Parliament Question: Infant and Maternal Mortality in Katihar

GOVERNMENTOFINDIA MINISTRYOFHEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE LOK SABHA UNSTARREDQUESTION NO. 3427 TO BE ANSWERED ON08.08.2025 INFANTAND MATERNALMORTALITYIN KATIHAR 3427: SHRITARIQANWAR : Will the Ministerof HEALTH AND FAMILYWELFAREbe pleasedtostate: (a) whether special arrangements have beenmade for disease control thisyearinviewof the increase in incidence of Acute Encephalitis Syndrome in Katihar district of Bihar and if so, the detailsthereofalong with the numberof vaccinationcampsconductedso far; (b) the current status of maternal childhealthservices (especiallypre-natal care and institutional delivery) in community health centres if the said district and the targeted programmesbeingundertakento reduce infant andmaternalmortalityrates; (c) the data available regarding availability and effectiveness of mobile medical units in remote rural areasof Katihar district andthe plantoincrease theirnumber; and (d) the detailsof the information about the functioningandavailability of Nutrition RehabilitationCentres (NRCs)to reduce the malnutritionrate inthe said district? ANSWER THE MINISTER OFSTATEIN THE MINISTRYOFHEALTH AND FAMILY WELFARE (SMT.ANUPRIYAPATEL) (a) The Integrated Disease Surveillance Programme (IDSP) at National Center for Disease Control (NCDC) was initiated in the year 2004, and is mandated with surveillance & response to outbreak prone communicable diseases in the country. Under this program there is a Central surveillance Unit (CSU) at Central level, State Surveillance Unit (SSU) at the State/UTs level and District Surveillance Unit (DSU) at district level. The program is responsible for the Surveillance of 50 plus epidemic prone diseases including Acute Encephalitis Syndrome (AES). The surveillance tool consists of S (Syndromic) form filled byAuxiliary Nurse Midwife (ANMs) at the Sub-centre level, P(Presumptive) form filled bymedical officers at health facility levelandL(Laboratory confirmed)form filled bylaboratoriesasperstandard case definitions. As per Integrated Disease Surveillance Programme - Integrated Health Information Platform (IDSP-IHIP) Report, no AES case has been reported from Katihar district during last 3.5years(2022–2025). The Katihar district isunderRoutine Immunization(RI). (b) The district of Katihar has one Special Newborn Care Unit (SNCU), one Newborn Stabilization Unit and one Paediatric Care Unit to provide care to sick and critically ill childrenat facility level. The Ministry of Health and Family Welfare (MoHFW) supports in implementation of Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition (RMNCAH + N)strategy under National Health Mission (NHM) based on the Annual Program Implementation Plan (APIP) submitted by respective State / UT. The details of interventions to improve child health outcome all across the country including Stateof Bihar, are placed as below:  Facility Based Newborn Care: Special New-born Care Units (SNCUs) are established at District Hospital and Medical College level, Newborn Stabilization Units (NBSUs) are established at First Referral Units (FRUs)/ Community Health Centres (CHCs) for care of sick andsmall babies.  Community Based care of Newborn and Young Children: Under Home Based New- born Care (HBNC) and Home-Based Care of Young Children (HBYC) program, home visits are performed by ASHAs to improve child-rearing practices and to identify sick newborn andyoungchildreninthe community.  Janani Shishu Suraksha Karyakram (JSSK): Sick infant up to one year of age is entitled to free treatment in public health institutions along with the provision of free transport, diagnostics, medicines, bloodandconsumables.  Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS) initiative implemented since 2019 for reduction of childhood morbidity and mortality due to Pneumonia.  STOPDiarrhoea campaign is implemented for promoting use of ORS and Zinc and for reducingmorbidityandmortality due tochildhooddiarrhoea.  Rashtriya Bal Swasthya Karyakram (RBSK): Children from 0 to 18 years of age are screenedfor 32 healthconditions(i.e.Diseases, Deficiencies, DefectsandDevelopmental delay) under Rashtriya Bal Swasthya Karyakram (RBSK) to improve child survival. District Early Intervention Centres (DEICs) at district health facility level are established for confirmationandmanagement of childrenscreened underRBSK. Under National Health Mission (NHM), Government of India implements the followings schemes/program to provide maternal health services including services for antenatal care and institutional delivery to reduce the maternal mortality among all States/UTs including Katihardistrict of Bihar-  Surakshit Matritva Aashwasan (SUMAN) provides assured, dignified, respectful and quality healthcare at no cost and zero tolerance for denial of services for every woman and newborn visiting public health facilities to end all preventable maternal and newborn deaths.  Janani Shishu Suraksha Karyakram (JSSK) entitles every pregnant woman to free delivery, including caesarean section, in public health institutions along with the provision of free transportation, diagnostics, medicines, blood, other consumables and diet.  Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) provides pregnant women a fixed day, free of cost assured and quality antenatal check up by an Obstetrician/Specialist/Medical Officeronthe 9thdayof everymonth. ExtendedPMSMAstrategy ensures qualityANC topregnant women, especiallyto high-risk pregnancy(HRP)women andindividual HRPtrackingtill a safe deliveryisachievedby meansof financialincentivization for the identifiedhighrisk pregnant women and accompanyingASHAfor extra 3 visits overandabove the PMSMAvisit.  OptimizingPostnatal Careaims to strengthen the quality of post-natal care by laying emphasis on detection of danger signs in mothers and incentivization of ASHAs for prompt detection,referral & treatmentof such high-risk postpartum mothers. Monthly Village Health, Sanitation and Nutrition Day (VHSND) an outreach activity at Anganwadi centres ensures provision of maternal and childcare including nutrition in convergence with the IntegratedChild DevelopmentServices (ICDS).  Mother and Child Protection (MCP) Card and Safe Motherhood Booklet are distributed to the pregnant women for educating them on diet, rest, danger signs of pregnancy, benefitschemesandinstitutional deliveries.  Janani Suraksha Yojana (JSY) is a safe motherhood intervention under the National Health Mission, implemented with the objective of reducing maternal and neonatal mortality by promoting institutional delivery among pregnant women. It is a centrally sponsored scheme,which integratescash assistance with deliveryandpost-delivery care. (c) Public Health and Hospitals is a State Subject and the responsibility for strengthening of healthcare system including Mobile Medical Unit(MMU) in remote rural areas lies with respective State/Union Territory Governments. The key objective of the Mobile Medical Units is to reach the population in remote, difficult, underserved and inaccessible areas with a set of preventive, promotive and curative services, including but not limited to Reproductive Child Health(RCH) Services.These services arefreeforthepatientatthePoint ofCare. NationalHealth Mission(NHM)providestechnicalandfinancial supporttotheStates/UnionTerritoriesforMMUs. Ministry of Health and Family Welfare provides support to the States based on the proposal submitted by States in PIP (Program Implementation Plan) based on the respective State’s requirement every year. As per the report of NHM MIS December,2024, there is no Mobile MedicalUnitinBiharunderNHM. (d) The Ministry of Health and Family Welfare has established Nutrition Rehabilitation Centres (NRCs) at public health facilities to provide in-patient medical and nutritional care to children under 5 years suffering from Severe Acute Malnourishment (SAM) with medical complications, across the country including Katihar district of Bihar. In addition to the curative care, efforts are made to build capacities of the mothers/caregivers through counselling and support on timely, adequate and age-appropriate feeding practices during admission in NRC. As per the report received from the State of Bihar for FY2024-25, one NRC is functionalat District Hospital in Katihar district with admissions of 280 children under 5 years suffering from Severe AcuteMalnutrition(SAM)withmedicalcomplications. *****