doc2021122061
doc2021122061
“आज बदलते हुए भारत में देश की बहनों-बेटियों के पास भी आगे बढ़ने के अवसर बढ़ रहे हैं। घर, शौचालय, बबजली, पानी,
गैस, जैसी सुबवधाओं से सभी बहनों को जोडा जा रहा है। बहनों-बेटियों की बशक्षा, स्वास््य, पोषण, िीकाकरण और दूसरी
ज़रूरतों पर भी सरकार पूरी संवेदनशीलता से काम कर रही हैI”
The National Family Health Survey (NFHS-5) of 2019-21 released by the Ministry of Health & Family
Welfare (MoHFW) on the 24th November 2021, captures this progress. As stated by Dr. Vinod Kumar Paul,
Member (Health), NITI Aayog, NFHS-5 clearly indicates that the ―momentum towards achieving the
Sustainable Development Goals (SDG) is getting accelerated.‖ The survey has shown progress on
demographic and health indicators such as the total fertility rate (TFR), women‘s education, child mortality
rates, pointing to coverage of immunisation, antenatal care (ANC), institutional deliveries amongst other
indicators. There has also been progress across family health indicators in the surveyed Phase II states —
Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttarakhand, and Uttar Pradesh.
Especially in the sector of Maternal and Child Health, this progress has been accelerated due to several
initiatives such as the National Rural Health Mission (NRHM)2, Surakshit Matritva Aashwasan (SUMAN),
Pradhan Mantri Swasthya Suraksha Yojana (PMSSY), Ayushman Bharat Pradhan Mantri Jan Arogya
Yojana (AB-PMJAY) amongst others.
Initiatives & Interventions by the Government of India towards Maternal & Child Health:
The Government adopted the Reproductive, Maternal, New-born, Child and Adolescent Health
(RMNCH+A) framework in 2013. It essentially aims to address the major causes of mortality and morbidity
among women and children. This framework also helps to understand the delays in accessing and utilizing
health care services. Based on the framework, comprehensive care is provided to women and children
through five pillars or thematic areas of reproductive, maternal, neonatal, child, and adolescent health. The
programmes and strategies developed by various divisions are guided by central tenets of equity, universal
care, entitlement, and accountability to provide ‗continuum of care‘ ensuring equal focus on various life
stages.
1
https://twitter.com/PMOIndia/status/1425730069490585603?s=20
2
https://nhm.gov.in/index1.php?lang=1&level=1&lid=49&sublinkid=969
Launched on the 10th October 2019, the 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 new-born visiting the public health facility in order to end all
preventable maternal and new-born deaths and morbidities and provide a positive birthing
experience. Under SUMAN, all existing schemes for maternal and neonatal health have been brought
under one umbrella in order to create a comprehensive and cohesive initiative which goes beyond
entitlements and provides a service guarantee for the entitlements.
Launched in March 2018, Poshan Abhiyaan
aims to address the problem of malnutrition in the
Country. The goal of POSHAN Abhiyaan is to improve
nutritional outcomes for children from 0-6, Adolescent
Girls, Pregnant Women and Lactating Mothers in a time
bound manner and reduction in stunting, wasting in
children (0-6 years) as well as reduction of anaemia in
Women and children.
Pradhan Mantri Matru Vandana Yojana4 (PMMVY) is a Conditional Cash Transfer maternity
benefit programme implemented in all districts of the country effective since 01.01.2017. The
maternity benefit under this scheme is available to
Source
eligible beneficiaries for first living child of the family
and Rs.5,000/- is provided to the eligible beneficiary in
three instalments during pregnancy and lactation in
response to individual fulfilling certain nutrition and
health seeking condition.
3
https://laqshya.nhp.gov.in/
4
https://wcd.nic.in/sites/default/files/FINAL%20PMMVY%20%28FAQ%29%20BOOKELT.pdf
Launched in June 2016, the Pradhan Mantri Source
Surakshit Matritva Abhiyaan (PMSMA) provides
fixed day, free of cost assured and quality Antenatal
Care to all pregnant women in the country. The
Abhiyan also involves private sector‘s health care
providers as volunteers to provide specialist care in
Government facilities.
Launched in 2011, the Janani Shishu Suraksha Karyakaram5 aims to motivate those who still
choose to deliver at their homes to opt for institutional deliveries. It is an initiative with a hope that
states would come forward and ensure that benefits under JSSK would reach every needy pregnant
woman coming to government institutional facility.
