Lok Sabha Question No. 1037 (UNSTARRED), answered on 2023-12-08
Subject: Maternal and Childcare Health Services
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Jagannath Sarkar

## GOVERNMENTOFINDIA MINISTRY OFHEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 1037 TO BE ANSWERED ON 8 th DECEMBER 2023

## MATERNALANDCHILDCAREHEALTHSERVICES

## 1037. SHRI JAGANNATH SARKAR:

Will the MINISTER OF HEALTH AND FAMILY WELFARE be pleased to state:

- (a) the details of the initiatives taken / proposed to be taken to improve the maternal and childcare health services in the country, State/UT -wise including West Bengal during the last two years and the current year; and
- (b) the details of the budget allocated for this purpose, State/UT -wise including West Bengal during the last two years and the current year?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILYWELFARE (DR. BHARATI PRAVIN PAWAR)

- (a) : Under National Health Mission (NHM), Government of India has taken various initiatives /programmes to improve the maternal and childcare health services across all States/UTs of the country including State of West Bengal are as follows:
-  Surakshit Matritva Aashwasan (SUMAN) provides assured, dignified, respectful and quality healthcare at no cost and zero tolerance for denial of services for every woman and newborn visiting public health facilities to end all preventable maternal and newborn deaths.
-  Janani Suraksha Yojana (JSY) , a demand promotion and conditional cash transfer scheme for promoting institutional delivery.
-  Under Janani Shishu Suraksha Karyakram (JSSK) , every pregnant woman is entitled to free delivery, including caesarean section, in public health institutions along with the provision of free transport, diagnostics, medicines, blood, other consumables & diet.
-  Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) provides pregnant women a fixed day, free of cost assured and quality antenatal check up by a Specialist/Medical Officer on the 9th day of every month.
-  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.

-  Optimizing Postnatal Care aims to strengthen the quality of post-natal care by laying emphasis on detection of danger signs in mothers and incentivization of ASHAs for prompt detection, referral & treatment of such high-risk postpartum mothers.
-  Midwifery Initiatives provides respectful and positive birthing experiences to all pregnant women by promoting natural birthing through Nurse Practitioner Midwives (NPMs) who are skilled in accordance to (ICM) competencies.
-  LaQshya improves 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.
-  Monthly Village Health, Sanitation and Nutrition Day (VHSND) is an outreach activity at Anganwadi centers for provision of maternal and child care including nutrition in convergence with the ICDS.
-  Birth Waiting Homes (BWH) are established in remote and tribal areas to promote institutional delivery and improve access to healthcare facilities.
-  Outreach camps are provisioned for improving the reach of health care services especially in tribal and hard to reach areas. This platform is used to increase the awareness for the Maternal & Child health services, community mobilization as well as to track high risk pregnancies.
-  Functionalization of First Referral Units (FRUs) by ensuring manpower, blood storage units, referral linkages to improve the access to quality of care for pregnant women.
-  Setting up of Maternal and Child Health (MCH) Wings at high caseload facilities to improve the quality of care provided to mothers and children.
-  Obst.HDU & ICU: Operationalization of Obst.HDU & ICU in high case load tertiary care facilities across the country to handle complicated pregnancy.
-  Reproductive and child health (RCH) portal is a name-based web-enabled tracking system for pregnant women and newborn so as to ensure seamless provision of regular and complete services to them including antenatal care, institutional delivery and post-natal care.
-  Mother and Child Protection (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.
-  Regular IEC/BCC : is also a part of all the schemes for greater demand generation. Health and nutrition education through mass and social media is also promoted to improve healthy practices and to generate demand for service uptake.
-  Facility Based New-born Care: Special New-born Care Units (SNCUs) are established at District Hospital and Medical College level, New-born Stabilization Units (NBSUs) are established at First Referral Units (FRUs)/ Community Health Centres (CHCs) for care of sick and small babies.
-  Community Based care of New-born and Young Children : Under Home Based New-born Care (HBNC) and Home-Based Care of Young Children (HBYC) program,

home visits are performed by ASHAs to improve child rearing practices and to identify sick new-born and young children in the community.

