Parliament Question: Maternal and Newborn Health Coverage under NHM

GOVERNMENTOFINDIA MINISTRYOFHEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE LOK SABHA UNSTARREDQUESTION NO. 1145 TOBE ANSWERED ON25THJULY,2025 MATERNALANDNEWBORNHEALTHCOVERAGEUNDERNHM †1145SMT. MAHIMAKUMARIMEWAR: SHRICHINTAMANIMAHARAJ: SHRIYOGENDER CHANDOLIA: SHRIARUN GOVIL: SHRIALOK SHARMA: SHRICHHATRAPALSINGH GANGWAR: SHRIMANOJ TIWARI: SHRICHAVDAVINOD LAKHAMSHI: SHRIDILIPSAIKIA: DR. HEMANG JOSHI: SHRIPRAVEENPATEL: SMT.HIMADRI SINGH: SHRIBIBHU PRASAD TARAI: SMT.SANDHYARAY: DR. RAJESH MISHRA: SHRISHANKAR LALWANI: SHRIBHOJRAJ NAG: SHRIPPCHAUDHARY: SHRIPARBHUBHAINAGARBHAI VASAVA: SHRICAPTAINBRIJESH CHOWTA: SHRIBIDYUTBARAN MAHATO: SHRIJASHUBHAI BHILUBHAI RATHVA: SHRIDINESHBHAI MAKWANA: SHRIVIJAYBAGHEL: SHRIPC MOHAN: SHRIRAMESH AWASTHI: SHRIDULU MAHATO: SHRILUMBARAM CHOUDHARY: SMT.SMITAUDAYWAGH: SMT.APARAJITASARANGI: SHRIBHARATSINHJISHANKARJI DABHI: SHRIJANARDAN MISHRA: DR. PRASHANTYADAORAO PADOLE: SHRIKHAGEN MURMU: DR. BHOLASINGH:SHRIBHARTRUHARI MAHTAB: DR. HEMANTVISHNU SAVARA: SHRIHASMUKHBHAI SOMABHAIPATEL: SHRIMITESH PATELBAKABHAI: SMT.KAMLESH JANGDE: MSKANGNARANAUT: SHRIRAJKUMAR CHAHAR: SHRIGODAM NAGESH: DR. SANJAYJAISWAL: SHRIRODMALNAGAR: SMT.SHOBHANABEN MAHENDRASINHBARAIYA: Will the Ministerof HEALTHANDFAMILYWELFAREbe pleasedtostate: (a)the keymeasures/initiatives beingtakenaswell asthe mannerinwhich the Government is working to improve the outcomes of maternal and neonatal health under the National Health Mission (NHM) and related schemes in the country, State-wise including Jharkhand, Rajasthan, Maharashtra andJalgaon district of Maharashtra; (b) the details of achievements made by India in the field of elimination and control of major communicable/ infectious diseases, particularly in the State of Jharkhand and Maharashtra including Sirohidistrict of Rajasthan, tribal dominatedarea of Palghardistrict inMaharashtra underthe Ayushman Bharat Yojana; (c)the detailsof progress made byAyushman Bharat Yojana inensuring healthcoverage for all citizens across the country, including the State of Chhattisgarh particularly in Sidhi Lok SabhaConstituency inMadhya PradeshandJalgaon LokSabhaConstituency inMaharashtra; (d) the details of the role of community participation, ASHA Workers and local health institutions inimprovingmaternal andchildhealthoutcomesinthe country; and (e) whether the Government has taken any special measures to enhance infrastructure, diagnostics and human resources in public health facilities across Maharashtra and whether Jalgaon isincludedinsuch development plans, if so, the detailsthereof? ANSWER THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND FAMILY WELFARE (SMT. ANUPRIYAPATEL) (a): The Government of India has undertaken various measures/initiatives under the National HealthMission (NHM) toimprove maternaland neonatalhealthoutcomesacross the country, including in the State of Jharkhand, Rajasthan and Maharashtra (including Jalgaon district), keyamongst which are asfollows:  Janani Suraksha Yojana (JSY) isa demand promotion andconditional cash transfer scheme for promotinginstitutional delivery. JananiShishuSuraksha Karyakram(JSSK)entitlesallpregnantwomen delivering in public health institutions to have free and no-expense delivery, including caesarean section. Theentitlementsincludefree drugsandconsumables,free dietduring thestay, free diagnostics, free transportation and free blood transfusion, if required. Similar entitlementsare also inplace for sick infants.  Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) provides pregnant women a fixed day, free of cost, assured and quality antenatal checkup by a Specialist/Medical Officeronthe 9thdayof everymonth. ExtendedPMSMAstrategy focuses on quality antenatal care (ANC) for pregnant women, especially high-risk pregnant (HRP) women and individual HRP tracking with financial incentivization for the identified high-risk pregnant women and accompanying AccreditedSocial Health Activists (ASHAs) for extra 3visits overand above the PMSMAvisit.  