Under the Janani Suraksha Yojana (JSY), the eligible beneficiary also receives the remaining cash
incentive as per approved norms towards maternity benefit so that on an average, a woman gets
Rs.6,000/-. JSY is a safe motherhood intervention under the NRHM being implemented with the
objective of reducing maternal and neo-natal mortality by promoting institutional delivery among
the poor pregnant women. The scheme focuses on the poor pregnant woman with special
dispensation for states having low institutional delivery rates namely the states of Uttar Pradesh,
Uttaranchal, Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Assam, Rajasthan, Orissa and Jammu
and Kashmir.
Announced in 2003 and launched in 2006, the Pradhan Mantri Swasthya Suraksha Yojana
(PMSSY) was announced with objectives of correcting regional imbalances in the availability of
affordable/ reliable tertiary healthcare services and also to augment facilities for quality medical
education in the country by setting up of various institutions like AIIMS and upgrading government
medical college institutions.
As on date, establishment of 22 new AIIMS and 75 projects of upgradation of Government Medical
Colleges (GMCs)/Institutes have been sanctioned under PMSSY.
Out of 22 new AIIMS sanctioned under PMSSY, 6 AIIMS, which were sanctioned in first
phase i.e., AIIMS at Bhopal, Bhubaneswar, Jodhpur, Patna, Raipur and Rishikesh are
functional. Limited facilities for treatment of Covid-19 patients have also been started at
AIIMS Mangalagiri, Nagpur, Rae Bareli, Gorakhpur, Kalyani, Bibinagar and Bathinda.
Covid Test Labs are also functional in these AIIMS.
13 existing Government Medical College (GMC) institutions spread over 10 States have
been upgraded with an outlay of Rs. 120 crores (Rs. 100 crores from Central Government
and Rs. 20 crores from State Government) for each institution.
5
https://pib.gov.in/PressReleasePage.aspx?PRID=1606211
Since inception of the scheme, 46 projects of Super Speciality Hospitals / Trauma Centre in existing Govt
Medical Colleges / Institutions have been completed, adding more than 10000 Super-specialty beds
including 2000 ICU beds. Following 3 projects have been completed during this year.
S. No. Name of the State Phase Type of Total ICU Beds No of Super
GMC/Institute facility Beds Specialities
Source
Launched in 1975, Integrated Child Development Scheme (ICDS)6 was a unique early childhood
development programme, aimed at addressing malnutrition, health and also development needs of
young children, pregnant and nursing mothers. It was launched to improve the nutrition and health
status of children in the age group of 0-6 years, lay the foundation for proper psychological, physical
and social development of the child, effective coordination and implementation of policy among the
various departments and to enhance the capability of the mother to look after the normal health and
nutrition needs through proper nutrition and health education. This Centrally Sponsored Scheme, is
anchored by Ministry of Women and Child Development (MoWCD), Government of India (GoI).
7
Scheme for Adolescent Girls : Under this scheme, out of school adolescent girls in the age
group of 11-14 years are provided supplementary nutrition under ICDS containing 600
calories, 18-20 grams of protein and micronutrients for 300 days in a year. Under the non-
nutrition component, the scheme aims at motivating out of school girls in the age group of
11-14 years to return to formal schooling or skill training and several services like IFA
supplementation, health check-up and referral services are provided to the beneficiaries. The
focus of the scheme is to mainstream out of school adolescent girls into formal education
system
8
Anganwadi Services: Anganwadi Services under Umbrella Integrated Child Development
Services (ICDS) Scheme is a centrally sponsored scheme, aiming at holistic development of
children below 6 years of age and pregnant women & lactating mothers, by providing a
package of six services comprising (i) Supplementary nutrition; (ii) Pre-school non-formal
education; (iii) Nutrition and health Education; (iv) Immunization; (v) Health check-up; and
(vi) Referral services through Anganwadi Centres at grassroots level. Three of the six
services viz., immunization, health check-up and referral services are related to health and are
provided by Ministry of Health and Family Welfare through NRHM & Public Health
Infrastructure.
6
https://darpg.gov.in/sites/default/files/ICDS.pdf
7
https://pib.gov.in/PressReleaseIframePage.aspx?PRID=1658302
8
Ibid.