-  Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS) initiative implemented since 2019 for reduction of childhood morbidity and mortality due to Pneumonia.
-  Rashtriya Bal Swasthya Karyakram (RBSK): Children from 0 to 18 years of age are screened for 32 health conditions (i.e. Diseases, Deficiencies, Defects and Developmental delay) under Rashtriya Bal Swasthya Karyakram (RBSK) to improve child survival. District Early Intervention Centres (DEICs) at district health facility level are established for confirmation and management of children screened under RBSK.
-  Intensified Diarrhoea Control Fortnight / Defeat Diarrhoea (D2) initiative implemented for promoting ORS and Zinc use and for reducing diarrhoeal deaths.
-  Capacity Building: Several capacity building programs of health care providers are taken up for improving maternal and child survival and health outcomes.
- (b) : State/UT wise budget allocated for the maternal and childcare health services under National Health Mission (NHM) including State of West Bengal for the last two years and the current year are placed at Annexure I and II.

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Annexure-I State/UT wise details of SPIP Approvals and Expenditure for Maternal Health under NHM for the FY 2021-22 to FY 2023-24 (Rs. in lakhs)

| Sl. No.   | State/UT                           | 2021-22       | 2021-22     | 2022-23       | 2022-23     | 2023-24       | 2023-24     |
|-----------|------------------------------------|---------------|-------------|---------------|-------------|---------------|-------------|
| Sl. No.   | State/UT                           | SPIP Approval | Expenditure | SPIP Approval | Expenditure | SPIP Approval | Expenditure |
| 1         | Andaman and Nicobar Islands        | 56.89         | 2.57        | 56.00         | 5.49        | 57.20         | 1.03        |
| 2         | Andhra Pradesh                     | 18,854.41     | 14,054.51   | 18,217.36     | 9,768.92    | 17,648.77     | 9,057.66    |
| 3         | Arunachal Pradesh                  | 954.71        | 623.00      | 2,782.40      | 2,338.14    | 2,110.76      | 454.69      |
| 4         | Assam                              | 18,704.78     | 13,401.62   | 23,460.78     | 19,155.49   | 23,600.92     | 4,879.28    |
| 5         | Bihar                              | 56,787.02     | 38,489.86   | 93,403.07     | 52,066.07   | 76,475.50     | 16,114.65   |
| 6         | Chandigarh                         | 250.54        | 6.63        | 155.02        | 3.47        | 175.07        | 1.62        |
| 7         | Chhattisgarh                       | 10,614.46     | 10,016.95   | 13,139.32     | 11,208.47   | 13,092.04     | 2,624.45    |
| 8         | Dadra &Nagar Haveli and Daman &Diu | 132.38        | 60.28       | 120.50        | 63.00       | 118.45        | 30.85       |
| 9         | Delhi                              | 1,348.81      | 343.18      | 1,753.01      | 301.31      | 2,933.45      | 164.41      |
| 10        | Goa                                | 207.51        | 130.61      | 253.97        | 236.29      | 254.92        | 87.06       |
| 11        | Gujarat                            | 16,090.72     | 12,081.03   | 17,256.24     | 11,391.40   | 16,735.02     | 4,281.91    |
| 12        | Haryana                            | 3,677.17      | 2,978.70    | 8,545.07      | 6,183.48    | 5,168.13      | 2,638.37    |
| 13        | Himachal Pradesh                   | 4,847.96      | 4,844.69    | 3,966.34      | 4,122.25    | 5,735.67      | 655.14      |
| 14        | Jammu and Kashmir                  | 7,224.70      | 6,349.02    | 8,538.46      | 8,491.99    | 8,905.30      | 1,693.63    |
| 15        | Jharkhand                          | 19,563.48     | 11,506.16   | 26,825.69     | 23,352.28   | 28,390.13     | 5,492.57    |
| 16        | Karnataka                          | 11,702.72     | 7,365.85    | 34,653.95     | 25,683.41   | 22,066.36     | 3,181.48    |
| 17        | Kerala                             | 5,264.06      | 6,494.49    | 8,076.10      | 7,625.60    | 6,958.33      | 2,402.32    |
| 18        | Ladakh                             | 346.34        | 400.79      | 346.83        | 331.64      | 345.56        | 55.79       |
| 19        | Lakshadweep                        | 80.51         | 18.96       | 43.56         | 31.70       | 44.54         | 11.32       |
| 20        | Madhya Pradesh                     | 44,246.13     | 46,165.77   | 44,246.84     | 35,137.69   | 50,583.12     | 11,736.03   |
| 21        | Maharashtra                        | 18,859.75     | 19,632.77   | 32,593.55     | 19,139.45   | 31,514.91     | 8,013.84    |
| 22        | Manipur                            | 1,724.77      | 375.99      | 2,321.01      | 578.97      | 1,997.28      | 43.10       |
| 23        | Meghalaya                          | 3,409.04      | 1,548.69    | 2,814.14      | 2,172.33    | 2,647.23      | 1,784.81    |

