Maternal Health

Maternal Health in Haryana

  1. Increase in Institutional Delivery especially in the The maternal mortality rate in Haryana has declined over the years and the MMR of Haryana vis-à-vis India as per SRS is as follows:

MMR (Maternal Mortality Rate) - SRS

Year

Haryana

India

1999-01

176

327

2001-03

162

301

2004-06

186

254

2007-09

153

212

As per SRS 2007-09, it ranks 7th in MMR amongst all the States and UTs.

  1. Govt. Sector:

Institutional Deliveries CRS Data (Rural & Urban)

Year

Govt. Inst.

Pvt. Inst.

Total Inst.

Non Inst.

Total

2006

83133

166464

249597

259373

508970

16.30%

32.70%

49.04 %

51%

2007

96948

178273

275221

236752

511973

18.90%

34.80%

53.70%

46.20%

2008

120042

198053

318095

219224

537319

22.34%

36.85%

59.19%

40.79%

2009

164388

196864

361252

177658

538910

30.50%

36.53%

67.03%

33%

2010

205086

197282

402368

142252

544620

37.65%

36.22%

73.88%

26.11%

2011

237067

198607

435674

127882

563556

42.07%

35.24%

77.31%

22.69%

2012

247153

202143

449296

114437

563733

43.84%

35.86%

79.70%

20.30%

2013
Jan. to Sep.

180605

142512

323117

60435

383552

47.10%

37.20

84.20%

15.80%

                   As per directions of Worthy Principal Secretary Health to Govt. of Haryana all districts to improve the institutional deliveries to reach the target of more than 90% institutional deliveries in Haryana.

 

  1. Operationalization of 24x7 delivery points

 

List of 24x7 Delivery Points

Year

DH

SDH

CHC

PHCs

SC-cum-Delivery Huts

Medical Colleges

ESI Hospitals

Military Hospitals

Urban FRUs

Total

2009-10

21

10

53

110

460

3

2

3

2

664

2010-11

21

11

54

114

468

3

2

3

2

678

2011-12

21

12

56

121

469

5

2

3

2

691

2012-13

21

19

98

253

473

6

2

3

2

877

2013-14 (Upto Sep-13)

20

18

103

278

473

6

2

3

2

905

  1. Janani Shishu Suraksha Karyakram (JSSK):

Funds allocated for free diet under JSSK

Year

Funds Utilized
(Rs. in lacs)

Funds allocated
(Rs. in lacs)

Percentage of
Utilization of funds

2011-12

93.24

312.00

29.88%

2012-13

282.44

412.60

68.45%

2013-14 (Upto Sep-13)

184.10

91.80

200.54%

Free Services under JSSK

Year

Free Blood

Free Diagnostics

Free Diet

2012-13

9556

162889

172097

2013-14 (Upto Sep-13)

8633

106039

112051

  1. Janani Suraksha Yojana (GoI):

Performance of JSY (GoI)

Year

JSY Beneficiaries

Expenditure
(Rs. in crores)

Funds allocated
(Rs. in crores)

Percentage of Utilization of funds

2007-08

48076

2.231

2.00

111.55%

2008-09

57447

3.07

5.00

61.30%

2009-10

63326

4.41

5.99

73.65%

2010-11

63171

4.29

5.94

73.14%

2011-12

65659

4.33

4.41

98.18%

2012-13

61902

4.14

5.03

82.00%

2013-14 (Upto
Sept.-2013)

15710

1.05

5.92

17.7%

  

  1. Janani Suraksha Yojana (State):

JSY State Plan

Year

No. of Beneficiaries

Budget (in lakhs)

2008-09

17769

473.8

2009-10

27502

279

2010-11

20370

369

2011-12

37322

869

2012-13

49686

1200

2013-14
(Upto Sep -2013

2411

1590

  1. Progress of Ante-Natal Registration in First Trimester (HMIS):

ANC in First Trimester

Year

Survey

Percentage

2002-04

DLHS-II

13.7 %

2007-08

DLHS-III

55.1 %

2009

CES

57.4 %

2010-11

HMIS

46.89 %

2011-12

HMIS

51.02%

2012-13

HMIS

50.40%

2013-14
(Upto Sep – 2013)

HMIS

49.03%

  1. Number having Hb less than11 gm

Year

Survey

Number

Percentage

2010-11

HMIS

260274

42.76%

2011-12

HMIS

298795

49.71%

2012-13

HMIS

412323

70.84%

2013-14 (Upto Sep – 2013)

HMIS

321405

110.16%

  1. No. having severe anaemia Hb<7 gms treated at Institution:

Year

Survey

Number

Percentage of severe anaemic women
to women with Hb level <7gms

2010-11

HMIS

40065

6.58%

2011-12

HMIS

36852

6.13%

2012-13

HMIS

23448

4.03%

2013-14 (Upto Sep  – 2013)

HMIS

8719

2.99%

  1. Mothers who had full Ante Natal Check-up (3 ANCs):

Mothers who had full Ante Natal Check-up

Year

Survey

Percentage

2002-04

DLHS-II

10.3 %

2007-08

DLHS-III

13.3 %

2009

CES

42.9 %

2010-11

HMIS

77.31%

2011-12

HMIS

81.75%

2012-13

HMIS

84.52%

2013-14 (Upto Sep – 2013)

