Public Health is a State subject. However, to reduce infant mortality and still birth, various programmes and schemes under National Health Mission are implemented by States/ UTs as follows:
Promotion of Institutional deliveries through cash incentive under Janani Suraksha Yojana (JSY) and Janani Shishu Suraksha Karyakaram (JSSK) entitles all pregnant women (PW) delivering in public health institutions to free ante-natal check-ups, delivery including Caesarean section, post-natal care and treatment of sick infants till one year of age.
Strengthening of delivery points for providing comprehensive and quality Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) Services, ensuring essential newborn care at all delivery points, establishment of Special Newborn Care Units (SNCU), Newborn Stabilization Units (NBSU) and Kangaroo Mother Care (KMC) units for care of sick and small babies.
India Newborn Action Plan (INAP) was launched in 2014 to make concerted efforts towards attainment of the goals of “Single Digit Neonatal Mortality Rate” and “Single Digit Still birth Rate,” by 2030. Comprehensive Lactation Management Centres (CLMCs) at facilities with SNCU and Lactation Management Units (LMUs) at Sub-district level are made functional to ensure availability of Human Milk for feeding small newborns. Home Based Newborn Care (HBNC) and Home Based Care of Young Children (HBYC) are provided by ASHAs to improve child rearing practices.
Early initiation and exclusive breastfeeding for first six months and appropriate Infant and Young Child Feeding (IYCF) practices are promoted in convergence with Ministry of Women and Child Development. Village Health and Nutrition Days (VHNDs) are observed for provision of maternal and child health services and creating awareness on maternal and child care including health and nutrition education. Mothers’ Absolute Affection (MAA) programme for improving breastfeeding practices (Early Initiation Breastfeeding within one hour, Exclusive Breastfeeding up to six months and initiation of complementary feeding at six months of age with continued breastfeeding up to two years or beyond) through mass media campaigns and capacity building of health care providers in health facilities as well as in communities.
Universal Immunization Programme (UIP) is supported to provide vaccination to children against life threatening diseases such as Tuberculosis, Diphtheria, Pertussis, Polio, Tetanus, Hepatitis B, Measles, Rubella, Pneumonia and Meningitis caused by HaemophilusInfluenzae B. “Mission Indradhanush and Intensified Mission Indradhanush” was launched to immunize children who are either unvaccinated or partially vaccinated, i.e., those that have not been covered during the rounds of routine immunization for various reasons.
LaQshya a Labour Room quality improvement programme is implemented in over 2100 health facilities across the country including medical colleges.
Pradhan MantriSurakshitMatritvaAbhiyan (PMSMA) is implemented to provide fixed-day assured, comprehensive and quality antenatal care universally to all pregnant women on the 9th of every month.
Universal screening of pregnant women including anaemic pregnant women is carried out at all public health facilities and 180 iron & folic acid (IFA) tablets are given in the antenatal and 180 IFA tablets are given in the post-natal period to all pregnant women. Double doses tablets are given as a part of treatment regimen to those found to be clinically anaemic.
Guidelines on standardization of Labour Rooms and creation of Obstetric HDU and Obstetric ICU at District Hospitals and Medical Colleges has also been prepared and disseminated to the States for improving quality of care during delivery and child birth.
Name based tracking of mothers and children till two years of age (Mother and Child Tracking System) is done to ensure complete antenatal, intranatal, postnatal care and complete immunization as per schedule.
Rashtriya Bal SwasthyaKaryakram (RBSK) for health screening, early detection of birth defects, diseases, deficiencies, development delays and early intervention services has been operationalized to provide comprehensive care to all the children in the age group of 0-18 years in the community.
Nutrition Rehabilitation Centres (NRCs) have been set up at public health facilities to treat and manage the children with Severe Acute Malnutrition (SAM) admitted with medical complications.
Iron and folic acid (IFA) supplementation for the prevention of anemia among the vulnerable age groups, home visits by ASHAs to promote exclusive breast feeding and promote use of ORS and Zinc for management of diarrhoea in children under Intensified Diarrhoea Control Fortnight (IDCF), administration of de-worming tablets to all the children in the age group of 1-19 years during National De-worming Day (February and August) are carried out.
Health and nutrition education through Information, Education &Communication (IEC) and Behavior Change Communication (BCC) to promote healthy practices and create awareness to generate demand and improve service uptake.
To tackle the problem of anemia due to malaria, particularly in pregnant women and children, Long Lasting Insecticide Nets (LLINs) and Insecticide Treated Bed Nets (ITBNs) are distributed in endemic areas.
Dietary counseling to pregnant women is provided during ante-natal visits through the existing network of sub-centers and primary health centers and other health facilities as well as through outreach activities at Village Health & Nutrition Days (VHNDs).
Various trainings are conducted to build and upgrade the skills of healthcare providers in basic and comprehensive obstetric care of mother during pregnancy, delivery and essential new-born care.
The details of Fund released for Reproductive and Child Health Program under National Health Mission for last three financial years (2016-17, 2017-18 and 2018-19) is at Annexure-I.
Under National Health Policy, 2017, Infant Mortality Rate (IMR) target for the year 2019 is 28 per 1000 live births and Still Birth Rate is Single Digit by 2025.
As per latest Sample Registration System bulletin of Registrar General of India, the Infant Mortality Rate is 33 per 1000 live births at National level in 2017 (at Annexure-II) and Still Birth rate is 4 per 1000 birth in 2016 (at Annexure-III).
Status of Key Maternal and Child Health Indicators for the year 2018-19 is at Annexure-IV.