Surakshit Matritva Aashwasan (SUMAN) aims to provide assured, dignified, respectful and quality healthcare at no cost and zero tolerance for denial of services for every woman and newborn visiting a public health facility, to end all preventable maternalandnewborn deaths.  Optimizing Postnatal Care aims 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 & treatment of such high-risk postpartum mothers.  Monthly Village Health, Sanitation and Nutrition Day is an outreach activity at Anganwadi centers for provision of maternal and child care including nutrition in convergence with the IntegratedChild DevelopmentScheme (ICDS).  Outreach camps are provisioned to improve the reach of health care services, especially in tribal and hard-to-reach areas. This platform is used to increase awareness for Maternal andChild health services andcommunitymobilizationaswell astotrackhigh-risk pregnancies.  The establishment of Special Newborn Care Units (SNCUs) and Newborn Stabilization Units (NBSUs) under Facility Based Newborn Care (FBNC) program to provide specialized care to sick and small newborns at district and sub-district levels, addressing neonatalhealth complications.  The Mothers’ Absolute Affection (MAA) Program is implemented to promote breastfeeding practices, emphasizing the importance of early initiation of breastfeedingandexclusive breastfeedingfor first six months.  ASHAs conduct scheduled home visits under Home-Based Newborn Care (HBNC) and Home-Based Care of Young Children (HBYC), improving child-rearing practices and identifying sick newborns and young children for timely referral and care.  The SocialAwarenessandActionstoNeutralizePneumoniaSuccessfully(SAANS) initiative targets pneumonia-related childhood morbidity and mortality through enhancedawareness andearlyintervention.  STOP Diarrhoea campaign is implemented for promoting use of ORS and Zinc and for reducingmorbidityandmortality due tochildhooddiarrhoea. Anemia Mukt Bharat (AMB) strategy is implemented to reduce anemia among six beneficiaryage groups - children (6-59 months), children(5-9 years), adolescents(10- 19 years), pregnant and lactating women and women of reproductive age group (15- 49 years) in life cycle approach through implementation of six interventions via robust institutional mechanisms.  Childrenfrom 0to18yearsof age are screenedfor 32healthconditions(i.e.Diseases, Deficiencies, Defects and Developmental delay) under Rashtriya Bal Swasthya Karyakram(RBSK) toimprove childsurvival. District EarlyIntervention Centres (DEICs) at district health facility level are established for confirmation and managementof children screenedunderRBSK.  Nutrition Rehabilitation centres (NRCs) are set up at public health facilities to provide in-patient medical and nutritional care to children under 5 years suffering from SevereAcute Malnourishment (SAM) with medicalcomplications. (b): The Government of India has attained considerable achievements in elimination and control of major communicable/infectious diseases, including in the State of Jharkhand and Maharashtra and in Sirohi district of Rajasthan and Palghar district of Maharashtra, key amongst which are asfollows:  The incidence rate of Tuberculosis (TB) in India has shown an 18% decline from 237 cases per lakh population in 2015 to 195 cases per lakh population in 2023, which is more than double the global reduction, while deaths due to TB have reduced by 21% from 28 deaths per lakh population in 2015 to 22 deaths per lakh population in 2023 as per the World Health Organization’s Global TB Report, 2024. The details of TB cases notified in the country and the State of Jharkhand, Maharashtra, Palghar district of Maharashtra andSirohidistrict of Rajasthan isplacedinAnnexure-I.  The country has achieved a reduction of 78.1% in malaria morbidity and 77.6% in malaria mortality between 2015 and 2024 with Annual Parasite Incidence (API) reduced to0.18 in2024 comparedto 0.92in 2015.The malaria cases and deathsin the country have reduced by 69% and 68% respectively in 2023 in comparison to 2017 and India is no longer a High Burden to High Impact (HBHI) country as per World Malaria Report 2024.  