Lok Sabha Question No. 1371 (UNSTARRED), answered on 2024-02-09
Subject: Health Awareness Camps in Rural Areas
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Gaurav Gogoi

## GOVERNMENT OFINDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OFHEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 1371 TO BE ANSWERED ON 09/02/2024

## HEALTHAWARENESSCAMPSINRURALAREAS

## 1371. SHRI GAURAV GOGOI:

Will the Minister of HEALTHANDFAMILYWELFARE be pleased to state:

- (a) the number of maternal deaths, stillbirths and newborn deaths in the last five years, State/UTwise;
- (b) whether the Government is organizing awareness camps and regular pregnancy-related health camps in rural areas as almost 16 per cent of Indian women are not receiving any form of healthcare during their pregnancy;
- (c) if so, the details of the budgetary expenditure under Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) for the last five years; and
- (d) the number of beneficiaries under Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), Since 2016, State-wise and year-wise?

## ANSWER THE MINISTER OFSTATE IN THE MINISTRY OF HEALTH AND

## FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

- (a) As per the report of Sample Registration System (SRS) released by Registrar General of India (RGI) in 2018-20, Maternal Mortality Ratio (MMR) of India is 97 per 100,000 live births. The details of State/UT wise MMR during the last five years is placed at Annexure-1.

Similarly, as per Sample Registration System of Registrar General of India (RGI) 2020, the Still Birth Rate (SBR) of India is 3 per 1000 total births and Neonatal Mortality Rate (NMR) of India is 20 per 1000 live births. States/ UTs wise SBR and NMR during last five years is placed at Annexure II and Annexure III respectively.

- (b) Government of India has implemented following schemes/initiatives for providing regular health check-ups and awareness camps to all pregnancy women across the country including rural areas;
-  Government of India launched 'Pradhan Mantri Surakshit Matritva Abhiyan' (PMSMA) with an aim to provide fixed-day, free of cost, assured, comprehensive and quality antenatal care on the 9 th day of every month, universally to all pregnant women in their 2nd / 3rd trimesters of pregnancy.
-  Extended PMSMA strategy was launched to ensure quality ANC to pregnant women, especially to high-risk pregnancy (HRP) women and individual HRP tracking till a safe delivery

is achieved by means of financial incentivization for the identified high risk pregnant women and accompanying ASHA for extra 3 visits over and above the PMSMA visit.

-  Janani Shishu Suraksha Karyakaram (JSSK) entitles every pregnant woman to free delivery including for caesarean section, in public health institutions along with the provision of free transport, diagnostics, medicines, other consumables, diet and blood (if required). Similar entitlements have been put in place for all sick infants accessing public health institutions for treatment.
-  Surakshit Matritva Aashwasan (SUMAN) aims to provide assured, dignified, respectful and quality healthcare at no cost and zero tolerance for denial of services for every woman and newborn visiting the public health facility.
-  LaQshya (Quality Improvement Initiatives)Government of India launched LaQshya programme in 2011 to improve the quality of care in labour room and Maternity operation Theatres.
-  Outreach camps in rural are also provisioned for improving the reach of health care services especially in tribal and hard to reach areas. This platform is used to increase awareness for the Maternal and Child health services, community mobilization as well as to track high risk pregnancies.
-  Monthly Village Health, Sanitation and Nutrition Day (VHSND) is an outreach activity at Anganwadi centres for provision of maternal and child-care including nutrition in convergence with the ICDS.
-  Health and wellness centreHWC team organizing camps on a periodic basis, reaching the marginalized, support treatment compliance and follow-up pregnant women and newborn etc.
-  MCP Card and Safe Motherhood Booklet are distributed to the pregnant women for educating them on diet, rest, danger signs of pregnancy, benefit schemes and institutional deliveries.
-  Kilkari is a centralized interactive voice response (IVR) based mobile health service which delivers free, weekly, time-appropriate 72 audio messages about pregnancy, childbirth, and childcare directly to families' mobile phones from the second trimester of pregnancy until the child is one year old.
-  IEC/BCC campaigns: One of the key focus areas of Maternal Health is to generate demand through Information Education & Communication (IEC), Inter-personal Communication (IPC) and Behaviour Change Communication (BCC) activities.