National Family Health Survey (NFHS-5)9
The Ministry of Health & Family Welfare (MoHFW) released the National Family Health Survey
(NFHS-5) of the 2019-21 on 24th November 2021. It comprises of Factsheets of key indicators on
population, reproductive and child health, family welfare, nutrition and others for India and 14 States/UTs
(clubbed under Phase-II). The States and UTs which were surveyed in the Phase-II were Arunachal
Pradesh, Chandigarh, Chhattisgarh, Haryana, Jharkhand, Madhya Pradesh, NCT of Delhi, Odisha,
Puducherry, Punjab, Rajasthan, Tamil Nadu, Uttar Pradesh and Uttarakhand. The findings of NFHS-
5 in respect of 22 States & UTs covered in Phase-I were released in December, 2020.
The NFHS-5 survey work was conducted in around 6.1 lakh sample households from 707 districts (as on
March, 2017) of the country; covering 724,115 women and 101,839 men to provide disaggregated estimates
up to district level.
The key results from India and Phase-II States/UTs NFHS-5 Factsheets areas below:
The Total Fertility Rates (TFR), an average number of children per women has further declined from
2.2 to 2.0 at the national level and all 14 States/UT‘s ranging from 1.4 in Chandigarh to 2.4 in Uttar
Pradesh. All Phase-II States have achieved replacement level of fertility (2.1) except Madhya
Pradesh, Rajasthan, Jharkhand and Uttar Pradesh.
Overall Contraceptive Prevalence Rate (CPR) has increased substantially from 54% to 67% at all-
India level and in almost all Phase-II States/UTs with an exception of Punjab. Use of modern
methods of contraceptives has also increased in almost all States/UTs.
Unmet needs of family Planning have witnessed a significant decline from 13 per cent to 9 per cent
at all-India level and in most of the Phase-II States/UTs. The unmet need for spacing which remained
a major issue in India in the past has come down to less than 10 per cent in all the States except
Jharkhand (12%), Arunachal Pradesh (13%) and Uttar Pradesh (13%).
Full immunization drive among children aged 12-23 months has recorded substantial improvement
from 62 per cent to 76 per cent at all-India level.11out of 14 States/UTs has more than three-fourth
of children aged 12-23 months with fully immunization and it is highest (90%) for Odisha.
On comparing NFHS-4 and NFHS-5 data, the increase in full immunization coverage is observed to
be expeditious in many states and UTs; More than 50 per cent of Phase-II States/ UTs are sharing
over 10 percentage points during the short span of 4 years. This can be attributed to the flagship
initiative of Mission Indradhanush launched by the government in December 2014.10
There is an increase from 51 per cent to 58 per cent of women receiving the recommended four or
more ANC visits by health providers at all-India level.
Also, all the Phase-II States/UTs have shown improvement except Punjab between 2015-16 to2019-
20.
Institutional births have increased substantially from 79 per cent to 89 percent at all-India Level.
Institutional delivery is 100 per cent in Puducherry and Tamil Nadu and more than 90 per cent in 7
States/UTs out of 12 Phase II States/UTs.
Along with an increase in institutional births, there has also been a substantial increase in C-section
deliveries in many States/UTs especially in private health facilities.
Child Nutrition indicators shows a slight improvement at all-India level as Stunting has declined
from 38 per cent to 36 per cent, wasting from 21 per cent to 19 per cent and underweight from 36 per
cent to 32 percent at all India level. In all phase-II States/UTs situation has improved in respect of
child nutrition but the change is not significant as drastic changes in respect of these indicators are
unlikely in short span period.
Anaemia among children and women continues to be a cause of concern. More than half of the
children and women (including pregnant women) are anaemic in all the phase-II States/UTs and all-
India level compared to NFHS4, in spite of substantial increase in the composition of iron folic acid
(IFA)tablets by pregnant women for 180 days or more.
9
https://pib.gov.in/PressReleasePage.aspx?PRID=1774533
10
Pg 12 of https://darpg.gov.in/sites/default/files/National%20Health%20Mission.pdf
Exclusive breastfeeding to children under age 6 months has shown an improvement in all-India level
from 55 percent in 2015-16 to 64 per cent in 2019-21. All the phase-II States/UTs are also showing a
considerable progress.
Women's empowerment indicators portray considerable improvement at all India level and across all
the phase-II States/UTs. Significant progress has been recorded between NFHS-4 and NFHS-5 in
regard to women operating bank accounts from 53 percent to 79 percent at all-India level. For
instance, in the case of Madhya Pradesh the increase was to the tune of 37 percentage point from 37
per cent to 75 per cent. More than 70 per cent of women in every state and UTs in the second phase
have operational bank accounts.
