Rise in Number of Institutional Child Delivery
The institutional deliveries in the country have increased from 38.7% as per the National Family Health Survey (NFHS-III) in 2005-06 to 46.9% as per District Level Household Survey (DLHS-III) in 2007-08. As per the Coverage Evaluation Survey (CES 2009) conducted by the UNICEF, the institutional delivery is 72.9%.
Institutional delivery rates in rural and urban areas were 28.9% and 67.5% respectively as per NFHS-III in 2005-06 which rose to 37.8% and 70.4% as per DLHS–III in 2007-08. Under CES 2009, the rural and urban institutional delivery was 68% and 85.6% respectively.The ASHA plays an important role in improving access to institutional deliveries by motivating the pregnant mother and her family for continued contact with the health system and ensuring at-least four antenatal check-ups at health facility, spreading awareness on the Janani Shishu Suraksha Karyakram (JSSK), which entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery, including caesarean section and also serving as a support during delivery and post partum care as required. ASHA is incentivized for performing these activities under Janani Suraksha Yojana (JSY).
The role of the Auxiliary Nurse Midwives (ANMs) is to conduct regular antenatal visits at the outreach session namely, Village Health and Nutrition Days (VHND) or at the sub-centres, and also to serve as a Skilled Birth Attendant(SBA) in those sub-centres which are conducting deliveries.
The role of Self Help Groups (SHG) is to get involved in the Village Health, Sanitation and Nutrition Committees, which are expected to support the functions of the ASHA and the ANM, including improving access for women to institutional deliveries.
Under the National Health Mission (NHM), steps taken to increase the institutional delivery rates across the country include the following:-
· Promotion of institutional deliveries through Janani Suraksha Yojna.
· Janani Shishu Suraksha Karyakram (JSSK) entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery including Caesarean section. This initiative also provides for 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 newborns and sick infants accessing public health institutions for treatment.
· 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.
· Name Based 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.
· 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.
· Village Health and Nutrition Days in rural areas as an outreach activity which also serves as a platform to promote institutional delivery.
The institutional deliveries in the country have increased from 38.7% as per the National Family Health Survey (NFHS-III) in 2005-06 to 46.9% as per District Level Household Survey (DLHS-III) in 2007-08. As per the Coverage Evaluation Survey (CES 2009) conducted by the UNICEF, the institutional delivery is 72.9%.
Institutional delivery rates in rural and urban areas were 28.9% and 67.5% respectively as per NFHS-III in 2005-06 which rose to 37.8% and 70.4% as per DLHS–III in 2007-08. Under CES 2009, the rural and urban institutional delivery was 68% and 85.6% respectively.The ASHA plays an important role in improving access to institutional deliveries by motivating the pregnant mother and her family for continued contact with the health system and ensuring at-least four antenatal check-ups at health facility, spreading awareness on the Janani Shishu Suraksha Karyakram (JSSK), which entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery, including caesarean section and also serving as a support during delivery and post partum care as required. ASHA is incentivized for performing these activities under Janani Suraksha Yojana (JSY).
The role of the Auxiliary Nurse Midwives (ANMs) is to conduct regular antenatal visits at the outreach session namely, Village Health and Nutrition Days (VHND) or at the sub-centres, and also to serve as a Skilled Birth Attendant(SBA) in those sub-centres which are conducting deliveries.
The role of Self Help Groups (SHG) is to get involved in the Village Health, Sanitation and Nutrition Committees, which are expected to support the functions of the ASHA and the ANM, including improving access for women to institutional deliveries.
Under the National Health Mission (NHM), steps taken to increase the institutional delivery rates across the country include the following:-
· Promotion of institutional deliveries through Janani Suraksha Yojna.
· Janani Shishu Suraksha Karyakram (JSSK) entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery including Caesarean section. This initiative also provides for 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 newborns and sick infants accessing public health institutions for treatment.
· 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.
· Name Based 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.
· 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.
· Village Health and Nutrition Days in rural areas as an outreach activity which also serves as a platform to promote institutional delivery.
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