Universalising the Facility of Institutional Delivery
As per National family Health Survey (NFHS-IV 2015-16), institutional delivery in rural areas is 75.1%. Data on Institutional delivery being conducted in rural areas is not being captured through survey data on a yearly basis. As per data available through National Family Health Survey (NFHS), Institutional delivery in rural areas has increased from 31.1% in 2005-06(NFHS-III) to 75.1% in 2015-16(NFHS-IV).
The key strategies and interventions being implemented to universalize the facility of institutional delivery in the country is given below:
Under National Health Mission, the key steps taken by Government of India to universalize the facility of institutional delivery in the country are:
• Promotion of institutional deliveries through Janani Suraksha Yojana (JSY), a conditional cash transfer scheme.
• Janani Shishu Suraksha Karyakaram (JSSK) entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery, including caesarean section. Similar entitlements have been put in place for all sick infants accessing public health institutions for treatment.
• Operationalization of Sub-Centers, Primary Health Centers, Community Health Centers and District Hospitals for providing 24x7 basic and comprehensive obstetric care.
• Capacity building of health care providers in basic and comprehensive obstetric care with a strategic initiative “Dakshata” to enable service providers in providing high quality services during childbirth at the institutions
• Mother and Child Tracking System is being implemented to ensure antenatal, intranatal and postnatal care along-with immunization services.
• Engagement of more than 9.90 lakh Accredited Social Health Activists (ASHAs) to generate demand and facilitate accessing of health care services by the community.
• Establishing Maternal and Child Health (MCH) Wings at high caseload facilities to improve the quality of care provided to mothers and children.
• Newer interventions to reduce maternal mortality and morbidity- Diagnosis & management of Gestational Diabetes Mellitus, Hypothyroidism during pregnancy, 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 strengthening intra-partum care.
• The Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) has been introduced with the aim of conducting special ANC checkups for pregnant women (in their 2nd / 3rd Trimesters of pregnancy) in the country on 9th of every month by Medical Officer/OBGY specialist in the government health facilities and also through Private sector on voluntary basis for tracking of high risk pregnancy to ensure institutional deliveries.
• Enhancing the availability of human resources particularly in high priority districts(HPDs) through a slew of measures like - improving retention of specialists, medical officers and nursing personnel particularly in difficult areas through special incentives; hiring of contractual personnel including MOs and Nurses particularly for operationalization of comprehensive RMNCH services at Delivery Points
• To sharpen the focus on the low performing districts, 184 High Priority Districts (HPDs) have been prioritized for Reproductive Maternal New-born Child Health+ Adolescent (RMNCH+A) interventions for achieving improved maternal and child health outcomes.
• The government has framed a set of Performance Based Incentives for the human resource working in these HPDs.
• Referral transport for pregnant women, sick neonates and sick infants is being provided by the States as per their local needs, using different models i.e. 108/102 which include a network of emergency response vehicles using toll free number, government ambulances, available transport under public private partnership etc.
The Minister of State (Health and Family Welfare), Sh Faggan Singh Kulaste stated this in a written reply in the Rajya Sabha here today.
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MV/LK