| Sl. No.   | State/UT      | 2021-22       | 2021-22     | 2022-23       | 2022-23     | 2023-24       | 2023-24     |
|-----------|---------------|---------------|-------------|---------------|-------------|---------------|-------------|
| Sl. No.   | State/UT      | SPIP Approval | Expenditure | SPIP Approval | Expenditure | SPIP Approval | Expenditure |
| 24        | Mizoram       | 712.77        | 347.48      | 701.94        | 122.67      | 763.42        | 157.89      |
| 25        | Nagaland      | 997.91        | 1,119.30    | 1,069.74      | 499.49      | 1,189.16      | 130.88      |
| 26        | Odisha        | 18,829.11     | 20,307.78   | 25,983.09     | 22,510.76   | 25,432.89     | 10,062.17   |
| 27        | Puducherry    | 755.23        | 188.89      | 590.61        | 308.77      | 593.95        | 56.06       |
| 28        | Punjab        | 5,963.99      | 6,153.90    | 11,454.98     | 7,770.19    | 9,290.55      | 3,511.30    |
| 29        | Rajasthan     | 47,038.23     | 35,106.90   | 41,408.15     | 37,245.29   | 41,408.15     | 13,419.88   |
| 30        | Sikkim        | 220.78        | 210.52      | 625.88        | 626.47      | 210.59        | 90.09       |
| 31        | Tamil Nadu    | 11,323.47     | 14,147.95   | 22,044.14     | 21,273.45   | 44,410.48     | 15,455.69   |
| 32        | Telangana     | 11,847.17     | 8,388.68    | 15,721.74     | 24,057.55   | 15,640.91     | 2,148.17    |
| 33        | Tripura       | 1,673.57      | 1,088.29    | 2,558.16      | 1,573.45    | 2,606.73      | 635.10      |
| 34        | Uttar Pradesh | 1,01,068.6 4  | 36,695.92   | 1,39,617.5 3  | 61,869.06   | 1,69,183. 08  | 25,927.64   |
| 35        | Uttarakhand   | 3,995.53      | 3,196.59    | 6,624.70      | 4,158.66    | 5,688.16      | 1,145.64    |
| 36        | West Bengal   | 29,860.21     | 22,283.63   | 34,022.72     | 29,780.15   | 34,938.61     | 8,135.62    |

## Note:

1. The above data is as per available Financial Management Reports (FMRs) submitted by States/UTs.
2. Expenditure includes expenditure against Central Release, State release & unspent balances at the beginning of the year and are provisional.
3. Expenditure for the FY 2023-24 is updated up-to 30.09.2023.

Annexure-II State/UT wise details of SPIP Approvals and Expenditure for Child Health under NHM for the FY 2021-22 to FY 2023-24 (Rs. in lakhs)