Amongst the states which have shown improvement in NFHS-5 Phase II survey, Uttar Pradesh has made
considerable progress across key health indicators mentioned below:
The Sex Ratio (females per 1,000 males) has improved from 991 in NFHS-4 to 1020 in NFHS-5
which means there are 1020 females per 1000 males in Uttar Pradesh. This shows that schemes like
Beti Bachao Beti Padhao and Pradhan Mantri Matru Vandana Yojana are having a positive impact in
the state.
Population living in households with electricity also increased from 88% in the last survey to 96.8%.
This indicates that central government schemes such Sahaj Bijli Har Ghar Yojana – Saubhagya and
Ujala Yojana by the Ministry of Power are faring well in Uttar Pradesh.
Percentage of Households using clean fuel for cooking has also seen an improvement from 44% to
59% which shows the success of Pradhan Mantri Ujjwala Yojana (PMUY) by the Ministry of
Petroleum and Natural Gas (MOPNG).
Even though Uttar Pradesh hasn‘t reached the replacement level of fertility (2.1), the Total Fertility
Rates (TFR) has declined from 2.7 to 2.4 which is an encouraging indicator.
Overall Contraceptive Prevalence Rate (CPR) has increased from 45.5% to 62.4% in line with the
progress of all the Phase-II States/UTs with the exception of Punjab. The use of modern methods of
contraception also increased to 44.5% from 31.7%.
Unmet needs of family Planning have witnessed a decline from 18 per cent to 13.
Full immunization drive among children aged 12-23 months has recorded substantial improvement
from 51 per cent to 70 per cent.
There is an increase from 26.4 per cent to 42.4 per cent of women receiving the recommended four
or more ANC visits by health providers
Institutional births have increased from 67.8 per cent to 83.4 percent at all-India Level. Institutional
births in public facility have increased from 44.5 to 57.7 showing substantial growth in accessibility
to public facilities. This shows that UP has benefitted from the Janani Shishu Suraksha Karyakaram,
Pradhan Mantri Matru Vandana Yojana (PMMVY) and Janani Suraksha Yojana (JSY).
As on 9.3.2020, 24,68,818 beneficiaries have received full financial assistance of Rs. 5,000
under the Pradhan Mantri Matru Vandana Yojana (PMMVY) and total amount disbursed is
INR 1009,58,37,000.
Along with increase in institutional births, births attended by a skilled health personnel also showed
an increment from 70.4 to 84.8.
Along with an increase in institutional births, there has also been an increase in C-section deliveries
in private health facilities.
Neonatal mortality rate is the number of deaths during the first 28 completed days of life per 1000
live births in a given year or other period. Neonatal mortality rate (NNMR) dropped from 45.1% to
35.7%.
Infant mortality rate (IMR) is the number of deaths per 1,000 live births of children under the age of
one. IMR for UP dropped down from 64 % to 50%.
The under-five mortality rate (U5MR) is the number of deaths per 1,000 live births of children
between birth and five years of age. Under-five mortality rate has reduced from 78% to 60%.
Child Nutrition indicators shows a marginal shift as Stunting (low height for age) has declined from
46 per cent to 40 per cent, wasting (low weight for height) from 18 per cent to 17 per cent and
underweight from 40 per cent to 32 percent. The situation has improved slightly with respect to child
nutrition but the change is not significant.
Anaemia is a condition caused due to low Haemoglobin (Hb) available in the body and if left
unattended, it can adversely impact the heart.
Anaemia among women aged 15-49 who are pregnant has decreased by 5 per cent from 51
per cent to 46 per cent despite the concerning increment of 2 per cent (from 50.4 per cent to
52.2 per cent) in national average.
Number of Mothers who consumed iron folic acid for 100 days or more when they were
pregnant increased to 22.3% from 12.9%
Number of Non-Pregnant women age 15-49 years who are anaemic has dropped to 51% from
53%
Number of women age 15-49 years who are anemic also reduced from 54% to 53%
In 2018, the Government of India launched the Anaemia Mukt Bharat (AMB) strategy with the target
to reduce anaemia in women, children and adolescents in life cycle approach.
Exclusive breastfeeding to children under age 6 months has shown considerable improvement in
from 41.6 percent in 2015-16 to 59.7 per cent in 2019-21.
Women's empowerment indicators portray considerable improvement. Significant progress has been
recorded between NFHS-4 and NFHS-5 in regard to women operating bank accounts from 55
percent to 75 percent.
