Parliament Question: Institutional Child Deliveries

GOVERNMENTOFINDIA MINISTRYOFHEALTH ANDFAMILYWELFARE DEPARTMENTOFHEALTHAND FAMILYWELFARE LOK SABHA STARREDQUESTION NO. 182 TOBE ANSWERED ON1ST AUGUST,2025. INSTITUTIONALCHILD DELIVERIES *182: SHRI CHAMALAKIRAN KUMAR REDDY: SMT. D.K. ARUNA: Will the Minister of HEALTH ANDFAMILYWELFARE be pleased to state: (a) whether the Government is aware that ever since the launch of National Rural Health Mission (NRHM), institutional child deliveries have increased in the country, if so, the details thereof and the reasons therefor; (b) whether the Government has taken note of the hardships being faced by the pregnant women for transportation that from rural/forest areas and far away islands to reach a proper health facility centre for child-birth/delivery; (c) if so, the number of such cases reported and the corrective measures taken/being taken and the results achieved therefrom since the past six years; and (d) the amount of funds sanctioned and utilised for the purpose during the said period till date, State-wise including Uttar Pradesh, Himachal Pradesh and Telangana? ANSWER THE MINISTER OFHEALTHAND FAMILYWELFARE (SHRIJAGATPRAKASH NADDA) (a)to (d): Astatement islaidonthe Table of the HouseSTATEMENTREFERRED TOIN REPLYTO LOK SABHASTARREDQUESTION NO.*182 FOR1STAUGUST, 2025 ****** (a): Under NHM, institutional deliveryincreased from 38.7% inNFHS-3 (2005-06) to 88.6% in NFHS-5 (2019-21). The programmatic interventions, which led to the increase in institutional deliveries incountry,include schemesasmentionedbelow:  Janani Suraksha Yojana (JSY) is a safe motherhood intervention under the National Health Mission, implemented with the objective of reducing maternal and neonatal mortalitybypromoting institutional delivery amongpregnantwomen. It isa centrally sponsored scheme, which integrates cash assistance with delivery and post- deliverycare.  Janani Shishu Suraksha Karyakram (JSSK) under which every pregnant woman and sick infant is entitled to free delivery, including caesarean section in public health institutions along with the provision of free transport, diagnostics, medicines, blood,otherconsumables& diet.  Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) provides pregnant women a fixed day, free of cost assured and quality antenatal check up by a Specialist/Medical Officer on the 9th day of every month. Extended PMSMA(e- PMSMA) enables individual High Risk Pregnancy (HRP) tracking for pregnant women.  LaQshya (Labour Room Quality Improvement Initiative) improves the quality of care in labour room and maternity operation theatres to ensure that pregnant women receiverespectful and qualitycare during deliveryandimmediate post-partum.  Surakshit Matritva Aashwasan (SUMAN) provides the assured, dignified, respectful and quality healthcare at no cost and provision of services for every woman and newborn visiting the public health facilityfocussing towards preventable maternalandnewborn deaths.  OptimizingPostnatal Care strengthens the quality of postnatal care by laying emphasis on detection of danger signs in mothers and incentivisation of Accredited Social Health Activists (ASHAs) for prompt detection, referral & treatment of such high-risk postpartum mothers.  Functionalization of First Referral Units (FRUs) by ensuring manpower, blood storage units, referral linkages to improve the access to quality of care for pregnant women.  Setting up of Maternal and Child Health(MCH) Wings at high caseload facilities toimprove the quality of care providedtomothersandchildren.  Operationalization of Obstetric High Dependency Units & Intensive Care Units (Obst. HDU & ICU) in high case load tertiary care facilities across the country to handle complicated pregnancy.  Birth Waiting Homes (BWH) are established in remote and tribal areas to promote institutional delivery andimprove accesstohealthcarefacilities. Village Health Sanitation and Nutrition Days (VHSNDs) are observed for provision of maternal and child health services and creating awareness on maternal and child-care including nutrition inconvergence with Ministry of Women and Child Development.  Outreach camps are provisioned for improving the reach of health care services especially in tribal and hard to reach areas. This platform is used to increase the awareness for the Maternal and Child health services, community mobilization as well astotrackhigh-risk pregnancies.  Under Pradhan MantriMatru Vandana Yojana (PMMVY) scheme of Ministry of Women and Child Development, cash incentives are directly provided in the Bank/Post Office account of the eligible beneficiary for the first child and second child(subject tothe second childbeinga girl), afterthe institutional delivery. (b) and(c): Tofacilitatethe institutional childdelivery, following measures have beentaken:  National Ambulance Service: National Ambulance Services (NAS) under NHM, providestwotypesofambulanceservices:108(ALS/BLS)and102(PatientTransport Vehicle- PTV). Dial 108 is an emergency response system, primarily designed to attend to critical care patients, trauma, and accident victims etc, while Dial 102 servicesprovidesbasic patienttransportationforpregnantwomen,mothers,newborns andchildrentoandfromhealthfacilities.  