Lok Sabha Question No. 3384 (UNSTARRED), answered on 2016-08-05
Subject: PHCs of Hilly Terrain
Ministry: HEALTH AND FAMILY WELFARE
Asked by: PREM DAS RAI

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

## LOK SABHA UNSTARRED  QUESTION NO. 3384 TO BE ANSWERED ON 5 TH AUGUST, 2016

## PHCs OF HILLY TERRAIN

## 3384. SHRI PREM DAS RAI:

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

(a) whether the Government has taken cognizance that Primary Health Centres (PHCs) at hilly terrain are not easily accessible to pregnant women/women in labour;

(b) if so, the details thereof;

(c) whether the Government proposes any action to tackle unreported deaths of mothers in transit to the health centres for delivery, if so, the details thereof; and

(d) the steps taken by the Government to address the above issue and fix accountability of the Accredited Social Health Activists (ASHA) workers?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI FAGGAN SINGH KULASTE)

(a) & (b): Yes.  Under  National  Health  Mission  (NHM),  to  improve  access  of  pregnant women/women  in  lab our  to  Primary  Health  Centres  (PHCs),  Government  of  India  provides relaxed norms for setting up of PHCs and Sub -health Centres (SHCs) in hilly areas. SHCs in hilly  areas  can  be  set  up  under  'time  to  care'  norm  of  half  an  hour  of  travel  time  by  walk between the habitation and SHC facility. Besides large number of ambulances and empanell vehicles (over 22000) that are used to transport pregnant women/women in labour to approp health  institutions,  Doli/Palkis  are  also  being  supported  under  the  NHM  to  ca rry  pregnant women/women in labour  in hilly areas to nearest road points, from where they are carr 102/208 ambulances.

(c): Public Health is a state subject. States/UTs have established a system for Maternal Review for notification  and review of maternal  deaths including deaths of mothers occurring during transit in all States/ UTs. Under this system, the ASHA/AWW/ANM is expected to not all women deaths (including deaths during transit) in the age group of 15 to 49 years f area  to  th e  Block  Medical  Officer  (BMO)  within  24  hours.  The  local  panchayats  and  othe relevant  persons/  groups  can  also  inform  the  Block  Medical  Officer  about  women's  deaths  in their area. All maternal deaths occurring in the hospital are also reported by the medi cal officer in - charge.  Maternal deaths are then reviewed at both community and facility level by desi medical officers followed by a detailed review at district level by district Maternal Dea Committee and District Magistrates. States/UTs a re regularly advised to ensure that every death including maternal death is reported in village level birth and death register.

(d): Under National Health Mission (NHM), ASHAs are envisaged as honorary volunteers and  the  role  of  escorting  the  pregnant  mot hers t the  health  facility  for  delivery  is  only voluntary function for ASHAs. ASHAs across the country have been trained to support famil in advance birth planning and preparedness, so that a smooth and timely process of trans the  pregnant  wo men  to  appropriate  facilities,  at  the  time  of  start  of  the  labour - pain,  can  be ensured. They are expected to 'support universal registration of births and deaths', for which they  are  also  entitled  to  a  monthly  incentive  of  Rs.  100/ - .  The  objective  of  Mate rnal  Death Review is to ascertain the cause of maternal deaths to enable Government to take corr measures in this regard.