Lok Sabha Question No. 4018 (UNSTARRED), answered on 2019-01-04
Subject: Infant and Maternal Mortality
Ministry: HEALTH AND FAMILY WELFARE
Asked by: HARISH DWIVEDI

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

LOK SABHA UNSTARRED QUESTION NO. 4018 TO BE ANSWERED ON 04 TH JANUARY, 2019

## INFANT AND MATERNAL MORTALITY

## 4018. SHRI HARISH CHANDRA ALIAS HARISH DWIVEDI:

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

- (a) the increase in percentage of maternal mortality rate in rural and urban areas of t separately during the last three years and the current year;
- (b) whether the country has very high infant mortality rate;
- (c) if so, the details thereof, along with the reasons therefor, State/UT - wise; and
- (d) the corrective steps taken by the Government to reduce the number of maternal and mortality in the country?

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

- (a) : As per the latest RGI - SRS Report on Maternal Mortality Ratio (MMR) in India 2014 - 16; the MMR of India has declined by 37 points from 167/ lakh live births in 2011 - 13 to 130/ lakh live births in 2014 - 16.  RGI - SRS  Report  does not  publish  separate  MMR  for  urban  and  rural areas of the country.
- (b)& (c) : As per Sample registration System (SRS) of Registrar General of India, the In Mortality Rate (IMR) at National level is  34 per 1,000 live births in 2016. The coun shown continuous decline in Infant Mortality Rate (IMR) since 2014.
- (d) : To  reduce  MMR  &  IMR,  various  programmes  and  schemes  under  National  Health Mission  are  being  implemented  by  States/  UTs  and  the  Central  government  recommends financial  assistanc e  to  States/  UTs  based  on  proposals  received  in  their  Annual  Progra Implementation Plan (APIP). Details of these programmes are annexed.

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## Steps taken/ being taken by the Government to reduce MMR

- Janani  Suraksha  Yojana  (JSY), a  demand promotion  and  conditional  cash  transfer scheme  is  being  implemented  with  the  objective  of  reducing  Maternal  and  Infa Mortality by encouraging institutional deliveries.
- Janani Shishu Suraksha Karyakram (JSSK) aims to eliminate out - of - pocket expenses for p regnant women and sick neonates.  Under JSSK, every pregnant woman is entitled t free delivery, including caesarean section, in public health institutions. This als absolutely free transport, diagnostics, medicines, other consumables, food and b lood, if required. The scheme has now been expanded to cover sick infants up to one year of a
- Pradhan  Mantri  Surakshit  Matritva  Abhiyan  (PMSMA) has  been  launched  to provide fixed - day  assured,  comprehensive  and  quality  antenatal  care  universally  to pregnant women on the 9th of every month.
- LaQshya is a focused and targeted approach to strengthen key processes related to labour rooms and maternity operation theatres in order to improve quality of care a birth and ensure respectful maternity c are.
- Special  provision  of Birth  waiting  homes has  been  made  under  NHM  for  pregnant women from tribal/ difficult areas.
- Under  NHM  States  are  supported  to  provide  monetary  and  non - monetary  incentives including hard area allowances etc to attract Human Resources.
- Maternal and Child Health (MCH) Wings are established at high caseload facilities to improve the quality of care provided to mothers and children.
- Capacity  building of  MBBS  doctors  in  Anaesthesia  (LSAS)  and  Obstetric  Care including C - section (Em OC) skills is undertaken to overcome the shortage of specialist in these disciplines, particularly in rural areas. Skill Labs are being set up to enhance the quality of training.
- Mother  and  Child  Tracking  System  (MCTS) and  Mother  and  Child  Tracking Facili tation Centre (MCTFC): A name based web enabled system has been introduced by Government of India to track every pregnant women and child in order to ensure a monitor timely and quality services to them.
- Universal  screening  of Gestational  Diabetes  Mellit us ,  screening  for hypothyroidism for high risk group during pregnancy has been initiated.
- Over  10  lakhs Accredited  Social  Health  Activists  (ASHAs) have  been  engaged  to facilitate access of health care services by the community, particularly pregnant wo .

## Annexure

- Under the Anemia Mukt Bharat (Intensified National Iron Plus Initiative), iron and fo acid  supplementation  is  provided  across  life  stages  including  for  pregnant,  la women and adolescent girls at health facilities and during outreach activities.
- IEC/BCC focusing on messages on early registration for ANC, regular ANC, institutio delivery,  nutrition,  and  care  during  pregnancy  etc  is  carried  out  regularly  t awareness of beneficiaries.

## Steps taken/ being taken by the Government to reduce IMR

Apart  from  implementation  of  above  mentioned  schemes  such  as Janani  Suraksha  Yojana (JSY),  Janani  Shishu  Suraksha  Karyakaram  (JSSK) , LaQshya etc  mentioned  above, following is implemented:

- Establishment of Special Newborn Care Units (SNCU), Newborn Stabilization Units (NBSU) and Kangaroo Mother Care (KMC) units for care of sick and small babies.
- Home  Based  Newborn  Care  (HBNC) and Home  Based  Care  of  Young  Children (HBYC) by ASHAs to improve child rearing practices.
- Focus  on Infant  and  Young  Child  Fe eding  (IYCF) practices  in  convergence  with Ministry  of  Women  and  Child  Development. Mothers'  Absolute  Affection  (MAA ) programme for improving breastfeeding practices
- Universal Immunization Programme (UIP) to provide vaccination to children against many  l ife  threatening  diseases  such  as  Tuberculosis,  Diphtheria,  Pertussis,  P Tetanus,  Hepatitis  B  ,  Measles  and  Hib  Meningitis. 'Mission  Indradhanush  and Intensified Mission Indradhanush' launched to fully immunize children who are either unvaccinated or p artially vaccinated.
- Rashtriya Bal Swasthya Karyakram (RBSK) for health screening, early detection of birth defects, diseases, deficiencies, development delays and early intervention ser
- Nutrition Rehabilitation Centres (NRCs) to treat and manage th e children with Severe Acute Malnutrition (SAM).
- Iron  and  folic  acid  (IFA)  supplementation  for  the  prevention  of  anaemia  among vulnerable age groups and home visits by ASHAs to promote use of ORS and Zinc for management of diarrhoea in children.
- Healthand nutrition education through Information, Education & Communication (IEC) and Behaviour Change Communication (BCC) .
- Capacity building of health care providers in essential new - born care.