(c) The budgetary expenditure under Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) during the last five years is placed at Annexure-IV

(d) Since inception (2016), more than 4.72 crore pregnant women have received Comprehensive ANC under PMSMA across all states and UTs. The number of beneficiaries, state-wise and year-wise, since 2016 is placed at Annexure-V.

## Annexure - I

| Maternal Mortality Ratio (MMR): India &States   | Maternal Mortality Ratio (MMR): India &States   | Maternal Mortality Ratio (MMR): India &States   | Maternal Mortality Ratio (MMR): India &States   | Maternal Mortality Ratio (MMR): India &States   | Maternal Mortality Ratio (MMR): India &States   |
|-------------------------------------------------|-------------------------------------------------|-------------------------------------------------|-------------------------------------------------|-------------------------------------------------|-------------------------------------------------|
| Name of State                                   | 2014-16                                         | 2015-17                                         | 2016-18                                         | 2017-19                                         | 2018-20                                         |
| INDIA                                           | 130                                             | 122                                             | 113                                             | 103                                             | 97                                              |
| Assam                                           | 237                                             | 229                                             | 215                                             | 205                                             | 195                                             |
| Bihar                                           | 165                                             | 165                                             | 149                                             | 130                                             | 118                                             |
| Jharkhand                                       | NA                                              | 76                                              | 71                                              | 61                                              | 56                                              |
| Madhya Pradesh                                  | 173                                             | 188                                             | 173                                             | 163                                             | 173                                             |
| Chhattisgarh                                    | NA                                              | 141                                             | 159                                             | 160                                             | 137                                             |
| Odisha                                          | 180                                             | 168                                             | 150                                             | 136                                             | 119                                             |
| Rajasthan                                       | 199                                             | 186                                             | 164                                             | 141                                             | 113                                             |
| Uttar Pradesh                                   | 201                                             | 216                                             | 197                                             | 167                                             | 167                                             |
| Uttarakhand                                     | NA                                              | 89                                              | 99                                              | 101                                             | 103                                             |
| Andhra Pradesh                                  | 74                                              | 74                                              | 65                                              | 58                                              | 45                                              |
| Telangana                                       | 81                                              | 76                                              | 63                                              | 56                                              | 43                                              |
| Karnataka                                       | 108                                             | 97                                              | 92                                              | 83                                              | 69                                              |
| Kerala                                          | 46                                              | 42                                              | 43                                              | 30                                              | 19                                              |
| Tamil Nadu                                      | 66                                              | 63                                              | 60                                              | 58                                              | 54                                              |
| Gujarat                                         | 91                                              | 87                                              | 75                                              | 70                                              | 57                                              |
| Haryana                                         | 101                                             | 98                                              | 91                                              | 96                                              | 110                                             |
| Maharashtra                                     | 61                                              | 55                                              | 46                                              | 38                                              | 33                                              |
| Punjab                                          | 122                                             | 122                                             | 129                                             | 114                                             | 105                                             |
| West Bengal                                     | 101                                             | 94                                              | 98                                              | 109                                             | 103                                             |

(Source: Registrar General of India (RGI): Special Bulletin on MMR. RGI release MMR for Major States including EAG & Assam, south and other states)

## Annexure-II

|                  |   2016 |   2017 |   2018 4 |   2019 |   2020 |
|------------------|--------|--------|----------|--------|--------|
| Andhra Pradesh   |      3 |      3 |        3 |      1 |      1 |
| Assam            |      2 |      2 |        2 |      2 |      3 |
| Bihar            |      3 |      2 |        2 |      1 |      1 |
| Chhattisgarh     |     10 |     13 |        9 |      9 |      6 |
| Delhi            |      4 |      5 |        5 |      1 |      0 |
| Gujarat          |      6 |      5 |        4 |      3 |      4 |
| Haryana          |      5 |      9 |        6 |      5 |      7 |
| Himachal Pradesh |     24 |     12 |        7 |      5 |      4 |
| Jammu &Kashmir   |      2 |      1 |        1 |      1 |      3 |
| Jharkhand        |      0 |      1 |        1 |      1 |      2 |
| Karnataka        |      6 |      6 |        5 |      5 |      3 |
| Kerala           |      6 |      7 |        5 |      3 |      4 |
| Madhya Pradesh   |      8 |      6 |        5 |      6 |      5 |
| Maharashtra      |      4 |      5 |        5 |      3 |      3 |
| Odisha           |     13 |     12 |       10 |      8 |     10 |
| Punjab           |      6 |      5 |        5 |      3 |      3 |
| Rajasthan        |      3 |      8 |        6 |      3 |      4 |
| Tamil Nadu       |      3 |      3 |        4 |      4 |      2 |
| Telangana        |      1 |      1 |        2 |      0 |      2 |
| Uttar Pradesh    |      3 |      3 |        3 |      2 |      4 |
| Uttarakhand      |      9 |     11 |        8 |      3 |      6 |
| West Bengal      |      3 |      5 |        5 |      5 |      4 |

