**Executive Summary**
This document addresses Lok Sabha Unstarred Question No. 941, to be answered on December 5th, 2025, concerning postpartum hemorrhage (PPH) care in India. It provides information on maternal deaths attributed to PPH, the implementation of WHO guidelines, and specific details related to PPH management in the Konaseema district of Andhra Pradesh. The report includes data on training programs, facility readiness, monitoring mechanisms, and allocated funds for PPH prevention and management.
**Key Points / Main Content**
* **Maternal Deaths due to PPH:**
* Percentage of maternal deaths attributed to PPH in India and states, including Konaseema district of Andhra Pradesh, are provided for the last three years (FY 2022-23 to FY 2024-25) as per Health Management Information System (HMIS) data (Annexure I).
* **Implementation of WHO Guidelines:**
* The Government of India has implemented multiple strategies through the National Health Mission to prevent PPH-related deaths.
* WHO recommendations on PPH management are already implemented in the Indian context as appropriate.
* **PPH Management in Konaseema District:**
* Healthcare providers receive competency-based training (SBA, Dakshata, BEmONC, CEmONC) including skill-drills and on-site mentoring simulations.
* Training focuses on AMTSL, administration of uterotonics, management of atonic PPH, shock management, and emergency preparedness.
* All delivery points are equipped with essential medicines and equipment as per Government of India guidelines. Facility readiness assessments are conducted periodically.
* Adherence to PPH protocols is monitored through mechanisms like MDSR, Dakshata, and CEmONC supportive supervision visits. District-wise performance is reviewed monthly at the state level.
* Key indicators monitored include uterotonics availability, AMTSL protocol adherence, tranexamic acid administration, response time, and documentation quality.
* Details of funds allocated, released, and utilized under centrally sponsored schemes for the prevention and management of PPH during the last three years, including information for Konaseema district are provided in Annexure II.
**Impact Analysis**
**Ministry of Health and Family Welfare:**
* **Impact:** Required to compile and provide data on PPH-related maternal deaths, the implementation of WHO guidelines, and specific details regarding PPH management in the Konaseema district.
* **Action Required:** Ensure continued monitoring and reporting of PPH-related data and the effective implementation of PPH management strategies.
**State of Andhra Pradesh (Including Konaseema District):**
* **Impact:** Subject to scrutiny regarding the effectiveness of PPH management strategies, training programs, facility readiness, and fund utilization.
* **Action Required:** Continue training programs, maintain facility readiness, adhere to monitoring mechanisms, and ensure proper fund utilization for PPH prevention and management.
**Healthcare Providers:**
* **Impact:** Directly involved in implementing PPH management protocols and participating in training programs.
* **Action Required:** Attend regular competency-based trainings, adhere to standard treatment protocols, and ensure optimal facility readiness for PPH management.
Key Entities Referenced
Postpartum Haemorrhage (PPH): A significant focus of the policy, this is the primary health condition addressed by the initiatives discussed, referring to excessive bleeding after childbirth.
National Health Mission: A centrally sponsored scheme under which strategies to prevent PPH related deaths have been implemented.
Ministry of Health and Family Welfare: The primary government body responsible for the policies and initiatives discussed in the document.
Andhra Pradesh: The specific state where data is being collected and some initiatives are focused, particularly the Konaseema district.
World Health Organization (WHO): Referenced as a source for guidelines and protocols related to PPH management.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH AND FAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 941
TOBE ANSWERED ON5TH DECEMBER, 2025
POSTPARTUMHAEMORRHAGE CARE
941SHRIG M HARISH BALAYOGI:
Will the Minister of HEALTHANDFAMILYWELFARE be pleased tostate:
(a) the numberofcases ofPostpartumHaemorrhage (PPH)maternaldeathsattributedtoPPH,
percentage of maternal deaths due to PPHin the country, during the last three years, year-
wise andState-wise including Andhra Pradesh,especiallyKonaseema district;
(b) whether the Government hasadopted/plans toadopt WHO’s2025 consolidatedguidelines
on prevention, diagnosis, treatment of PPH, if so, the timeline of adoption, along with
steps takenfor itsimplementation;
(c) the details regarding training programmes, capacity building activities, simulation drills
conducted for healthcare providers in Konaseema district to align with PPH care bundles
recommendedbyWHO;
(d) the number of facilities in Konaseema districts equipped with essential medicines,
equipmenttomanage PPH,andstatus of readiness of these facilities;
(e) the amount of funds allocated, released, utilised under centrally sponsored schemes for
prevention andmanagement of PPH during last three years, year-wise anddistrict-wise in
Andhra Pradesh,especiallyKonaseema district; and
(f) the monitoringmechanism adopted totrackcompliance with PPH protocolsas perWHO-
roadmap, key indicators being captured alongwith performance data for Andhra Pradesh,
district-wise?
