Lok Sabha Question No. 985 (UNSTARRED), answered on 2019-11-22
Subject: Maternal Death
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Nusrat Jahan Ruhi

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

LOK SABHA UNSTARRED QUESTION NO. 985 TO BE ANSWERED ON 22 ND NOVEMBER, 2019

## MATERNAL DEATH

## 985. SHRIMATI NUSRAT JAHAN RUHI:

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

- (a) the number of maternal deaths occurred in last three years in the country, State - wise; and
- (b) the reasons behind those deaths and steps taken by the Government to address the probl

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

- (a): Registrar General of India provides estimates on fertility and mortality using the Registration System (SRS), which does not generate maternal mortality data on  yearly b Maternal  deaths  being  a  rare  event,  require  prohibitively  large  sample  siz e  to  provide  robust estimates. In order to enhance the SRS sample size, the results are derived by pooling t years data to yield reliable estimates of maternal mortality.

As per the report of Sample Registration System (SRS) released by Registrar G eneral of India (RGI), Maternal Mortality Ratio (MMR) of India reduced from 167, per 100,000 live birth SRS 2011-13 to 130 in SRS 2014 - 16  which further reduced to 122 per 100,000 live births in 2015- 17.

The detailed state - wise maternal deaths is placed at Annexure.

- (b) : As perthe RGI SRS report titled 'Maternal Mortality in India: 2001 - 2003 trends, causes and risk factors', major causes of maternal deaths in the country are haemorrhage (38%), sepsis (11%), hypertensive disorders (5%), obstructed la bour (5%), abortion (8%) and other Conditions (34%) , which includes anaemia

Under  the  National  Health  Mission  (NHM),  following  steps  are  being  taken  to  redu maternal deaths in the country:

- Janani Suraksha Yojana (JSY), a demand promotion and conditional cash transfer scheme was launched in April 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 entitled to free delivery, including caesarean section, in public health ins This also includes free trans port, diagnostics, medicines, other consumables, diet and bloo (if required).
- The Pradhan  Mantri  Surakshit  Matritva  Abhiyan (PMSMA)  Under  PMSMA,  all pregnant  women  in  the  country  are  provided  fixed  day,  free  of  cost  assured  and  qu Antenatal Care.  A s part of the campaign, a minimum package of antenatal care service
- (including investigations and drugs) is being provided to the beneficiaries on the 9 th day of every month.
- Surakshit Matratva Ashwasan( SUMAN) a comprehensive multipronged  and coordinate d 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 end all preventable maternal and newborn deaths and morbidities and provide positive birthing experience
- Comprehensive abortion care services are being strengthened through trainings of healt care  providers,  supply  of  drugs,  equipments,  Information  Education  and  Communicatio (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 Pra ctitioners in 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 underta ken 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 progra ms are established to 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 RMNCH+A services.
- Functionalisation of FRUs : Provision of Emergency Obstetric care at FRUs is being done by operationalizing FRUs. While operationalizin g, the thrust is on the critical components such as manpower, blood storage units, referral linkages etc.
- LaQshya - LaQshya programme aims to improve the quality of care in Labour room and Maternity operation theatres to ensure that pregnant women receive respectful and quality 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 pregnancy etc.
- Over 10 lakhs Accredited Social Health Activists (ASHAs) have been engaged to facilitat access of health care services by the community, particularly pregnant women.
- Maternal Death Surveillance Review (MDSR) is being implemented both at facilities and at the community level. The purpose is to take corrective action at appropriate level 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.

………………

## State-wise Maternal Deaths

|   Sl.No. | State/UT         | Estimated Maternal deaths as per RGI - SRS 2011- 13   | 2014- 16(Mid year 2015)   | 2015- 17 (Mid year 2016)   |
|----------|------------------|-------------------------------------------------------|---------------------------|----------------------------|
|        1 | Andhra Pradesh   | 800                                                   | 640                       | 640                        |
|        2 | Assam            | 2100                                                  | 1,720                     | 1,660                      |
|        3 | Bihar            | 6100                                                  | 4,900                     | 4,900                      |
|        4 | Chhatisgarh      | 1400                                                  | NA                        | 890                        |
|        5 | Gujarat          | 1500                                                  | 1,200                     | 1,150                      |
|        6 | Haryana          | 700                                                   | 570                       | 560                        |
|        7 | Jharkhand        | 1700                                                  | NA                        | 630                        |
|        8 | Karnataka        | 1500                                                  | 1,230                     | 1,110                      |
|        9 | Kerala           | 300                                                   | 230                       | 210                        |
|       10 | Madhya Pradesh   | 4400                                                  | 3,440                     | 3,740                      |
|       11 | Maharashtra      | 1300                                                  | 1,170                     | 1,060                      |
|       12 | Odisha           | 1900                                                  | 1,490                     | 1,390                      |
|       13 | Punjab           | 600                                                   | 540                       | 540                        |
|       14 | Rajasthan        | 4400                                                  | 3,630                     | 3,390                      |
|       15 | Tamil Nadu       | 900                                                   | 750                       | 710                        |
|       16 | Telangana        | 600                                                   | 520                       | 490                        |
|       17 | Uttar Pradesh    | 16000                                                 | 11,480                    | 12,340                     |
|       18 | West Bengal      | 1700                                                  | 1,480                     | 1,380                      |
|       19 | Uttarakhand      | 500                                                   | NA                        | 170                        |
|       20 | Other States/UTs |                                                       | 940                       | 930                        |