## Annexure-III

|                  |   2016 |   2017 23 |   2018 23 |   2019 22 |   2020 |
|------------------|--------|-----------|-----------|-----------|--------|
| Andhra Pradesh   |     23 |        23 |        21 |        18 |     17 |
| Assam            |     23 |        22 |        21 |        20 |     19 |
| Bihar            |     27 |        28 |        25 |        23 |     21 |
| Chhattisgarh     |     26 |        26 |        29 |        28 |     26 |
| Delhi            |     12 |        14 |        10 |         8 |      9 |
| Gujarat          |     21 |        21 |        19 |        17 |     16 |
| Haryana          |     22 |        21 |        22 |        19 |     19 |
| Himachal Pradesh |     16 |        14 |        13 |        13 |     13 |
| Jammu &Kashmir   |     18 |        17 |        17 |        15 |     12 |
| Jharkhand        |     21 |        20 |        21 |        19 |     17 |
| Karnataka        |     18 |        18 |        16 |        16 |     14 |
| Kerala           |      6 |         5 |         5 |         5 |      4 |
| Madhya Pradesh   |     32 |        33 |        35 |        33 |     31 |
| Maharashtra      |     13 |        13 |        13 |        13 |     11 |
| Odisha           |     32 |        32 |        31 |        30 |     28 |
| Punjab           |     13 |        13 |        13 |        12 |     12 |
| Rajasthan        |     28 |        27 |        26 |        25 |     23 |
| Tamil Nadu       |     12 |        11 |        10 |        10 |      9 |
| Telangana        |     21 |        20 |        19 |        17 |     15 |
| Uttar Pradesh    |     30 |        30 |        32 |        30 |     28 |
| Uttarakhand      |     30 |        24 |        22 |        19 |     17 |
| West Bengal      |     17 |        17 |        16 |        15 |     14 |

## State/UT wise expenditure towards Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) Activities under RCH Flexible Pool under NHM from F.Y. 2019-20 to 2023-24

| S. N.   | State/UT                    | 2019-20     | 2020-21     | 2021-22     | 2022-23     | 2023-24     |
|---------|-----------------------------|-------------|-------------|-------------|-------------|-------------|
|         |                             | Expenditure | Expenditure | Expenditure | Expenditure | Expenditure |
| 1       | Andaman and Nicobar Islands | 0.19        | 0.11        | 0.38        | 1.13        | 0.10        |
| 2       | Andhra Pradesh              | NR          | NR          | NR          | NR          | 26.00       |
| 3       | Arunachal Pradesh           | 2.63        | 11.78       | 10.70       | 99.23       | NR          |
| 4       | Assam                       | 31.34       | 28.89       | 32.40       | 51.34       | 45.70       |
| 5       | Bihar                       | 533.31      | 263.06      | 419.00      | 597.09      | 343.64      |
| 6       | Chandigarh                  | 2.04        | 1.55        | 1.65        | 0.82        | 1.95        |
| 7       | Chhattisgarh                | NR          | 1.63        | 1.51        | 395.40      | 154.53      |
| 8       | Dadra &Nagar Haveli         | 0.55        | 0.30        | NR          | NR          | NR          |
| 8       | Daman &Diu                  | NR          |             |             |             |             |
| 9       | Delhi                       | 3.96        | 1.02        | 0.41        | 4.78        | 6.56        |
| 10      | Goa                         | 0.08        | 0.09        | 0.10        | 0.61        | 0.07        |
| 11      | Gujarat                     | 39.32       | 39.45       | 28.04       | 445.52      | 501.74      |
| 12      | Haryana                     | 28.53       | 24.49       | 30.44       | 23.03       | 22.41       |
| 13      | Himachal Pradesh            | NR          | NR          | 23.46       | 32.62       | 25.58       |
| 14      | Jammu and Kashmir*          | 2.15        | 1.69        | 0.83        | 1.94        | 0.15        |
| 15      | Jharkhand                   | 96.23       | 93.85       | 85.10       | 559.31      | 205.98      |
| 16      | Karnataka                   | 28.16       | 14.61       | 18.08       | 11.82       | 8.78        |
| 17      | Kerala                      | 8.60        | 2.43        | 0.95        | 19.54       | 23.24       |
| 18      | Ladakh*                     | NR          | 1.46        | 0.92        | 1.30        | 0.65        |
| 19      | Lakshadweep                 | 0.01        | 0.18        | 0.22        | 0.05        | 0.02        |
| 20      | Madhya Pradesh              | 6.16        | 0.61        | 23.12       | 551.12      | 155.92      |
| 21      | Maharashtra                 | 21.85       | 11.65       | 11.24       | 7.35        | 126.84      |
| 22      | Manipur                     | 20.12       | 10.42       | 5.29        | 14.80       | 2.83        |
| 23      | Meghalaya                   | 8.90        | 5.70        | 3.56        | 38.94       | 6.29        |
| 24      | Mizoram                     | 2.61        | 7.05        | 4.60        | 5.95        | NR          |
| 25      | Nagaland                    | NR          | NR          | 1.12        | 5.92        | 3.76        |

