Lok Sabha Question No. 4450 (UNSTARRED), answered on 2019-07-19
Subject: Maternal Deaths
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Ajay Bhatt

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

LOK SABHA UNSTARRED QUESTION NO. 4450 TO BE ANSWERED ON 19 TH JULY, 2019

## MATERNAL DEATHS

## 4450. SHRI AJAY BHATT:

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

- (a) whether as per the report of the World Health Organisation (WHO) the maximum/highe number of pregnancy related deaths per year in the world occurs in India;
- (b) if so, the details thereof and the reasons therefor alon g with the data in this regard during the last three years, State/ UT - wise particularly in Uttarakhand; and
- (c) the steps taken/being taken by the Government to reduce the number of such deaths?

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

- (a)& (b) : As  per  the  latest  report  of  Sample  Registration  System  (SRS)  released Registrar General of India (RGI), Maternal Mortality Ratio(MMR) of India is 130 per 100,000 live births in 2014 - 16.

As  per  the  latest  RGI -SRS  Report  on  Causes  of  Maternal  Deaths  (2001 - 20 3)  the identified primary causes of maternal deaths are haemorrhage (38%), sepsis (11%), abor -(8%), hypertensive disorders - (5%), obstruct ed labour (5%), other conditions (ectopic pregnancy, severe anaemia, embolism) etc. (34%). The detailed state - wise MMR is placed at Annexure.

- (c) : Under  the  National  Health  Mission  (NHM),  following  are  the  steps  taken  to  redu maternal deaths in the coun try:
- 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) was launched in June 2011 to reduce out of pocket expenditure for pregnant women and sick neonates. The initiative entitles all p women delivering in public health institutions to absolutely free and no expense de including caesarean s ection.
- 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.  As part of the campaign, a minimum package of antenatal care serv (i ncluding investigations and drugs) is being provided to the beneficiaries on the 9th every month.
- Mother and Child Tracking System (MCTS) : A Web based system has been introduced by Government of India to track every pregnant woman and child in orde r to ensure timely and quality services.
- Monthly  Village  Health  and  Nutrition  Days (VHND)  as  an  outreach  activity  at Anganwadi  centers  for  provision  of  maternal  and  child  care  including  nutrition convergence with the ICDS.
- 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 RMNCHA services.
- Functionalisation of FRUs : Provision of Emergency Obstetric at FRUs is bei ng done by operationalizing all FRUs in the country. While operationalizing, the thrust is on th components such as manpower, blood storage units, referral linkages etc.
- Maternal Death Review (MDR) is being implemented across the country both a t facilities and  in  the  community.  The  purpose  is  to  take  corrective  action  at  appropriate  leve improve the quality of obstetric care.
- Comprehensive abortion care services are being strengthened through trainings of healt care  providers,  supply  of drugs,  equipments,  Information  Education  and  Communication (IEC) etc.
- 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, p articularly in rural areas.
- Skill  Labs with  earmarked  skill  stations  for  different  training  programs  establishe enhance the quality of training in the states. Five National and over 100 State level S are now operational for conducting train ing.
- Maternal  and  Child  Health  (MCH)Wings established  at  high  caseload  facilities  to improve the quality of care provided to mothers and children.
- LaQshya -LaQshya programme was launched in December 2017 to improve the quality of care in Labour room and Maternity operation theatres to ensure that pregnant women rec respectful and quality care during delivery and immediate post - partum.
- Midwifery programme has b een initiated in 2018 with an aim to create a cadre for Nurs Practitioners in Midwifery who are skilled in accordance to International Confederat Midwives  (ICM)  competencies  and  capable  of  providing  compassionate  women -centred, reproductive, materna l and new - born health care services.
- Over 10 lakhs Accredited Social Health Activists (ASHAs) have been engaged to facili access of health care services by the community, particularly pregnant women.
- Regular IEC/BCC is conducted including messages on early registration for ANC, regul ANC, institutional delivery, nutrition, and care during pregnancy etc.

## Maternal Mortality Ratio: India and State wise

(Source: RGI-SRS MMR Bulletin 2014-16)

| States                       |   maternal deaths/ 1,00,000 live births |
|------------------------------|-----------------------------------------|
| India                        |                                     130 |
| Assam                        |                                     237 |
| Andhra Pradesh               |                                      74 |
| Bihar/Jharkhand              |                                     165 |
| Gujarat                      |                                      91 |
| Haryana                      |                                     101 |
| Karnataka                    |                                     108 |
| Kerala                       |                                      46 |
| Madhya Pradesh /Chhattisgarh |                                     173 |
| Maharashtra                  |                                      61 |
| Odisha                       |                                     180 |
| Punjab                       |                                     122 |
| Rajasthan                    |                                     199 |
| Tamil Nadu                   |                                      66 |
| Telangana                    |                                      81 |
| Uttar Pradesh /Uttarakhand   |                                     201 |
| West Bengal                  |                                     101 |
| *Others                      |                                      97 |

## Annexure