Women aged 15-24 years who use hygienic methods of protection during their menstrual period
shows upstate trend from 47 per cent to 72.6.
Mobile phone ownership and usage by women has increased from 37 per cent to 47 per cent.
To tackle the problem of anaemia among children in Uttar Pradesh, the Government has implemented
several schemes and programs under the Umbrella Integrated Child Development Services Scheme as
direct targeted interventions to address the problem of malnutrition in the country. All these schemes address
one or other aspects related to nutrition and have the potential to improve nutritional outcomes in the
country. For alleviation of malnutrition, Government has announced Mission POSHAN 2.0 to strengthen
nutritional content, delivery, outreach and outcomes with focus on developing practices that nurture health,
wellness and immunity to disease and malnutrition. Steps have been taken to improve nutritional quality and
testing in accredited labs, strengthen delivery and leverage technology to improve governance. Government
has advised States/UTs to ensure that the quality of supplementary nutrition conforms to prescribed
standards laid down under the Food Safety and Standards Act, 2006 and regulations made there under. The
situation can improve substantially through behavioural change mechanisms and awareness.
No. of medical colleges have increased by a whooping 120% in the state, as there were only 30
medical colleges in 2014 but now there are 66 medical colleges (as of 10.12.2021).
No. of MBBS seats have increased by 122% in the state as there were only 3749 seats in 2014 but
now there are 8328 seats (as of 10.12.2021)
Number of PG seats have increased by 1816% in the state as there were only 148 seats in 2014 but
now there are 2836 seats (as of 10.12.2021)
A total of 27 new government medical colleges have been approved during the years in three phases
of the centrally sponsored scheme for establishment of new medical colleges attached with existing
district/referral hospitals. The details of funds released during the years is as follows:
Click here to see Key Developments in Maternal & Child Health Sector in India (2020).
***
Video Reference
Major boost to Uttar Pradesh's health infrastructure as PM Modi dedicates AIIMS, Gorakhpur!
PM Modi's speech on launch of 'Beti Bachao-Beti Padhao' National Programme in Panipat, Haryana
PM Modi discussed about Beti Bachao Beti Padhao in Mann ki Baat which empowered the daughters
PM Modi inaugurated Health and Wellness Centre to mark the launch of Ayushman Bharat, in Bijapur, Chhattisgarh11
Prime Minister Modi interacts with young students at a school in Narur, Varanasi
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https://www.cbhidghs.nic.in/showfile.php?lid=1155
https://wcd.nic.in/sites/default/files/Booklet.pdf
Union Minister For Women & Child Development Chairs National Conference Of States/UTs At Kevadia, Gujarat
PIB Press Release Union Health Ministry releases NFHS-5 Phase II Findings Dated 24 November, 2021.
PIB Press Release Beti Bachao Beti Padhao Scheme Increases Awareness and Sensitize the Masses on Gender Equality
PIB Press Release Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) Dated 23 July, 2021.
PIB Press Release Beneficiaries under Ayushman Bharat Yojana Dated 09 February, 2021.
PIB Press Release Amalgamation of Ayushman Bharat Yojana with State Health Schemes Dated 02 February, 2021.
Integrated Child Development Scheme (ICDS) Manual for District 2017
PIB Press Release Development of Women and Children Dated 23 September 2020.
PIB Press Release Malnutrition in India Dated 18 September 2020.
PIB Press Release Major Welfare Schemes of the Ministry Dated 17 September 2020.
PIB Press Release Beneficiaries under PMMVY Dated 25 March 2021.
PIB Press Release Maternity Benefits under PMMVY Dated 06 December, 2019.
PIB Press Release Implementation of Pradhan Mantri Matru Vandana Yojana Dated 06 March, 2020.
PIB Press Release Maternity Benefit Disbursed to 1.36 Crore Beneficiaries under PMMVY Dated 13 March, 2020.
PIB Press Release Empowerment of Adolescent Girls Dated 19 March, 2020.
http://164.100.24.220/loksabhaquestions/annex/175/AU840.pdf
https://www.facebook.com/UPMahilaKalyan/photos/pcb.4409712619155208/4409706972489106/?type=3&theater
https://wcd.nic.in/bbbp-schemes
PIB Press Release Pradhan Mantri Mahila Shakti Kendra Scheme Dated 12 February, 2021.
AG/HP/RN/SK
11
https://youtu.be/NouUASN2f5A