HMIS

52.16%

  1. No. of women discharged under 48 hours of delivery in Public Health Facility:

Year

Survey

Number

Percentage of women discharged
under 48 hours of delivery to total
reported deliveries at public health facilities

2010-11

HMIS

200972

89.71%

2011-12

HMIS

213657

87.76%

2012-13

HMIS

200642

83.62%

2013-14
(Upto Sep – 2013)

HMIS

113543

89.39%

  1. Women receiving post-partum checkup within 48 hours after delivery:

Year

Survey

Number

Proportion of women receiving post-partum
 checkup within48 hours after
delivery to total reported deliveries

2010-11

HMIS

273194

68.29%

2011-12

HMIS

297180

68.45%

2012-13

HMIS

292744

77.41%

2013-14
(Upto Sep – 2013)

HMIS

104066

81.93%

  1. RTI/STI Services:

RTI/STI Services (HMIS Survey)

2010-11

2011-12

2012-13

2013-14
(Upto Sep.-13)

Male Patients

40492

36778

30166

7309

Female Patients

130987

136931

114492

35901

Total (Male & Female)

171479

173709

144658

43210

No. of wet mounts

714

807

2300

1177

  1. Maternal Death Review:

Maternal Death Review (Source: NRHM Report)

 

2009-10

 2010-11

2011-12

2012-13

2013-14
(Upto Sep-13)

Maternal Deaths

164

200

360

381

369

 

DETAILS OF INTERVENTIONS AND ACTIVITIES DONE BY THE STATE TO REDUCE MMR
The various Maternal Health Schemes which have been implemented in Haryana include:

  1. Promotion of Institutional deliveries through operationalizing 24x7 delivery facilities
  2. Operationalization of FRUs so that distance from delivery point to FRU is not more than half an hour drive
  3. Maternal Death Audit to discover the gaps and address them
  4. Janani Suraksha Yojna (JSY-GoI) (cash incentive for BPL /SC deliveries)
  5. Janani Suraksha Yojna (JSY-State) (cash incentive for SC deliveries)
  6. JSSK (Janani Shishu Suraksha Karyakarm) (Free Antenatal services, delivery and caesarean and Post Natal Services in Govt. Hospitals)
  7. Reverse tracking of Severe Anaemia
  8. Safe MTP Services
  9. Upgradation of Labour Rooms


Various schemes for pregnant women

  1. Janani Shishu Suraksha Karyakaram: Janani Shishu Suraksha Karyakram (JSSK) is the national initiative to guarantee zero expenses deliveries and zero expenditure treatment of sick new born in public health institutions alongwith the provision of free transport to and from.

The initiative was launched on 1st June, 2011from Mewat, Haryana.

  1. Entitlement for pregnant women:
  2. Eliminating out-of-pocket expenses for families of pregnant women and sick newborns in government health facilities
  3. Extended to all antenatal & post natal complications of pregnancy
  4. Free and cashless delivery from the  time of first diagnosis of pregnancy including Free C-section
  5. Free drugs and consumables
  6. Free diagnostics
  7. Free provision of blood
  8. Free diet during stay in health institutions
    1. Up to 3 days for normal delivery
    2. 7 days for Caesarean sections
  9. Free transport
    1. Home to health institution
    2. Between health institutions in case of referral
    3. Drop back home after delivery
  10. Exemption from all kinds of user charges, including for seeking hospital care up to 6 weeks post delivery (for post natal complications)
  11. Entitlement for Sick New Born and infants
  12. Timely access to care for sick newborns
  13. Free treatment at the public health institutions
  14. Free drugs and consumables
  15. Free diagnostics
  16. Free provision of blood
  17. Free transport
  18. Home to health institution
  19. Between health institutions in case of referral
  20. Drop back home after delivery
  21. Exemption from all kinds of user charges
  22. Now Same entitlements for sick infants
  1. JSY Scheme (GoI) : The JSY Scheme has been implemented in the State of Haryana in right earnest since its inception in 2005.

Janani Suraksha Yojana (JSY) aims at reducing maternal and neo-natal mortality by encouraging and increasing institutional deliveries. In this scheme cash incentive is given to the mother during her post-partum period in order to ensure her a good diet and care. The details of incentives are as follows:


Incentive

Urban

Rural

Institutional

Rs.600/-

Rs.700/-

Home

Rs.500/-

Rs.500/-

The scheme is applicable for the BPL women of all categories for deliveries at home or institutions, Govt. or accredited private and SC/ST families. The scheme is also applicable for non-BPL SC/ST women but only for deliveries at a Govt. institution or at an accredited private institution.

  1. Janani Suraksha Yojna (State Plan): This scheme was launched in April, 2008 under the State Plan. Under this scheme an assistance of Rs.1500/- is given to each pregnant woman belonging to SC/ST family for delivery in the health institution, be it in Govt. or Private sector, provided she is above 19 years of age. This assistance is given in three installments i.e. 1st installment of Rs.500/- on registration of pregnancy case, second installment of Rs.500/- on getting check-up done in 3rd trimester and Rs.500/- on the day of delivery or maximum within 5 working days after delivery.

Even for a pregnant SC/ST woman coming directly for delivery to the institution without any prior antenatal check-up, full payment of Rs.1500/- is made. The year wise expenditure and no. of beneficiaries under the scheme is as below:-