ANSWER
THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND FAMILY
WELFARE
(SMT. ANUPRIYAPATEL)
(a): As per Health Management Information System (HMIS), the percentage of maternal
deaths attributed to Postpartum Haemorrhage (PPH) in the country and states including
Konaseema district of Andhra Pradesh during the last three years and state wise are placed at
Annexure I(b): Under the National Health Mission, the Government of India has implemented multiple
strategies to prevent deaths related to Postpartum Haemorrhage (PPH) across the country.
The recommendations issued by the World Health Organization (WHO) are already been
implementedtothe Indiancontextasappropriate.
(c) to (f): Based on the information received from the State of Andhra Pradesh, the status of
training programmes, availability of essential medicines and equipment, monitoring
mechanism and funds allocated for the prevention and management of Postpartum
Haemorrhage (PPH)for the district Konaseema isasfollows:
Healthcare providers undergo regular competency-based trainings such as Skilled
Birth Attendant (SBA), Dakshata, Basic Emergency Obstetric and Newborn Care
(BEmONC), and Comprehensive Emergency Obstetric and Newborn Care
(CEmONC). These trainings include routine skill-drills and on-site mentoring
simulations on active management of the third stage of labour (AMTSL),
administration of uterotonics, management of atonic PPH, shock management, and
emergency preparedness. The focusis onstrengthening team-based PPH management
inalignmentwith standard treatmentprotocols.
All delivery points are equipped with essential medicines and equipment required for
PPH management in accordance with Government of India guidelines, and periodic
facility readiness assessments are undertaken to ensure optimal preparedness for PPH
management.
The State monitors adherence to PPH management protocols through multiple
mechanisms, including Maternal Death Surveillance and Response (MDSR),
Dakshata, and Comprehensive Emergency Obstetric and New-born care (CEmONC)
supportive supervision visits. District-wise performance is reviewed monthly at the
state level to ensure compliance with the Government of India’s standard treatment
protocolsfor PPHmanagement.
Key indicators monitored include availability of uterotonics, adherence to AMTSL
protocols, timely administration of tranexamic acid, response time during PPH
emergencies, andqualityof documentation.
Details of funds allocated, released, and utilised under centrally sponsored schemes
for the prevention and management of PPH during the last three years, including
informationfor Konaseema district, are providedinthe Annexure II.
*********Annexure referred in reply to part (a) of Lok Sabha Unstarred Qn. No 941 to be
answered on5.12.2025
Annexure I
Percentage of MaternalDeathsdueto PPH(Source-HMIS)
Sr. States/UTs FY2022-23 FY2023-24 FY2024-25
no.
