maternal-healthcare

CONTEXT

The government’s recent announcement that the maternity benefit programme which provides ₹5,000 for first child will be extended to cover the second child only if it is a girl has met with sharp criticism from activists who have demanded its universalisation.

MATERNAL HEALTH 

  • Maternal malnutrition has been linked to an increased risk of maternal morbidity, premature birth and newborns that are too small for their gestational age.
  • Poor maternal nutrition in India is caused by combination of factors like early and repeated pregnancies, poverty, caste discrimination and gender inequality.
  • Data: Maternal malnutrition is still a global problem, with 24% of mothers in South Asia having a low BMI. Anaemia affects 30% of reproductive age women and 37% of pregnant women.
    • In India, every third woman is undernourished and every second woman is anaemic. An undernourished mother almost inevitably gives birth to a low birth weight baby.
  • Findings by National Nutrition Monitoring Bureau: According to the national nutrition monitoring bureau survey in 10 Indian states, cereals and millets make up the majority of rural diets with approximately half of pregnant women getting enough protein and calories.
    • The survey has also revealed that most pregnant women's iron, vitamin A & C and folic acid consumption were less than half of what was advised.
  • WHO’s recommendation: The World health Organisation recommends 49 interventions for antenatal care (ANC), 14 of which are dietary interventions.
  • National standards of India: India’s national standards are based on global recommendations for key nutrition treatments for pregnant women including better diet.
  • POSHAN Abhiyan-India’s flagship national nutrition Mission aims to enhance maternal nutrition by employing technology, behavioural change communication, community engagement and cross-sectoral convergence.
  • Schemes for maternal and child health in India are mostly implemented through flagship programmes of two ministries:
    • The Ministry of women and child development’s integrated Child development services (ICDS) programme provides micro nutrient-fortified supplementary food or energy dense take home meals for pregnant women and mothers who are breastfeeding.
    • The Ministry of health and family welfare provides micro nutrient supplements, deworming tablets, weight gain monitoring and nutrition advice to pregnant women as part of their antenatal care.

Integrated Child development services ( ICDS)

  • The programme is aimed towards children under the age of six as well as pregnant and breastfeeding women.
  • Take-home rations comprising micro nutrient fortified blended food or energy dense food are supplied to children aged 0-6 years as well as pregnant and lactating women for consumption at home under the scheme.
  • The take-home rations are provided with the goal of bridging a nutrition gap in improving infant and young child feeding practices.

Pradhan Mantri Matru Vandana Yojana (PMMVY)

  • The maternity benefits programme has been implemented in all regions of countries from 2017 as PMMVY as part of the National Food security Act, 2013.
  • The objective of the scheme is to provide partial compensation for the wage loss in terms of cash incentives so that the woman can take adequate rest before and after delivery of the first living child.
  • The cash incentive provided would lead to improved health seeking behaviour amongst the Pregnant Women and Lactating Mothers (PW&LM).
  • The beneficiary can apply for the plan if the scheme eligibility standards are met within 730 days of the recipient’s last menstrual period.
  • The eligible beneficiaries after the institutional delivery would receive the remaining cash incentives as per approved non-towards the maternity benefit under Janani Suraksha Yojana by the health department on annual basis. The pregnant women and lactating mothers shall receive a cash benefit of Rs.5000 in three installments.

Instalment

Conditions

Amount

First Instalment

Early Registration of pregnancy

₹1000

Second Instalment

Received at least one ANC

(can be claimed after 6 months of pregnancy)

₹2000

Third Instalment
  • Child Birth is registered
  • Child has received first cycle of BCG, OPV,DPT and Hepatitis-B or its equivalent/substitute

₹2000

Janani Suraksha Yojana

  • The national rural health Mission’s Janani Suraksha Yojana is a safe motherhood intervention.
  • It is being adopted with the goal of lowering maternal and infant mortality by encouraging pregnant women to give birth in a hospital.
  • The system is being implemented in all states and union territories with special focus on states that are underperforming, the scheme was started in 2005 by amending the national maternity benefit scheme (NMBS).
  • The pregnant women who have reached the age of 19 and live in the BPL households were eligible for financial support of Rs.500 per birth up to 2 live births under the NMBS was replaced by a tiered scale of aid based on state classification and whether the beneficiary was from a rural or urban region.
    • The states are classified as low performing states (LPS) or high performing states (HPS) based on their institutional delivery rate.
    • States with an institutional delivery rate of 25% or less were classified as low performing while those with more than 25% were classified as HPS. 
  • The scheme aims to reduce maternal and infant mortality by promoting institutional delivery among pregnant women.
  • The programme also offers performance-based incentives to ASHA  workers who promote institutional delivery among pregnant women.

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