Steps taken to Accelerate the Pace of Reduction for MMR Under National Health Mission (NHM)

As per the latest report of the Registrar General of India, Sample Registration System (RGI-SRS), Maternal Mortality Ratio (MMR) of India is 178 per 100,000 live births for the period 2010-12. This translates into an approximate number of 47,100 deaths per year for India. Establishing assured referral transport between the community and health facilities is important for addressing delay in reaching the health facility and timely care during any obstetric complications. Reproductive health services under the overall umbrella of the National Health Mission are provided free at all Government Health Services through a continuum of care approach of Reproductive, Maternal, New Born, Child Health and Adolescent (RMNCH+A) Health. It is a fact that some of the Government hospitals constructed much earlier have maternity and children ward located at different places. Under National Health Mission (NHM), the key steps taken by Government of India to address the above concerns and also to accelerate the pace of reduction for Maternal Mortality Ratio (MMR) are:  Promotion of institutional deliveries through Janani Suraksha Yojana.  Janani Shishu Suraksha Karyakaram (JSSK) has been launched on 1st June, 2011, which entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery including Caesarean section. The initiative stipulates free drugs, diagnostics, blood and diet, besides free transport from home to institution, between facilities in case of a referral and drop back home. Similar entitlements have been put in place for all sick infants accessing public health institutions for treatment.  184 High Priority Districts (HPDs) have been identified and prioritized for Reproductive, Maternal, New Born, Child Health and Adolescent (RMNCH+A) interventions for achieving improved maternal and child health outcomes  Capacity building of health care providers in basic and comprehensive obstetric care.  Operationalization of sub-centres, Primary Health Centres, Community Health Centres and District Hospitals for providing 24x7 basic and comprehensive obstetric care services.  To tackle the high bed occupancy in the maternity wards, Mother & Child Health Wings have been sanctioned at high case load facilities where the maternity and children ward are together for provision of continuum of care approach to pregnant women, newborns and children.  Name Based Web enabled Tracking of Pregnant Women to ensure antenatal, intranatal and postnatal care.  Mother and Child Protection Card in collaboration with the Ministry of Women and Child Development to monitor service delivery for mothers and children.  Antenatal, Intranatal and Postnatal care including Iron and Folic Acid supplementation to pregnant & lactating women for prevention and treatment of anaemia.  Engagement of more than 8.9 lakhs Accredited Social Health Activists (ASHAs) to generate demand and facilitate accessing of health care services by the community.  Referral systems have been established including emergency referral transport for pregnant women, for which the states have been given flexibility to use different models.  Village Health and Nutrition Days in rural areas as an outreach activity, for provision of maternal and child health services.  Health and nutrition education to promote dietary diversification, inclusion of iron and folate rich food as well as food items that promote iron absorption.