In geographically challenging areas, innovative solutions such as bike and boat ambulances are deployed to enhance the access and coverage by the State/UTs, as applicable.  Mobile Medical Unit: Under the National Health Mission (NHM), Government of India provides financial and technical support to States/UTs to strengthen their healthcare systems. In order to provide services at the doorsteps of population living in the most remote and hard-to-reach areas, States are supported with Mobile Medical Units (MMUs).  Janani Shishu Suraksha Karyakram (JSSK) entitles all pregnant women delivering in public health institutions to have free and no-expense delivery, including free transportation from home to healthcare facilities, inter-facilities and drop back from healthcare facilities to home. The States/UTs provide, as per requirement, alternative modesof transportation under JSSKsuch as, Palki,Boat and Air Ambulance in tribal, rural and hard-to-reach areas. Details of Pregnant women who availed JSSK services for free Home to facility transport, Inter-facility transfers andDrop Backhome isplacedat Annexure-I. (d): The State-wise details including Uttar Pradesh, Himachal Pradesh and Telangana for the expenditure inlast six yearsisplaced at Annexure-II. *****ANNEXURE-I Details of Pregnant women who availed JSSK services for free Home to facility transport, Inter-facility transfers, and Drop Back home Financial Year 2019-20 2020-21 2021-22 2022-23 2023-24 2024-25 (Provisional) Number of Pregnant Women provided - 49,26,653 54,42,079 58,08,138 65,14,137 45,95,707 50,98,464 Free Home to facility transport under JSSK Number of Pregnant Women provided – Inter-facility transfers 9,43,400 11,77,852 11,74,753 12,25,238 11,61,737 14,00,978 when needed under JSSK Number of Pregnant Women provided - 49,49,666 53,46,898 58,73,543 65,72,141 51,27,058 55,59,334 Free Drop Back home under JSSKANNEXURE-II State/UT-wise Expenditure for Referral Transport under NHM from FY2019-20 to FY2024-25 (Rs. in Lakhs) Sl. No. States 2019-20 2020-21 2021-22 2022-23 2023-24 2024-25 Andaman & Nicobar 1 72.68 0.00 0.00 0.00 0.00 0.00 Islands 2 Andhra Pradesh 2,023.97 9,468.01 9,295.20 3,470.32 4,021.36 950.88 3 Arunachal Pradesh 85.69 427.16 1,075.50 1,956.90 2,189.98 2,898.91 4 Assam 3,819.91 4,976.62 10,524.18 10,847.05 12,817.01 13,573.89 5 Bihar 1,625.99 5,009.52 7,506.29 8,831.67 15,224.08 14,903.50 6 Chandigarh 72.00 0.00 0.00 100.80 133.60 198.30 7 Chhattisgarh 8,280.29 9,700.25 11,472.46 8,695.28 12,122.61 11,471.47 Dadra & Nagar Haveli 0.00 8 0.00 0.85 0.26 0.00 0.00 Daman & Diu 0.52 9 Delhi 299.74 0.00 0.00 1,725.63 1,463.80 0.00 10 Goa 180.00 505.86 545.40 445.18 452.00 489.77 11 Gujarat 3,697.08 6,264.00 3,200.00 7,207.00 13,083.00 13,371.61 12 Haryana 4,747.14 1,082.17 4,367.78 5,504.87 6,418.70 5,953.21 13 Himachal Pradesh 2,025.88 3,229.80 3,342.60 2,847.77 2,808.49 1,566.35 14 Jammu & Kashmir 15.00 2,181.83 2,111.31 3,520.04 3,551.13 4,406.11 15 Jharkhand 7,826.82 3,568.92 3,698.35 2,942.81 5,793.03 4,801.25 16 Karnataka 3,847.86 2,596.86 5,097.72 4,336.20 6,375.49 5,782.97 17 Kerala 0.00 4,544.24 4,571.81 4,091.38 3,419.70 1,400.00 18 Lakshadweep 0.00 0.00 0.00 0.00 0.00 0.00 19 Madhya Pradesh 15,206.43 9,248.86 8,712.29 22,338.33 37,840.44 39,329.06 20 Maharashtra 2,532.02 117.24 86.31 0.00 193.34 0.00 21 Manipur 78.61 121.30 34.99 57.98 28.10 37.96 22 Meghalaya 39.53 148.34 179.28 641.35 0.08 0.67State/UT-wise Expenditure for Referral Transport under NHM from FY2019-20 to FY2024-25 (Rs. in Lakhs) 23 Mizoram 14.91 21.96 11.06 6.61 8.36 126.48 24 Nagaland 65.96 41.65 34.92 104.38 21.87 54.16 25 Orissa 7,407.07 7,264.67 9,369.31 10,291.57 11,531.46 9,331.87 26 Puducherry 32.44 32.77 45.34 48.42 28.01 23.06 27 Punjab 1,307.58 9.41 0.00 0.00 0.00 0.00 28 Rajasthan 2,350.20 7,435.29 7,497.11 13,509.28 18,505.00 23,706.58 29 Sikkim 174.96 117.94 436.16 204.15 168.89 141.19 30 Tamil Nadu 4,632.88 3.82 6,710.98 5,796.09 5,222.92 5,880.00 31 Telangana 758.00 2,889.61 3,945.30 7,297.20 8,105.17 9,967.43 32 Tripura 1.64 895.96 955.14 1,023.80 1,185.97 1,188.16 33 Uttar Pradesh 60,361.31 44,244.73 47,817.75 85,625.43 1,01,245.56 82,533.07 34 Uttarakhand 1,556.11 1,920.73 3,827.29 4,072.35 2,934.11 5,022.42 35 West Bengal 7,838.04 8,828.79 11,992.15 13,794.39 15,507.34 15,293.48 36 Ladakh 0.00 0.00 98.75 217.42 519.37 432.52 Note: (1) The above data is as per the available Financial Management Reports submitted by State/UTs and are provisional. (2) Expenditure includes expenditure against Central Release, State release & unspent balances at the beginning of the year.