Lok Sabha Question No. 456 (UNSTARRED), answered on 2023-07-21
Subject: Pradhan Mantri Surakshit Matritva Abhiyan
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shashi Tharoor, Adoor Prakash, Saptagiri Sankar Ulaka, Behanan Benny, Kumbakudi Sudhakaran, Anto  Antony, K. Muraleedharan

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO.456 TO BE ANSWERED ON 21/07/2023

## 'PRADHAN MANTRI SURAKSHIT MATRITVAABHIYAN'

## 456. DR. SHASHI THAROOR:

ADV.ADOOR PRAKASH:

SHRI SAPTAGIRI SANKAR ULAKA:

SHRI BENNY BEHANAN:

SHRI KUMBAKUDI SUDHAKARAN:

SHRI ANTO ANTONY:

SHRI K. MURALEEDHARAN:

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

(a) the number of maternal deaths, stillbirths and newborn deaths during the last five years and the current year, State/UT-wise;

(b) whether the Government has been organizing regular pregnancy health check-up camps regarding awareness among women in rural areas as almost 16 per cent women lack healthcare facilities in any form during their pregnancy;

(c) if so, details of the budgetary expenditure under Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) during the last five years and the current year;

(d) the number of beneficiaries, state/UT-wise and year-wise, under PMSMA, since 2016; and

(e) whether the Government is aware about the observation made in a report of United Nations (UN) that India is among the 10 countries which contributes upto 60 percent of the global maternal deaths and if so, the response thereto?

## ANSWER

## THE MINISTER OF STATE 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. India has accomplished the National Health Policy (NHP) target for MMR of less than 100/lakh live birth. The details of State/UT wise MMR during the last five years and the current year is placed at Annexure-1.

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/steps for creating awareness and regular health check-up camps for 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.
-  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.
-  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.
-  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.
-  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.
-  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.
-  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 and the current year is placed at Annexure-IV
- (d) Since inception, more than 4.18 crore pregnant women have received Comprehensive ANC under PMSMA programme across all states and UTs. The number of beneficiaries, state/UT-wise and year-wise, under PMSMA, since 2016 is placed at Annexure-V.

(e) Maternal Mortality Estimation Inter-Agency Group (MMEIG) provides global estimates of MMR. As per UN MMEIG 2020 report 'Trends in maternal mortality 2000 to 2020', MMR of India has declined from 384 in 2000 to 103 in 2020 whereas Global MMR has declined from 339 in 2000 to 223 in 2020. The average annual rate of reduction (ARR) in global MMR during the 2000-2020 periods was 2.07% while India's MMR has declined by 6.36%, which is higher than the global decline.

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: RGI: Special Bulletin on MMR)

## Annexure-II

|                  |   2016 |   2017 |   2018 |   2019 |   2020 |
|------------------|--------|--------|--------|--------|--------|
| India            |      4 |      5 |      4 |      3 |      3 |
| 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 |   2018 |   2019 |   2020 |
|------------------|--------|--------|--------|--------|--------|
| India            |     24 |     23 |     23 |     22 |     20 |
| 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 |

Annexure IV State/UT wise Approvals towards Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) Activities under RCH Flexible Pool under NHM from F.Y. 2018-19 to 2023-24

(In Lakhs)

|   S.N. | State/UT                 | 2018- 19   | 2019- 20   | 2020- 21   | 2021- 22   | 2022-23              | 2023-24              |
|--------|--------------------------|------------|------------|------------|------------|----------------------|----------------------|
|      1 | Andaman &Nicobar Islands | 1.00       | 5.00       | 3.00       | 6.33       | 3.22 3.22 (In Lakhs) | 3.22 3.22 (In Lakhs) |
|      2 | Andhra Pradesh           | -          | -          | -          | 31.00      | 31.00                | 31.00                |
|      3 | Arunachal Pradesh        | 14.50      | 13.50      | 13.00      | 15.00      | 107.20               | 127.00               |
|      4 | Assam                    | 46.50      | 49.59      | 46.58      | 39.50      | 101.95               | 105.19               |
|      5 | Bihar                    | 713.72     | 671.72     | 500.00     | 620.82     | 1,139.90             | 1,162.80             |
|      6 | Chandigarh               | 2.40       | 2.40       | 2.40       | 2.40       | 1.78                 | 8.45                 |
|      7 | Chhattisgarh             | 40.10      | 20.00      | 14.37      | 6.10       | 643.32               | 675.49               |
|      8 | Dadra &Nagar Haveli      | -          | -          | -          | -          | -                    | 21.45*               |
|      8 | Daman &Diu               | -          | -          | -          | -          | -                    | 21.45*               |
|      9 | Delhi                    | 12.00      | 12.00      | -          | 6.00       | 6.00                 | 6.00                 |
|     10 | Goa                      | 0.50       | 0.37       | 0.10       | 0.10       | 0.40                 | 0.40                 |
|     11 | Gujarat                  | 67.00      | 48.50      | 54.00      | 46.50      | 2,465.40             | 2,465.40             |
|     12 | Haryana                  | 26.00      | 29.00      | 32.50      | 32.50      | 22.00                | 22.00                |
|     13 | Himachal Pradesh         | -          | -          | -          | 48.00      | 48.00                | 196.40               |
|     14 | Jammu and Kashmir        | 27.00      | 38.00      | 35.00      | 22.00      | 44.50                | 44.50                |
|     15 | Jharkhand                | 286.00     | 292.00     | 622.00     | 99.00      | 1,837.26             | 2,074.25             |
|     16 | Karnataka                | 48.00      | 43.00      | 43.00      | 43.00      | 43.00                | 43.00                |