Out of 348Lymphatic Filariasis(LF) endemicdistricts, 143(41%) have stopped Mass Drug Administration (MDA) and cleared Transmission Assessment Survey (TAS1), up from 15% in 2014. Mass Drug Administration (MDA) coverage has improved from 75% in2014to85% in2025against total population. o The State of Maharashtra has reported coverage of 90% against total and 96% against eligible population in the MDA round conducted in 34 blocks of 5 districts in Feb 2025. A total of 18,186 Morbidity Management and Disability Prevention (MMDP) kits were distributed in the State in 2024. The Palghar district of Maharashtra has attained 93% coverage in the MDA round conducted in4 blocksof the district inFeb. 2025.All 646 lymphoedema cases inPalgharwere providedMMDPkits. o The State of Jharkhand has reported coverage of 79% against total and 90% against eligible population in the MDA round conducted in 92 blocks of 14districts in Feb 2025. A total of 44,676 MMDP kits were distributed in the Statein2024. o The Sirohidistrict of Rajasthan isa non-endemic area for Lymphatic Filariasis.  All 33 Kala-azar endemic blocks in 4 tribal dominated districts (Dumka, Godda, Pakur and Sahibganj) of Jharkhand have achieved the kala-azar elimination target i.e. less thanone case per10,000 population at blocklevelduring 2023.  The Case Fatality Rate (CFR) of Japanese Encephalitis has reduced from 17.6% in 2014to7.1% in2024.  Sentinel Surveillance Hospitals (SSHs) for free diagnosis of Dengue and Chikungunya have increased from 110 in 2007 to 869 in 2025. Apex Referral Laboratories (ARLs) with advanced diagnostic facilities increased from 12 in 2007 to 27 in 2024. Out of these, 51 SSHs and 2 ARLs are in Maharashtra, 63 SSHs and 2 ARLs are inRajasthan and16SSHsand 1ARLare inJharkhand.  Under the Integrated Disease Surveillance Programme (IDSP), the surveillance of 50 plus epidemic prone diseases is carried out by paperless, case based reporting through Integrated Health Information Platform (IHIP). IHIP provides Geotagging of the individual cases reported in outbreaks for visual geospatial analysis, along with heat map. This helps in health preparedness of the States for early detection and quick response.  The vertical transmission rate of HIV hasdeclined byaround74.5% nationally andby around 78% in Jharkhand, 83% in Maharashtra, and 67% in Rajasthan between 2010 and 2024 as per India HIV Estimates 2025. The global rate of vertical transmission declineisaround56.5% inthe same reference period. (c): The details of Ayushman cards created under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in the country as on 30th June 2025, State-wise including Chhattisgarh is enclosed in Annexure-II. Under AB-PMJAY, district-wise data is maintained and in district Sidhi 7.52 lakh and in Singrauli 7.61 lakh Ayushman cards were created in Sidhi Lok Sabha Constituency of Madhya Pradesh and in district Jalgaon 11.87 lakh cards were createdinJalgaon Lok SabhaConstituency of Maharashtra ason 30thJune 2025. (d): Under NHM, community-based platforms such as Village Health Sanitation and Nutrition Committee (VHSNC), Jan Arogya Samiti (JAS), andMAS (Mahila Arogya Samiti) are utilized to facilitate and improve community participation and engagement. The Village Health Sanitation and Nutrition Days (VHSND) platform is also utilized to deliver maternal andchildhealthcare services at the communitylevel. At the community level, ASHAs serve as critical links between communities and the public health system by ensuring increased access to maternal and child healthcare services by mobilizing women for antenatal check-ups, institutional deliveries, and postnatal care, contributing to the improved maternal and child health outcomes. ASHAs also conduct home visits for identification of danger signs, counsel mothers on optimal feeding practices etc. under Home-Based Newborn Care (HBNC) and Home-Based Care for Young Children (HBYC) programmes.The local health institutions have an important role in improving maternal and newborn health ouctomes. The local health institutions are the first point of contact for communities, especially in rural areas. The primary healthcare teams at Ayushman Arogya Mandir (AAM), including frontline workers, deliver comprehensive primary healthcare through 12 packages of services. These services include care in pregnancy and childbirth, neonatal and infant health care services, and childhood and adolescent health care services at the community level. The Sub Health Centres (SHC)-AAM, Primary Health Centres (PHC)-AAM and Community health Centres (CHCs) deliver essential maternal and child health services, including antenatal care, safe deliveries, immunization, postnatal care, nutrition and health counselling. (e): The Government of India through the National Health Mission (NHM) provides support to all States/UTs including Maharashtra to strengthen their healthcare system. The support is based on the State Programme Implementation Plans (SPIPs) submitted by Maharashtra, which would include healthpriorities of allof itsdistricts, includingJalgaon. The schemes/initiatives underNHM to strengthen healthcare systems includesupgradation of existing Sub Health Centers (SHCs) and Primary Health Centers (PHCs) to Ayushman Arogya Mandir (AAM) to deliver universal, free comprehensive primary healthcare services, with a focus on wellness and the delivery of an expanded range of services closer to the community. The diagnostic services are being provided free of cost to all beneficiaries availing the services at Public Health Facilities. The state of Maharashtra implements the Free Diagnostics LaboratoryServices and Tele-radiology services for x-ray reporting through Public Private Partnership (PPP) mode in all the districts including Jalgaon. The State also implements the Hemodialysis (HD) services under Pradhan Mantri National Dialysis Program (PMNDP) through mix mode (i.e. In-house as well as PPP-mode) in all 36 districts includingJalgaon. The Government has taken several policy-level measures to address the shortage of healthcare professionals in the country. Medical and Nursing colleges have increased resulting in increase in the availability of Human Resource for Health (HRH) in the rural public healthfacilities with NHM funding support. *****Annexure referred to in reply to part (b) of Lok Sabha Unstarred Q. No. 1145 to be answered on25.07.2025 Annexure-I Number of TB cases notified in the country and in the States of Jharkhand, Maharashtra, Palghar district of Maharashtra and Sirohi district of Rajasthan in 2024 and2025(till June 2025). Numberof TB Cases notified State/District January toDecember2024 January toJune 2025 India 26,17,923 13,95,911 Jharkhand 63,670 34,982 Maharashtra 2,30,163 1,14,300 District Palghar, Maharashtra 2,882 1,267 District Sirohi, Rajasthan 2,481 1,389Annexure referred to in reply to part (c) of Lok Sabha Unstarred Q. No. 1145 to be answered on25.07.2025 Annexure-II State/UT-wise number of Ayushman cards created under Ayushman Bharat Pradhan MantriJanArogyaYojana(AB-PMJAY)ason30thJune,2025 S.No. States/UTs Ayushmancards created 1 AndamanandNicobar Islands 80,093 2 Andhra Pradesh 1,61,70,534 3 Arunachal Pradesh 1,61,828 4 Assam 1,74,49,682 5 Bihar 3,91,99,682 6 Chandigarh 2,82,361 7 Chhattisgarh 2,37,31,624 8 Delhi 3,88,412 9 Dadra andNagar Haveli andDamanandDiu 4,45,800 10 Goa 94,511 11 Gujarat 2,82,88,362 12 Haryana 1,35,29,909 13 HimachalPradesh 14,10,402 14 Jammu andKashmir 87,09,601 15 Jharkhand 1,26,65,623 16 Karnataka 1,85,81,649 17 Kerala 83,75,566 18 Ladakh 1,96,591 19 Lakshadweep 36,563 20 Madhya Pradesh 4,35,66,400 21 Maharashtra 3,17,60,601 22 Manipur 6,82,035 23 Meghalaya 20,81,597 24 Mizoram 5,83,088 25 Nagaland 7,48,095 26 Odisha 3,46,19,714 27 Puducherry 5,37,951 28 Punjab 90,85,672 29 Rajasthan 2,25,93,582 30 Sikkim 90,403 31 TamilNadu 81,69,255 32 Telangana 83,26,118 33 Tripura 21,32,382 34 Uttar Pradesh 5,33,20,357 35 Uttarakhand 60,39,029