Lok Sabha Question No. 4433 (UNSTARRED), answered on 2016-08-12
Subject: Status of Institutional Birth
Ministry: HEALTH AND FAMILY WELFARE
Asked by: MAHEISH GIRRI

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

LOK SABHA UNSTARRED  QUESTION NO. 4433 TO BE ANSWERED ON 12 TH AUGUST, 2016

## STATUS OF INSTITUTIO NAL BIRTH

## 4433. SHRI MAHEISH GIRRI:

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

- (a) whether the Government has assessed the status of Institutional Birth in the country National Family Health Survey -4;
- (b) if so, the details thereof, State/UTwise; and
- (c)  the  steps  taken  by  the  Government  to  improve  the  status  of  Institutional  Birth States/UTs having poor performance on the said parameters?

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

- (a) &(b): National Family Health Survey - 4, (NFHS- 4) is carried out in two phases. Field work of the States/UTs pertaining to first phase has been completed and key results published States/UTs.  It is observed that percentage of Institutional Births , for the States/UTs whose key results  are  published  in  NFHS - 4(2015 - 16),  has  increased  in  comparison  to  those  found  in NFHS - 3(2005 - 06).  A  statement  showing  Institutional  Births  in  percentage  for  18  States/ published in NFHS - 4 alongwith their comparativ e values in NFHS - 3 is given at Annexure.
- (c): The  steps  taken  under  the  National  Health  Mission  to  increase  the    percentage Institutional Births further  across the country include the following:
- Promotion of institutional deliveries through Janani Suraksha Yojana (JSY) wherein JSY incentive is being given to all BPL/ SC/ ST pregnant women delivering in Governme health facilities/ accredited private institutions  in both High Performing States Performing States  regardless of age of mother and number of children.
- Implementation  of  Janani  Shishu  Suraksha  Karyakaram  (JSSK)  which    entitles  al pregnant women irrespective of caste and age delivering in public health institut absolutely free and no expense delivery, including caesa rean section. Similar entitlements have  been  put  in  place  for  all  sick  infants  accessing  public  health  institut treatment.

Contd…….

- Operationalization of Sub - Centers, Primary Health Centers, Community Health Centers and District Hospitals fo r providing 24x7 basic and comprehensive obstetric care.
- Capacity building of health care providers in basic and comprehensive obstetric car a  strategic  initiative  'Dakshata'  to  enable  service  providers  in  providing  high  quality services during childbirth at the institutions.
- Use of Mother and Child Protection Card in collaboration with the Ministry of Wom and Child Development to monitor service delivery for mothers and children.
- Implementation of Mother and Child Tracking System to ensure a ntenatal, intranatal and postnatal care along - with immunization services.
- Engagement  of  more  than  9.15  lakh  Accredited  Social  Health  Activists  (ASHAs)  to generate demand and facilitate accessing of health care services by the community.
- Organisation of Vil lage Health and Nutrition Days in rural areas as an outreach activ for provision of maternal and child health services.
- Tracking and line listing of severely anaemic cases of pregnant women at sub centre PHCs for their timely management.
- Operation alization  of  Safe  Abortion  Services  and  Reproductive  Tract  Infections  a Sexually Transmitted Infections (RTI/STI) at health facilities with a focus on 'Delivery Points'.
- Implementation of Maternal Death Review across the country both at facilities and in the community. The purpose is to take corrective action at appropriate levels and impro quality of obstetric care.
- Establishing Maternal and Child Health Wings at high caseload facilities to improv quality of care provided to mothers and chi ldren.
- Availability of assured referral transport through 108/102 toll free call centre.
- Implementation  of  a  new  initiative  of  'Prevention  of  Post - Partum  Hemorrhage  (PPH) through  Community  based  advance  distribution  of  Misoprostol'  by  ASHAs/Auxiliary Nurse Midwifes for high home delivery districts.
- Newer interventions to reduce maternal mortality and morbidity by improving qualit ante - natal  care  and  intrapartum care - Diagnosis & management of Gestational Diabetes Mellitus, Hypothyroidism during pregnanc y, Training of General Surgeons for performing    Caesarean  Section,  Calcium  supplementation  during pregnancy and lactation,  De - worming  during  pregnancy,  Maternal  Near  Miss  Review,  Screening  for Syphilis during pregnancy  and  Dakshata guidelines for strengt hening intra - partum care.
- The Pradhan Mantri Surakshit Matritva Abhiyan has been introduced with the aim of conducting  special  Antenatal  Care    check - ups  for  pregnant  women  (in  their  2nd /  3rd Trimesters  of  pregnancy)  in  the  country  on 9th  of  every  month  by  Medical  Officer/ Obstetrics and Gynecology specialist in the governme nt health facilities and also through private sector on voluntary basis.

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## Institutional Births inNFHS - 4 (2015 - 16)vis - à- vis NFHS- 3 (2005 - 06) (For births occurredin the 5 years before the survey)

| Sl. No.   | State/ UT                   | Institutional Births (%)   | Institutional Births (%)   |
|-----------|-----------------------------|----------------------------|----------------------------|
| Sl. No.   | State/ UT                   | NFHS - 4(2015-16)          | NFHS - 3(2005-06)          |
| 1         | Andhra Pradesh              | 91.6                       | NA                         |
| 2         | Assam                       | 70.6                       | 22.4                       |
| 3         | Bihar                       | 63.8                       | 19.9                       |
| 4         | Goa                         | 96.9                       | 92.3                       |
| 5         | Haryana                     | 80.5                       | 35.7                       |
| 6         | Karnataka                   | 94.3                       | 64.7                       |
| 7         | Madhya Pradesh              | 80.8                       | 26.2                       |
| 8         | Maharashtra                 | 90.3                       | 64.6                       |
| 9         | Manipur                     | 69.1                       | 45.9                       |
| 10        | Meghalaya                   | 51.4                       | 29.0                       |
| 11        | Sikkim                      | 94.7                       | 47.2                       |
| 12        | Tamil Nadu                  | 99.0                       | 87.8                       |
| 13        | Telangana                   | 91.5                       | NA                         |
| 14        | Tripura                     | 79.9                       | 46.9                       |
| 15        | Uttarakhand                 | 68.6                       | 32.6                       |
| 16        | West Bengal                 | 75.2                       | 42.0                       |
| 17        | A ndaman & N icobar Islands | 96.6                       | NA                         |
| 18        | Puducherry                  | 99.9                       | NA                         |

NA -Not Available    * New Andhra Pradesh State after bifurcation.