Infant mortality rate (IMR)

• IMR  is the number of deaths per 1,000 live births of children under one year of age. The rate for a given region is the number of children dying under one year of age, divided by the number of live births during the year, multiplied by 1,000

Maternal mortality rate:

• The maternal mortality ratio (MMR) is defined as the number of maternal deaths during a given time period per 100,000 live births during the same time period
• Maternal mortality refers to deaths due to complications from pregnancy or childbirth. From 2000 to 2017, the global maternal mortality ratio declined by 38 per cent – from 342 deaths to 211 deaths per 100,000 live births, according to UN inter-agency estimates.

Pradhan Mantri Surakshit Matritva Abhiyan:

• The Pradhan Mantri Surakshit Matritva Abhiyan has been launched by the Ministry of Health & Family Welfare (MoHFW), Government of India.
• The program aims to provide assured, comprehensive and quality antenatal care, free of cost, universally to all pregnant women on the 9th of every month.
• PMSMA guarantees a minimum package of antenatal care services to women in their 2nd / 3rd trimesters of pregnancy at designated government health facilities.
• The programme follows a systematic approach for engagement with private sector which includes motivating private practitioners to volunteer for the campaign; developing strategies for generating awareness and appealing to the private sector to participate in the Abhiyan at government health facilities.

Objectives of the program:

• Ensure at least one antenatal checkup for all pregnant women in their second or third trimester by a physician/specialist
• Improve the quality of care during ante-natal visits. This includes ensuring provision of the following services:
  • All applicable diagnostic services
  • Screening for the applicable clinical conditions
  • Appropriate management of any existing clinical condition such as Anaemia, Pregnancy induced hypertension, Gestational Diabetes etc.
  • Appropriate counselling services and proper documentation of services rendered
  • Additional service opportunity to pregnant women who have missed ante-natal visits
• Identification and line-listing of high risk pregnancies based on obstetric/ medical history and existing clinical conditions.
• Appropriate birth planning and complication readiness for each pregnant woman especially those identified with any risk factor or comorbid condition.
• Special emphasis on early diagnosis, adequate and appropriate management of women with malnutrition.
• Special focus on adolescent and early pregnancies as these pregnancies need extra and specialized care

Key Features of PMSMA

• If every pregnant woman in India is examined by a physician and appropriately investigated at least once during the PMSMA and then the process can result in reduction in the number of maternal and neonatal deaths in our country.
• Antenatal checkup services would be provided by OBGY specialists / Radiologist/physicians with support from private sector doctors to supplement the efforts of the government sector.
• Using the principles of a single window system, it is envisaged that a minimum package of investigations (including one ultrasound during the 2nd trimester of pregnancy) and medicines such as IFA supplements, calcium supplements etc would be provided to all pregnant women attending the PMSMA clinics.
• While the target would reach out to all pregnant women, special efforts would be made to reach out to women who have not registered for ANC (left out/missed ANC) and also those who have registered but not availed ANC services (dropout) as well as High Risk pregnant women.
• OBGY specialists/ Radiologist/physicians from private sector would be encouraged to provide voluntary services at public health facilities where government sector practitioners are not available or inadequate.
• Pregnant women would be given Mother and Child Protection Cards and safe motherhood booklets.
• One of the critical components of the Abhiyan is identification and follow up of high risk pregnancies. A sticker indicating the condition and risk factor of the pregnant women would be added onto MCP card for each visit:
  • Green Sticker- for women with no risk factor detected
  • Red Sticker – for women with high risk pregnancy
• ‘IPledgeFor9’ Achievers Awards have been devised to celebrate individual and team achievements and acknowledge voluntary contributions for PMSMA in states and districts across India.