17.The details are placed in Annexure.
- (b): As perthe RGI SRS report titled 'Maternal Mortality in India: 2001 - 2003 trends, causes and risk factors', maj or causes of maternal deaths in the country are haemorrhage (38%), seps (11%), hypertensive disorders (5%), obstructed labour (5%), abortion (8%) and other Condi (34%) , which includes anaemia.
- (c)&(d) : Under  the  National  Health  Mission  (NHM),  follo wing  steps  are  taken  by  the Government to reduce maternal deaths in the country including Dadar and Nagar Haveli a Marathwada district of Maharashtra.
- Janani Suraksha Yojana (JSY), a demand promotion and conditional cash transfer scheme was launched in A pril 2005 with the objective of reducing Maternal and Infant Mortality.
- Janani Shishu Suraksha Karyakram (JSSK) aims to eliminate out - of - pocket expenses for pregnant  women  and  sick  infants  (up  to  one  year  of  age).    Under  JSSK,  every  pregn woman is entit led to free delivery, including caesarean section, in public health insti This also includes free transport, diagnostics, medicines, other consumables, diet an (if required).
- Pradhan  Mantri  Surakshit  Matritva  Abhiyan (PMSMA)  Under  PMSMA,  al l  pregnant women are provided fixed day, free of cost assured and quality Antenatal Care.  As p the campaign, a minimum package of antenatal care services (including investigations drugs) is being provided to the beneficiaries on the 9 th day of e very month.
- Surakshit Matratva Ashwasan( SUMAN) a comprehensive multipronged  and coordinated policy approach with an aim to assured, dignified, respectful and quality healthcare a and zero tolerance for denial of services for every women and newborn visiting public facilities  in order to nd all preventable maternal and newborn deaths and morbidities an provide positive birthing experience
- Comprehensive Abortion Careservices are being strengthened through trainings of health care  providers,  supply  of  drugs,  equipments,  Information Education  and  Communication (IEC) etc.
- Monthly Village Health and Nutrition Days (VHND) as an outreach activity at Anganwadi centers for provision of maternal and child care including nutrition in convergence w ICDS.
- Midwifery programme has been initiated in 2018 to create a cadre for Nurse Practitione Midwifery who are skilled in accordance to International Confederation of Midwives (I competencies and  capable  of  providing compassionate  women -centred,  reproductive, maternal and new - born health care services.
- Capacity building is undertaken of MBBS doctors in Anesthesia (LSAS) and Obstetric Care including  C - section  (EmOC)  skills  to  overcome  the  shortage  of  specialists  in  the disciplines, particularly in rural areas.
- Skill Labs with earmarked skill stations for different training programs are establis enhance the quality of training. Five National and over 100 State level Skills labs operational for conducting training.
- Maternal and Child Health (MCH) Wings at high caseload facilities to improve the quality of care provided to mothers and children.
- Obs HDU&ICU -Operationalization of Obstetric ICU/HDU in a high case load tertiary ca facilities across country to handle complicated pregnancies
- Delivery Points -Over 25,000 'Delivery Points' across the country have been strengthened in terms of infrastructure, equipment, and trained manpower for provision of comprehen RMNCAH+N services.
- Functionalisation of FRUs : Provision of Emergency Obstetric care at FRUs is bei ng done by operationalizing FRUs. While operationalizing, the thrust is on the critical comp such as manpower, blood storage units, referral linkages etc.
- LaQshya - LaQshya programme aims to improve the quality of care in Labour room and Maternity o peration theatres to ensure that pregnant women receive respectful and qua care during delivery and immediate post - partum.
- Regular  IEC/BCC  is  conducted  for  early  registration  of  ANC,  regular  ANC,  institutio delivery, nutrition, and care during preg na cy etc.
- Over 10 lakhs Accredited Social Health Activists (ASHAs) have been engaged to facili access of health care services by the community, particularly pregnant women.
- Maternal Death Surveillance Review (MDSR) is being implemented both at facilit ies and at the community level. The purpose is to take corrective action at appropriate lev improve the quality of obstetric care.
- Name  Based  Web  enabled  Tracking  of  Pregnant  Women  and  New  born  babies  so  as  to ensure provision of regular and complete services to them.
- MCP Card and Safe Motherhood Booklet are being distributed to the pregnant women for educating them on dietary diversification and promotion of consumption of IFA
- .................

## ANNEXURE

Trends in Maternal Mortality Ratio (per 1,00,000 live births )

| India/States   | 2014- 16   | % annual compound rate of decline 2014 - 16 over 2011- 13   |   2015- 17 | % change (2015- 17 over 2014- 16)   |
|----------------|------------|-------------------------------------------------------------|------------|-------------------------------------|
| India          | 130        | - 8                                                         |        122 | - 6.2                               |
| Andhra Pradesh | 74         | - 7                                                         |         74 | 0                                   |
| Assam          | 237        | - 7.6                                                       |        229 | - 3.4                               |
| Bihar          | 165        | - 7.4                                                       |        165 | 0                                   |
| Chhattisgarh   |            |                                                             |        141 |                                     |
| Gujarat        | 91         | - 6.7                                                       |         87 | - 4.4                               |
| Haryana        | 101        | - 7.4                                                       |         98 | - 3                                 |
| Jharkhand      |            |                                                             |         76 |                                     |
| Karnataka      | 108        | - 6.7                                                       |         97 | - 10.2                              |
| Kerala         | 46         | - 9                                                         |         42 | - 8.7                               |
| Madhya Pr      | 173        | - 7.8                                                       |        188 | 8.7                                 |
| Maharashtra    | 61         | - 3.6                                                       |         55 | - 9.8                               |
| Odisha         | 180        | - 6.8                                                       |        168 | - 6.7                               |
| Punjab         | 122        | - 4.7                                                       |        122 | 0                                   |
| Rajasthan      | 199        | - 6.6                                                       |        186 | - 6.5                               |
| Tamil Nadu     | 66         | - 5.8                                                       |         63 | - 4.5                               |
| Telangana      | 81         |                                                             |         76 | - 6.2                               |
| Uttar Pradesh  | 201        | - 11                                                        |        216 | 7.5                                 |
| Uttarkhand     |            |                                                             |         89 |                                     |
| West Bengal    | 101        | - 3.7                                                       |         94 | - 6.9                               |