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Maternal Care in India, Challenges and Government Initiatives

Context: The Maternal Mortality Ratio (MMR) for India is on the decline, but there are States that need to focus on basic and systemic issues.

Maternal Care in India: Challenges

  • Three Delays Model: Delay in recognising complications and seeking care (due to low awareness, financial issues, social taboos).
    • Delay in reaching a health facility (poor roads, remote areas, lack of ambulances).
    • Delay in receiving adequate care at the facility (staff shortages, lack of blood banks, delayed referrals).
  • Shortage of Trained Health Professionals: High vacancy rates for specialists (obstetricians, anaesthetists, paediatricians), especially in Community Health Centres and First Referral Units (FRUs).
    • Eg., 66% vacancies of specialists in 5,491 community health centres.
  • Anaemia and Malnutrition: A large proportion of pregnant women are anaemic or malnourished, increasing the risk of complications and maternal deaths.
    • Eg., According to NFHS-5 (2019-21), over 50% of pregnant women in India are anaemic.
  • Home Deliveries and Unsafe Abortions: Despite progress, a section of deliveries still happen at home by untrained birth attendants, leading to sepsis, trauma, and increased mortality.
  • Socio-cultural and Economic Barriers: Early marriages, low education levels, poverty, and gender inequality hinder timely and safe maternal care.
  • Ineffective Maternal Death Audits: Weak implementation of mandatory reporting and audit of maternal deaths in several states limits systemic improvement.

Maternal Care in India

Major Government Initiatives Related to Maternal Care

Initiative Launched Main Focus Key Features
Janani Suraksha Yojana (JSY) 2005 Promote institutional delivery Cash incentives for mothers & ASHAs to deliver at health facilities
Janani Shishu Suraksha Karyakram (JSSK) 2011 Free maternity and newborn care Free delivery (incl. C-section), drugs, diagnostics, diet, blood, and transport for mother & newborn
PMSMA (Pradhan Mantri Surakshit Matritva Abhiyan) 2016 Quality antenatal care Free specialist ANC on the 9th of every month; focus on early risk detection
LaQshya 2017 Labour room quality improvement Upgradation of labour rooms, maternity OTs, staff training, and quality assurance
SUMAN (Surakshit Matritva Aashwasan) 2019 Dignified, assured maternal-newborn services Zero expense, respectful, quality care; grievance redressal; covers all public health facilities
Anaemia Mukt Bharat (AMB) 2018 Reduce anaemia in women and children 6×6×6 strategy: IFA, deworming, fortified foods, testing, behaviour change, address non-nutritional causes

Way Forward

  • Strengthen the Three Delays Model Response: Increase community awareness of maternal danger signs and the importance of institutional deliveries.
    • Expand financial and transport incentives for timely referral and access.
    • Ensure rapid response and triage at facilities, with a clear protocol for emergencies.
  • Increase Investment in Health Infrastructure: Fill vacancies of obstetricians, anaesthetists, and staff nurses at all FRUs/CHCs.
    • Upgrade operation theatres, blood banks, and critical care units at district and sub-district levels.
  • Improve Quality of Maternal Death Audits: Mandatory, confidential reviews of every maternal death (e.g., Kerala Model), with accountability and follow-up actions.
Kerala Model
Compulsory to report and review every maternal death, regardless of cause or location (hospital or home). All cases are reported within 24 hours.
  • Focus on Nutrition and Anaemia Control: Strengthen Iron Folic Acid (IFA) supplementation, nutrition counselling, and community-based interventions for adolescent girls and pregnant women.
  • Empower Frontline Workers and Women’s Groups: Continue training and incentivising ASHAs, ANMs, and SHGs for community mobilisation and support.

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Greetings! Sakshi Gupta is a content writer to empower students aiming for UPSC, PSC, and other competitive exams. Her objective is to provide clear, concise, and informative content that caters to your exam preparation needs. She has over five years of work experience in Ed-tech sector. She strive to make her content not only informative but also engaging, keeping you motivated throughout your journey!