NURTURING TOMORROW: EXPLORING MATERNAL AND NEONATAL CARE INITIATIVES in Amrit Kaal.

In the realm of public health, the provision of comprehensive maternal and neonatal care stands as an imperative duty to safeguard the rights and well-being of both mothers and newborns. Recognizing this obligation, the Modi Government has instituted a variety of schemes and initiatives tailored to address the unique needs and vulnerabilities of expectant mothers and their infants. The commitment of the Government to the cause is evidenced by the improving maternal and infant health indicators. For instance, India’s MMR declined by 6.36%, which is three times higher than the rate of global decline.

The establishment of the “continuum of care,” which includes integrated service delivery in different life stages like adolescence, pre-pregnancy, childbirth, and the postnatal period, childhood, and through reproductive age, as well as the availability of services at all levels, is becoming more and more recognised and emphasised globally. The strategic approach to reproductive, maternal, newborn, child, and adolescent health (RMNCH+A) in India includes the same concept. We will refer to it as the life-cycle strategy for ease of use. In this blog, the author undertakes a systematic examination of the maternal and neonatal schemes brought in by the Modi Government in the last two decades. Our exploration encompasses an analysis of such governmental policies, their progress, and their contribution.

Interventions for improving maternal health

The primary focus area of the government has been to identify and provide solutions to address the real causes of women’s mortality and morbidity. The focus has been on offering exceptional healthcare facilities to expectant mothers, starting from the early stages of pregnancy, and ending with postpartum care, in order to ensure a continuum of care that addresses maternal and child health in a holistic manner. Programmes have been created with the need for a variety of medical services in mind, including testing and routine checkups, facilities for a smooth delivery, and postnatal care for the mother and child. The life-cycle strategy has been adopted as a guiding principle and programs are designed accordingly.

Some of which are:

• Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA): This service, which was started in 2016, provides pregnant mothers on the ninth day of every month with cost-free, high-quality prenatal care. Under PMSMA, all expectant moms are eligible for services like prescription drugs, lab work, prenatal checkups, and ultrasounds.

• Since inception, more than 4.73 crore antenatal check-ups have been conducted till 8th February 2024 and 49.56 lakh high risk pregnancies have been identified under PMSMA across States/ UTs till 15th December 2023.

• Janani Suraksha Yojana (JSY): Under the National Health Mission, JSY is a safe motherhood intervention. The Janani Suraksha Yojana (JSY), which was introduced with the goal of lowering mother and newborn mortality, encourages pregnant women, particularly those from low-income households and Scheduled Castes and Tribes, to give birth in an institutional setting.

• The success of the scheme is to be assessed by the increase in institutional deliveries among low-income families as well as the overall number of institutional deliveries. Institutional Deliveries increased from 78.9% (NFHS-4) to 88.6% in NFHS-5 and Skilled Birth Attendant (SBA) attended deliveries increased from 81.4%(NFHS-4) to 89.4%inNFHS-5. Further, under JSY 43.35 lakhs beneficiaries received benefits during the period of April-September 2023 (Provisional data, FY 2023-24).

• Surakshit Matritva Aashwasan (SUMAN): It seeks to eliminate all avoidable maternity and newborn fatalities by offering every mother and child who visits the public health institution assured, dignified, respectful, and high-quality healthcare at no cost. It also vows to tolerate no service denials. Till 15th December 2023, 38,096 facilities have been notified under SUMAN. It also integrates existing initiatives (PMSMA, LaQshya, FRUs etc).

• LaQshya: It was introduced in 2017 with the goal of raising the standard of care in labour rooms and maternity operation theatres to guarantee that expectant mothers receive considerate and excellent care throughout labour and the first few hours after giving birth.

• Progress Till 30th November 2023, 873 Labour Rooms and 663 Maternity Operation Theatres are LaQshya certified at national level. During the FY 2022-23, 185 Labour Rooms and 129 Maternity Operation Theatres are LaQshya certified at national level.

• Pradhan Mantri Matru Vandana Yojana (PMMVY): A direct benefit transfer (DBT) programme that went into operation in 2017 gives pregnant women financial benefits directly into their bank accounts to satisfy their increased nutritional demands and partially make up for lost wages.

• Progress Under Pradhan Mantri Matru Vandana Yojana (PMMVY), more than 3.78 crores beneficiaries have been enrolled since inception of the Scheme in 2017-18 and till 29.01.2024. Further, maternity benefits of more than ₹14,758.87 crores have been disbursed to more than 3.29 crores beneficiaries during the aforesaid period.

• POSHAN Abhiyaan: The POSHAN Abhiyaan, launched by the Indian government in 2018, aims to improve the nutritional status of children, adolescent girls, pregnant women, and lactating mothers in a time bound manner.

Category wise beneficiaries registered under Poshan Tracker

Total Beneficiaries	Lactating Women	Pregnant Women	Children (0-6M)	Children (6M-3Y)	Children (3Y-6Y)
9,98,63,157	50,32,410	59,93,993	42,74,065	3,99,80,334	4,45,82,355

Neonatal Care Initiatives

The Modi government’s approach towards neonatal care emphasises the importance of early intervention, access to quality healthcare services, and community engagement to improve neonatal health outcomes and reduce neonatal mortality rates across India. Some of which include:

• Home Based Newborn Care (HBNC) program: During the 2022–2023 year, ASHAs referred over 8 lakh unwell babies to medical facilities, while 1.47 crore newborns received full schedules of home visits. In F.Y. 2023–2024 (Qtr. 1), ASHA performed scheduled visits with 33.5 lakh newborns, of whom 1.95 lakh were found to be ill and referred to medical facilities under the HBNC scheme.

• Rashtriya Bal Swasthya Karyakram (RBSK): Under this programme, children between the ages of one and eighteen are screened for the four Ds: defects at birth, diseases, deficiencies, and developmental delays. The screening covers thirty-two common health issues and allows for early discovery, free treatment, and management, including tertiary level surgery. Between April and November of 2023, 41.26 lakh neonates were checked at delivery locations as part of the RBSK Programme.

All things considered, the Modi government’s approach to neonatal care in India is a comprehensive strategy that tackles a number of factors that influence a baby’s health at birth, such as immunisations, nutrition, healthcare access, community engagement and technological innovation. The government hopes to lower neonatal mortality rates and guarantee that every newborn has the chance to flourish and realise their full potential by placing a high priority on neonatal health and putting tailored initiatives into place.

The government’s determination to “Surakshit Matritva Aashwasan” for the women by establishing a responsive healthcare system that aims to achieve zero preventable maternal and newborn deaths is reinforced by India’s success in lowering the MMR. 

The Government of India envisions that, as the nation celebrates “Amrit Kaal,” maternal and neonatal mortality will no longer be an issue. With the introduction and careful implementation of numerous initiatives and healthcare facilities, this vision is quickly becoming a reality.

The improvement in a few key health-related variables, as shown below, is indicative of an effective health approach.