State/UT wise Approvals towards Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) Activities under RCH Flexible Pool under NHM from F.Y. 2018-19 to 2023-24

State/UT wise Approvals towards Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) Activities under RCH Flexible Pool under NHM from F.Y. 2018-19 to 2023-24

|   S.N. | State/UT       | 2018- 19   | 2019- 20   | 2020- 21   |   2021- 22 | 2022- 23   | 2023- 24   |
|--------|----------------|------------|------------|------------|------------|------------|------------|
|     17 | Kerala         | 7.00       | 18.00      | 9.00       |       7    | 11.40      | 11.97      |
|     18 | Ladakh         | -          | -          | 12.92      |      12.92 | 11.07      | 11.07*     |
|     19 | Lakshadweep    | 0.20       | 0.20       | 0.22       |       0.4  | 0.42       | 0.44       |
|     20 | Madhya Pradesh | 19.62      | 13.10      | 10.00      |      52.16 | 1,737.26   | 1,737.26   |
|     21 | Maharashtra    | 118.00     | 34.00      | 33.55      |      34.37 | 57.23      | 57.23      |
|     22 | Manipur        | 12.50      | 15.00      | 55.75      |      55.75 | 117.75     | 117.75     |
|     23 | Meghalaya      | 6.84       | 7.50       | 7.50       |       7.8  | 117.80     | 139.80     |
|     24 | Mizoram        | 1.06       | 3.30       | 6.60       |       7.21 | 27.41      | 28.01      |
|     25 | Nagaland       | 1.00       | 1.00       | 1.58       |       1.58 | 27.03      | 22.16      |
|     26 | Odisha         | 41.00      | 41.00      | 41.00      |      36    | 1,100.00   | 1,670.00   |
|     27 | Puducherry     | -          | -          | -          |       1.6  | 1.60       | 5.00       |
|     28 | Punjab         | 3.45       | 25.00      | 30.00      |       5.5  | 999.40     | 999.4*     |
|     29 | Rajasthan      | -          | 41.75      | 42.92      |      75.37 | 873.85     | 873.85     |
|     30 | Sikkim         | 2.50       | 2.50       | 2.50       |       2.5  | 3.00       | 3.00       |
|     31 | Tamil Nadu     | -          | -          | 15.80      |       3.16 | 31.8*      | -          |
|     32 | Telangana      | 2.44       | 6.40       | 6.40       |       9.24 | 9.24       | 9.70       |

(In Lakhs)

|   S.N. | State/UT   |   2018- 19 |   2019- 20 |   2020- 21 |   2021- 22 |   2022- 23 |   2023- 24 |
|--------|------------|------------|------------|------------|------------|------------|------------|
|     33 | Tripura    |        4.2 |       4.76 |          8 |      16.82 |     138.12 |     138.12 |

|   34 | Uttar Pradesh   |   152.50 |   107.95 |   99.41 |   68.20 |   2,247.50 | 3,211.34   |
|------|-----------------|----------|----------|---------|---------|------------|------------|
|   35 | Uttarakhand     |        7 |      5.6 |     5.6 |    5.6  |     318.02 | 370.85     |
|   36 | West Bengal     |       29 |     29   |    30   |  342.72 |     342.72 | 1,180.30   |

## Note:

1. The SPIP Approvals are as per available Financial Management Reports submitted by the States/UTs.
2. After the reorganisation 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. * Ladakh, Punjab, Tamilnadu, Dadra & Nagar Haveli, Daman & Diu as per RoP 2022-24 and SPIP