All India 16.31 13.39 13.41
1. Andaman& NicobarIslands 0.00 0.00 33.33
2. Andhra Pradesh 13.53 6.43 8.58
3. Arunachal Pradesh 38.46 0.00 0.00
4. Assam 15.40 14.25 10.16
5. Bihar 20.25 13.38 14.45
6. Chandigarh 0.00 25.00 0.00
7. Chhattisgarh 14.41 17.14 12.23
8. Delhi 12.93 9.69 7.21
9. Goa 8.33 7.14 8.33
10. Gujarat 17.03 13.13 11.16
11. Haryana 17.47 17.75 12.46
12. Himachal Pradesh 17.39 10.00 7.14
13. Jammu and Kashmir 5.80 12.12 12.24
14. Jharkhand 18.51 14.18 13.12
15. Karnataka 16.24 12.55 19.67
16. Kerala 8.65 3.57 19.23
17. Ladakh 0.00 0.00 0.00
18. Lakshadweep 0.00 0.00 0.00
19. MadhyaPradesh 14.01 9.23 11.87
20. Maharashtra 9.67 7.26 8.30
21. Manipur 7.69 21.43 28.57
22. Meghalaya 18.35 13.01 10.29
23. Mizoram 33.33 18.18 22.22
24. Nagaland 21.43 0.00 33.33
25. Odisha 13.73 10.97 14.85
26. Puducherry 0.00 0.00 0.00
27. Punjab 5.64 10.19 8.46
28. Rajasthan 17.91 11.45 12.40
29. Sikkim 9.09 0.00 11.11
30. Tamil Nadu 7.08 14.32 13.85
31. Telangana 7.12 13.64 4.33
TheDadraand Nagar
32. 0.00 33.33
Haveliand Daman andDiu 0.00
33. Tripura 13.21 13.73 25.00
34. Uttarakhand 15.95 14.81 13.95
35. UttarPradesh 26.11 21.48 20.36
36. West Bengal 8.90 8.71 9.00Annexure referred in reply to parts (c) to (f) of Lok Sabha Unstarred Qn. No 941 to be
answered on5.12.2025
Annexure II
Budget allocated and utilised for prevention and management of PPH in the State of
AndhraPradesh (In lakhs)-Source:State Report
2022-23 2023-24 2024-25
Name of the Budget Budget Budget
S.NO Budget Budget Budget
District Utilize Utilize Utilize
Allotted Allotted Allotted
d d d
Alluri Sitharama
1 7.29 7.29 7.29 7.29 7.71 7.71
Raju
2 Anakapalli 7.29 7.29 7.29 7.29 7.71 7.71
3 Ananthapuramu 7.29 7.29 7.29 7.29 7.70 7.70
4 Annamayya 7.29 7.29 7.29 7.29 7.71 7.71
5 Bapatla 7.29 7.29 7.29 7.29 7.71 7.71
6 Chittoor 7.29 7.29 7.29 7.29 7.71 7.71
Dr. B.R.
7 Ambedkar 7.29 7.29 7.29 7.29 7.70 7.70
Konaseema
8 East Godavari 7.29 7.29 7.29 7.29 7.71 7.71
9 Eluru 7.29 7.29 7.29 7.29 7.71 7.71
10 Guntur 7.29 7.29 7.29 7.29 7.70 7.70
11 Kakinada 7.29 7.29 7.29 7.29 7.71 7.71
12 Krishna 7.29 7.29 7.29 7.29 7.71 7.71
13 Kurnool 7.29 7.29 7.29 7.29 7.71 7.71
14 Nandyal 7.29 7.29 7.29 7.29 7.71 7.71
15 NTR 7.29 7.29 7.29 7.29 7.71 7.71
16 Palnadu 7.29 7.29 7.29 7.29 7.71 7.71
Parvathipuram
17 7.29 7.29 7.29 7.29 7.71 7.71
Manyam
18 Prakasam 7.29 7.29 7.29 7.29 7.71 7.71
SriPotti Sriramulu
19 7.29 7.29 7.29 7.29 7.70 7.70
Nellore
20 SriSathya Sai 7.29 7.29 7.29 7.29 7.71 7.71
21 Srikakulam 7.29 7.29 7.29 7.29 7.70 7.70
22 Tirupati 7.29 7.29 7.29 7.29 7.71 7.71
23 Visakhapatnam 7.29 7.29 7.29 7.29 7.71 7.71
24 Vizianagaram 7.29 7.29 7.29 7.29 7.71 7.71
25 West Godavari 7.29 7.29 7.29 7.29 7.71 7.71
26 Y.S.R 7.29 7.29 7.29 7.29 7.71 7.71
State 189.58 189.58 189.58 189.58 200.42 200.42