|   26 | Odisha        | 12.60   | 14.58   | 12.95   | 202.96   | 250.04   |
|------|---------------|---------|---------|---------|----------|----------|
|   27 | Puducherry    | NR      | NR      | NR      | NR       | 0.14     |
|   28 | Punjab        | 16.46   | 3.86    | 1.82    | 38.43    | 103.58   |
|   29 | Rajasthan     | 22.50   | 21.30   | 54.25   | 75.47    | 7.37     |
|   30 | Sikkim        | 1.12    | NR      | 0.48    | 1.62     | 0.50     |
|   31 | Tamil Nadu    | 1.23    | 1.13    | 0.68    | NR       | NR       |
|   32 | Telangana     | 1.89    | 1.79    | 1.03    | 2.52     | 2.07     |
|   33 | Tripura       | 2.21    | 2.97    | 11.80   | 29.17    | 18.56    |
|   34 | Uttar Pradesh | 31.44   | 44.66   | 34.21   | 721.25   | 149.09   |
|   35 | Uttarakhand   | NR      | 2.79    | 3.20    | 39.40    | 14.36    |
|   36 | West Bengal   | 46.46   | 20.29   | 112.21  | 220.66   | 42.28    |

## Note:-

1. NR=Not reported.
2. *=After the Reorganization of the State of Jammu and Kashmir (J&K) into the Union Territory of J&K and Union Territory of Ladakh, NHM funds to the UT of Ladakh were disbursed for the first time during 2020-21. 3. The above data is as per available Financial Management Reports submitted by the States/UTs.
4. Expenditure is as per FMRs submitted by States/UTs. The expenditure w.r.t. flexible pool for RCH, etc. is updated up to 31.12.2023 except Arunachal Pradesh, Assam, Bihar, Chhattisgarh, Jharkhand, Puducherry, Uttar Pradesh, West Bengal (Updated upto 30.11.2023), Chandigarh, Karnataka, Manipur, Meghalaya, Odisha, Punjab, Tamil Nadu, Tripura (Updated up to 31.10.2023), Lakshadweep (Updated up to 30.09.2023) and is provisional.