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 |
|-------------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|
| INDIA       |   4767073 |   7162949 |   6965744 |   5470646 |   3187042 |   4746317 |   7300865 |
| A&N Islands |         0 |         0 |      4286 |      4574 |      3453 |      3051 |      3232 |

| State/UTs              |   2016-17 |   2017-18 |   2018-19 |   2019-20 |   2020-21 |   2021-22 |   2022-23 |
|------------------------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|
| Andhra Pradesh         |    268883 |    519483 |    326924 |    467269 |    271721 |    461175 |    905718 |
| Arunachal Pradesh      |      1256 |      4410 |      3534 |      4648 |      3385 |      4890 |      3308 |
| Assam                  |    112785 |    118694 |     77099 |     61162 |     20152 |     33616 |     59530 |
| Bihar                  |    252562 |    799974 |    916857 |    746382 |    493879 |    536687 |    795810 |
| Chandigarh             |      2610 |      5838 |      8211 |      8252 |      6237 |      6523 |      7953 |
| Chhattisgarh           |    247943 |    255897 |    225547 |    188651 |     35519 |     82724 |    267034 |
| Dadra And Nagar Haveli |      6169 |      3998 |      5693 |         0 |         0 |      4705 |      6531 |
| Daman & Diu            |      2921 |      6314 |      7551 |         0 |         0 |      3936 |     20817 |
| Delhi                  |     40116 |     99063 |     95002 |     86550 |     31077 |     44419 |     51836 |
| Goa                    |      2884 |      8014 |      7945 |      8696 |      5255 |      2837 |      5996 |
| Gujarat                |    561449 |    495435 |    380308 |    200674 |    164660 |    228471 |    253726 |
| Haryana                |    119644 |    172543 |    200443 |    256619 |    171961 |    238135 |    335462 |
| Himachal Pradesh       |     53787 |     63676 |     60190 |     38024 |     30647 |     55105 |     56167 |
| Jammu& Kashmir         |     42504 |     53206 |     56921 |     34993 |      9584 |     29154 |     58210 |
| Jharkhand              |     76504 |    169259 |    159256 |    174815 |    100701 |     97995 |    147590 |
| Karnataka              |    226730 |    497246 |    481696 |    204286 |     67202 |     40316 |    223773 |
| Kerala                 |      5959 |      8747 |      9756 |      7989 |      2591 |      2907 |      3364 |
| Lakshadweep            |         0 |       111 |      1592 |      1345 |       819 |       893 |       812 |
| Madhya Pradesh         |    473275 |    828820 |    850528 |    555042 |       981 |    530595 |    199503 |
| Maharashtra            |    783815 |    824309 |    703653 |    302233 |     72585 |     73282 |    290999 |
| Manipur                |      7584 |     13479 |     12975 |     12416 |      2265 |      4060 |      9432 |
| Meghalaya              |     11884 |     20766 |     14486 |      6202 |       553 |      3620 |     58828 |
| Mizoram                |      8099 |      7176 |      4838 |      3802 |      8951 |      6782 |      7052 |
| Nagaland               |       836 |      2320 |      1198 |      3762 |      1948 |      2285 |      2872 |
| Odisha                 |     77160 |    182178 |    208236 |    191197 |     75760 |    140797 |    267153 |
| Puducherry             |      3175 |      2730 |      1661 |         0 |         0 |         0 |         0 |

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 |
|-------------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|
| Punjab      |     72567 |    129598 |    113963 |    109031 |     53295 |     69523 |    114964 |
| Rajasthan   |    522227 |    748673 |    644180 |    239256 |    148291 |    149393 |    516744 |
| Sikkim      |       431 |      2166 |      1888 |       419 |       767 |       950 |      1236 |
| Tamil Nadu  |    338647 |    362981 |    367175 |    355815 |    305238 |    345227 |    325369 |

| Telangana     |   78818 |   137517 |   192583 |   223932 |   214756 |   248395 |   285672 |
|---------------|---------|----------|----------|----------|----------|----------|----------|
| Tripura       |    1520 |     4386 |     5330 |     2771 |     1985 |    19553 |    21949 |
| Uttar Pradesh |  296827 |   512305 |   715717 |   875170 |   837508 |  1135605 |  1680529 |
| Uttarakhand   |   18808 |    18617 |    18742 |    10922 |    11588 |    23702 |    27871 |
| West Bengal   |   46694 |    83020 |    79780 |    83747 |    31728 |   115009 |   283823 |