| Sl. No.   | State/UT                           | 2021-22       | 2021-22     | 2022-23       | 2022-23     | 2023-24       | 2023-24     |
|-----------|------------------------------------|---------------|-------------|---------------|-------------|---------------|-------------|
| Sl. No.   | State/UT                           | SPIP Approval | Expenditure | SPIP Approval | Expenditure | SPIP Approval | Expenditure |
| 1         | Andaman and Nicobar Islands        | 51.99         | 1.67        | 110.86        | 15.50       | 75.65         | 11.65       |
| 2         | Andhra Pradesh                     | 6,230.36      | 5,925.39    | 9,355.39      | 6,345.28    | 8,184.17      | 6,007.40    |
| 3         | Arunachal Pradesh                  | 736.26        | 306.69      | 1,013.26      | 793.99      | 1,011.59      | 41.86       |
| 4         | Assam                              | 5,406.10      | 3,877.57    | 8,403.80      | 5,800.40    | 7,659.56      | 1,727.08    |
| 5         | Bihar                              | 2,407.51      | 2,401.78    | 13,111.84     | 8,730.72    | 14,124.89     | 3,223.79    |
| 6         | Chandigarh                         | 5.05          | 1.80        | 84.54         | 15.11       | 57.36         | 17.92       |
| 7         | Chhattisgarh                       | 6,439.43      | 3,800.53    | 7,278.53      | 5,463.64    | 8,067.30      | 1,074.45    |
| 8         | Dadra &Nagar Haveli and Daman &Diu | 95.39         | 34.96       | 163.51        | 49.22       | 162.76        | 24.02       |
| 9         | Delhi                              | 1,887.70      | 96.55       | 2,614.03      | 972.17      | 1,914.45      | 365.53      |
| 10        | Goa                                | 119.28        | 61.16       | 156.48        | 76.09       | 138.49        | 51.48       |
| 11        | Gujarat                            | 10,897.53     | 7,482.55    | 15,673.38     | 12,355.66   | 14,499.74     | 5,082.76    |
| 12        | Haryana                            | 2,490.33      | 2,341.03    | 3,593.62      | 3,351.22    | 3,464.53      | 1,667.74    |
| 13        | Himachal Pradesh                   | 1,117.45      | 563.46      | 1,858.24      | 1,130.35    | 3,132.30      | 499.15      |
| 14        | Jammu and Kashmir                  | 2,836.64      | 940.16      | 3,594.02      | 1,954.87    | 4,058.38      | 687.76      |
| 15        | Jharkhand                          | 8,363.96      | 2,620.58    | 6,455.42      | 3,657.61    | 6,258.38      | 1,281.59    |
| 16        | Karnataka                          | 6,561.50      | 2,489.51    | 10,804.29     | 4,793.26    | 7,138.19      | 1,250.68    |
| 17        | Kerala                             | 3,837.71      | 1,530.84    | 9,932.65      | 6,206.12    | 6,938.48      | 1,455.00    |
| 18        | Ladakh                             | 154.45        | 75.48       | 416.79        | 187.68      | 311.89        | 64.94       |
| 19        | Lakshadweep                        | 29.86         | 15.44       | 27.28         | 9.82        | 25.10         | 11.95       |
| 20        | Madhya Pradesh                     | 19,787.43     | 11,429.68   | 16,267.80     | 11,336.01   | 14,926.35     | 3,210.77    |
| 21        | Maharashtra                        | 9,367.29      | 5,794.90    | 20,208.16     | 12,018.26   | 15,783.58     | 4,636.83    |
| 22        | Manipur                            | 535.15        | 78.75       | 3,303.96      | 1,917.30    | 1,820.12      | 61.48       |
| 23        | Meghalaya                          | 1,212.95      | 458.24      | 1,603.56      | 1,647.15    | 1,471.51      | 559.09      |
| 24        | Mizoram                            | 318.00        | 173.53      | 525.50        | 179.44      | 444.80        | 221.28      |
| 25        | Nagaland                           | 533.44        | 258.26      | 500.43        | 132.07      | 473.32        | 67.28       |

| Sl. No.   | State/UT      | 2021-22       | 2021-22     | 2022-23       | 2022-23     | 2023-24       | 2023-24     |
|-----------|---------------|---------------|-------------|---------------|-------------|---------------|-------------|
| Sl. No.   | State/UT      | SPIP Approval | Expenditure | SPIP Approval | Expenditure | SPIP Approval | Expenditure |
| 26        | Odisha        | 7,417.47      | 5,670.17    | 8,759.94      | 9,476.96    | 7,616.22      | 3,480.66    |
| 27        | Puducherry    | 191.74        | 69.82       | 144.09        | 46.67       | 163.59        | 99.82       |
| 28        | Punjab        | 2,633.03      | 1,580.39    | 4,196.04      | 2,257.89    | 3,715.79      | 1,231.82    |
| 29        | Rajasthan     | 17,700.93     | 8,469.05    | 16,427.49     | 7,540.70    | 17,526.49     | 2,785.10    |
| 30        | Sikkim        | 94.72         | 51.48       | 165.41        | 140.17      | 135.72        | 24.53       |
| 31        | Tamil Nadu    | 2,654.15      | 1,934.01    | 13,906.45     | 6,320.31    | 10,672.54     | 4,594.52    |
| 32        | Telangana     | 3,935.81      | 2,617.75    | 7,144.76      | 3,927.48    | 6,193.86      | 612.25      |
| 33        | Tripura       | 567.75        | 356.06      | 1,178.07      | 684.27      | 917.69        | 168.93      |
| 34        | Uttar Pradesh | 37,642.18     | 7,914.29    | 45,457.32     | 19,240.46   | 57,974.92     | 7,804.35    |
| 35        | Uttarakhand   | 1,458.07      | 1,042.61    | 3,360.44      | 1,736.48    | 2,923.50      | 823.82      |
| 36        | West Bengal   | 10,890.43     | 10,835.68   | 12,230.37     | 7,639.90    | 12,520.44     | 2,617.52    |

## Note:

1. The above data is as per available Financial Management Reports (FMRs) submitted by States/UTs.
2. Expenditure includes expenditure against Central Release, State release & unspent balances at the beginning of the year and are provisional.
3. Expenditure for the FY 2023-24 is updated up-to 30.09.2023.