Annexure-V Total Number of pregnant women received Antenatal care under PMSMA

| State/UTs              | 2016-17   | 2017-18   |   2018-19 | 2019-20    | 2020-21   | 2021-22   | 2022-23   | 2023-24 (Till Jan)   |
|------------------------|-----------|-----------|-----------|------------|-----------|-----------|-----------|----------------------|
| INDIA                  | 4767073   | 7162949   |   6965744 | 5470646    | 3187042   | 4746317   | 7300865   | 8212687              |
| A&N Islands            | NR        | NR        |      4286 | 4574       | 3453      | 3051      | 3232      | 3021                 |
| Andhra Pradesh         | 268883    | 519483    |    326924 | 467269     | 271721    | 461175    | 905718    | 786604               |
| Arunachal Pradesh      | 1256      | 4410      |      3534 | 4648       | 3385      | 4890      | 3308      | 2155                 |
| Assam                  | 112785    | 118694    |     77099 | 61162      | 20152     | 33616     | 59530     | 51170                |
| Bihar                  | 252562    | 799974    |    916857 | 746382     | 493879    | 536687    | 795810    | 729616               |
| Chandigarh             | 2610      | 5838      |      8211 | 8252       | 6237      | 6523      | 7953      | 7318                 |
| Chhattisgarh           | 247943    | 255897    |    225547 | 188651     | 35519     | 82724     | 267034    | 271938               |
| Dadra And Nagar Haveli | 6169      | 3998      |      5693 | NR         | NR        | 4705      | 6531      | 4293                 |
| Daman &Diu             | 2921      | 6314      |      7551 | NR         | NR        | 3936      | 20817     | 16009                |
| Delhi                  | 40116     | 99063     |     95002 | 86550      | 31077     | 44419     | 51836     | 53049                |
| Goa                    | 2884      | 8014      |      7945 | 8696       | 5255      | 2837      | 5996      | 16536                |
| Gujarat                | 561449    | 495435    |    380308 | 200674     | 164660    | 228471    | 253726    | 253307               |
| Haryana                | 119644    | 172543    |    200443 | 256619     | 171961    | 238135    | 335462    | 349624               |
| Himachal Pradesh       | 53787     | 63676     |     60190 | 38024      | 30647     | 55105     | 56167     | 53409                |
| Jammu& Kashmir         | 42504     | 53206     |     56921 | 34993      | 9584      | 29154     | 58210     | 60175                |
| Jharkhand              | 76504     | 169259    |    159256 | 174815     | 100701    | 97995     | 147590    | 135696               |
| Karnataka              | 226730    | 497246    |    481696 | 204286     | 67202     | 40316     | 223773    | 474832               |
| Kerala                 | 5959      | 8747      |      9756 | 7989       | 2591      | 2907      | 3364      | 3247                 |
| Lakshadweep            | NR        | 111       |      1592 | 1345       | 819       | 893       | 812       | 560                  |
| Madhya Pradesh         | 473275    | 828820    |    850528 | 555042     | 981       | 530595    | 199503    | 295081               |
| Maharashtra            | 783815    | 824309    |    703653 | 302233     | 72585     | 73282     | 290999    | 233160               |
| Manipur                | 7584      | 13479     |     12975 | 12416      | 2265      | 4060      | 9432      | 6257                 |
| Meghalaya              | 11884     | 20766     |     14486 | 6202       | 553       | 3620      | 58828     | 55490                |
| Mizoram                | 8099      | 7176      |      4838 | 3802       | 8951      | 6782      | 7052      | 5500                 |
| Nagaland               | 836       | 2320      |      1198 | 3762       | 1948      | 2285      | 2872      | 1970                 |
| Odisha                 | 77160     | 182178    |    208236 | 191197     | 75760     | 140797    | 267153    | 324417               |
| Puducherry             | 3175      | 2730      |      1661 | NR         | NR        | NR        | 974*      | 2135*                |
| Punjab                 | 72567     | 129598    |    113963 | 109031     | 53295     | 69523     | 114964    | 156416               |
| Rajasthan              | 522227    | 748673    |    644180 | 239256     | 148291    | 149393    | 516744    | 386836               |
| Sikkim                 | 431       | 2166      |      1888 | 419 355815 | 767       | 950       | 1236      | 686                  |
| Tamil Nadu             | 338647    | 362981    |    367175 |            | 305238    | 345227    | 325369    | 308049               |

| State/UTs     |   2016-17 |   2017-18 |   2018-19 |   2019-20 |   2020-21 |   2021-22 |   2022-23 |   2023-24 (Till Jan) |
|---------------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|----------------------|
| Telangana     |     78818 |    137517 |    192583 |    223932 |    214756 |    248395 |    285672 |               241447 |
| Tripura       |      1520 |      4386 |      5330 |      2771 |      1985 |     19553 |     21949 |                24831 |
| Uttar Pradesh |    296827 |    512305 |    715717 |    875170 |    837508 |   1135605 |   1680529 |              2546417 |
| Uttarakhand   |     18808 |     18617 |     18742 |     10922 |     11588 |     23702 |     27871 |                22035 |
| West Bengal   |     46694 |     83020 |     79780 |     83747 |     31728 |    115009 |    283823 |               331536 |

* As per the physical report received from UT-Puducherry NR-Not reported