Lok Sabha Question No. 3186 (UNSTARRED), answered on 2024-12-13
Subject: Maternal and Child Health Services
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Dr. Prabha Mallikarjun

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

## LOK SABHA UNSTARRED QUESTION NO. 3186 TO BE ANSWERED ON 13.12.2024

## MATERNALANDCHILDHEALTHSERVICES

## 3186. DR. PRABHAMALLIKARJUN:

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

- a) the steps taken by the Government to improve access to quality maternal and child health services, particularly in rural and underserved areas to support healthier families and communities in the country;
- b) whether any initiatives have been taken by the Government to ensure that women receive regular prenatal and postnatal care by introducing a mandatary Mother Card or Maaji Card from the Government for accurate information about pregnant women including the IMR,MMR and if so, the details thereof;
- c) whether the Government plan to increase the number of trained healthcare professionals and midwives in maternity and pediatric facilities to ensure comprehensive maternal and child health support and if so, the details thereof;
- d) the manner in which the Government plan to address malnutrition and immunization gaps among children in the country; and
- e) whether any measures have been implemented to make maternal health services more affordable , thereby reducing financial stress on families and encouraging them to seek necessary medical care in the country and if so, the details thereof?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SMT. ANUPRIYAPATEL)

- (a) to (e) Under National Health Mission (NHM), the steps/initiatives taken by the Government of India to improve access to quality and enhance the affordability of maternal and child health services in order to support healthier families and communities across the country including rural and undeserved areas are mentioned below:
- Janani Suraksha Yojana (JSY) is a demand promotion and conditional cash transfer scheme for promoting institutional delivery.

● Janani Shishu Suraksha Karyakram (JSSK) entitles all pregnant woman and sick infants (up to one year of age) delivering in public health institutions to have absolutely free and no expense delivery, including caesarean section. The entitlements include free drugs and consumables, free diet during stay, free diagnostics, free transportation and free blood transfusion, if required. Similar entitlements are also in place for sick infants up to one year of age.

- 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 focuses on quality antenatal care (ANC) for pregnant women, especially high-risk pregnant (HRP) women and individual HRP tracking with financial incentivization for the identified high-risk pregnant women and accompanying Accredited Social Health Activists (ASHAs) for extra 3 visits over and above the PMSMA visit.

- Facility Based Newborn Care: Neonatal Intensive Care Units (NICUs)/ Special Newborn Care Units (SNCUs) are established at Medical College and District Hospital, Newborn Stabilization Units (NBSUs) are established at First Referral Units (FRUs)/ Community Health Centres (CHCs) for care of sick and small babies.
- Kangaroo Mother Care (KMC ) is implemented at facility and community level for low birth weight/ pre-term babies. It includes early and prolonged skin-to-skin contact with the mother or family member and exclusive and frequent breastfeeding.
- Community Based care of Newborn and Young Children: Under Home Based Newborn 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 newborn and young children in the community for referral to health facility.
- Universal Immunization Programme (UIP ) is implemented to provide 11 vaccines to protect children against 12 preventable diseases.
- Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS) initiative has been implemented since 2019 for reduction of childhood morbidity and mortality due to Pneumonia.
- STOP Diarrhoea initiative is implemented for promoting use of ORS and Zinc and for reducing morbidity and mortality due to childhood diarrhoea.
- Rashtriya Bal Swasthaya 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 Swasthaya 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.

● Dissemination of information about the Schemes through Information, Education & Communication (IEC) & Behaviour Change Communication (BCC) strategies including mass media.

● Field level workers like ANMs, ASHAs and CHOs promote programme at the ground level through interpersonal communication.

● Communications through multiple channels with State Governments including letters, video conferencing etc.

● A system of supportive supervisory visits to the states and districts to monitor the implementation of various maternal and child health interventions.

- (b) To ensure that pregnant women receive regular prenatal and postnatal care, the Government of India introduced the Mother and Child Protection (MCP) Card and Safe Motherhood Booklet. These are distributed to all pregnant women as soon as their pregnancy is registered to educate them on prenatal and postnatal care, including diet, rest, danger signs during pregnancy and for newborns, benefit schemes, and institutional deliveries.
- (c) To increase the number of trained healthcare professionals and midwives in maternity and pediatric facilities across all States and Union Territories, the Government of India conducts regular training programmes. These include Basic Emergency Obstetric and Newborn Care (BEmONC), Comprehensive Emergency Obstetric and Newborn Care (CEmONC), Life Saving Anaesthesia Skills (LSAS), Skilled Birth Attendant (SBA), Nurse Practitioner Midwife (NPM) , Revised training package of Facility based Integrated Management of Neonatal & Childhood Illness (F-IMNCI), Integrated Management of Neonatal & Childhood illness(IMNCI), Revised training package of Facility Based Newborn Care (FBNC), Navjat Shishu Suraksha Karyakram (NSSK) and Newborn Stabilization Units (NBSUs).
- (d) The Government addresses malnutrition and immunization gaps among children in the country, which include the following:

● Anemia Mukt Bharat (AMB) strategy is implemented to reduce anemia among six beneficiaries age group - children (6-59 months), children (5-9 years), adolescents (10-19 years), pregnant and lactating women and women of reproductive age group (15-49 years) in life cycle approach through implementation of six interventions via robust institutional mechanism.

● Nutrition Rehabilitation Centers (NRCs) are set up at public health facilities to provide in-patient medical and nutritional care to children under 5 years suffering from Severe Acute Malnutrition (SAM) with medical complications. In addition to curative care, special focus is given on timely, adequate and appropriate feeding for children; on improving the skills of mothers and caregivers on complete age-appropriate caring and feeding practices.

- Mothers' Absolute Affection (MAA) Programme is implemented to improve breastfeeding coverage which includes early initiation of breastfeeding and exclusive breastfeeding for newborn.
- Lactation Management Centres : Comprehensive Lactation Management Centres (CLMC) are facilities established to ensure availability of safe, pasteurized Donor Human Milk for feeding of sick, preterm and low birth weight babies admitted in Neonatal Intensive Care Units and Special Newborn Care Units. Lactation Management Unit (LMU) are established for providing lactation support to mothers within the health facility for collection, storage and dispensing of mother's own breastmilk for consumption by her baby.
- Under National Deworming Day (NDD) albendazole tablets are administered in a single fixed day approach via schools and Anganwadi centres to reduce the soil transmitted helminth (STH) infestation among all children and adolescents (1-19 years).
- The Government of India implements Mission Indradhanush , a periodic catch-up campaign is the country's flagship immunization program, for the left out and dropped out children and pregnant women who have missed their routine immunizations. During the twelve phases of Mission Indradhanush conducted so far, 5.46 crore children and 1.32 crore pregnant women have been vaccinated.
- U-WIN is a digital platform for registering, recording and tracking all vaccination services provided under the Universal Immunization Programme to ensure timely administration of life-saving vaccines to pregnant women and children (0-16 years).

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