Women are foundation of a healthy, progressive nation

Women are not just beneficiaries of programmes, but also an important part of the team delivering health care

The story of India in the 21st century has been one of extraordinary growth and innovation. In the health scape, we have eliminated polio under incredibly challenging circumstances, and have been validated for maternal and neonatal tetanus elimination before the global date: two very significant achievements. A crucial pillar of our growth has been the contribution of women, who have shaped our society and our productivity in immensurable ways. They are a priority for the Government, which is ensuring through its policies and initiatives a progressive future for them.

The programmes, schemes and initiatives that are implemented by the Ministry of Health and Family Welfare care for women right from birth to adolescent and adulthood. Vaccines, home-visits by health workers, nutrition are provisioned to ensure a healthy childhood, from whereon the adolescent health programmes – Menstrual Hygiene program, Weekly Iron & Folic Acid Scheme (WIFS) and the Saathiya (Peer Educators), take on. Thereon married women are provided with family planning services and contraceptives, and specialised care is provided around pregnancy and child birth through the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), Surakshit Matritva Aashwashan (SUMAN), Laqshya (labor room quality improvement initiative), mid-wifery services, etc. With the Ministry’s commitment for providing universal healthcare, cancer screening for breast and cervical cancers is made available to women, free of cost, through Ayushman Bharat – Health & Wellness Centers (AB-HWCS).

PMSMA launched in June, 2016 aims to provide assured quality antenatal care – a minimum package of services, free of cost, universally to all pregnant women on the 9th day of every month. More than 2.38 crore pregnant women have received antenatal care under PMSMA and over 12.55 lakh high risk pregnancies have been identified.

To improve the quality of care in labor rooms and maternity operation theatres, Laqshya was launched in December 2017 with an aim to reduce preventable maternal and newborn mortality, and ensure that pregnant women receive the best quality of care. Till date, 506 labor rooms and 449 maternity operation theatres are State certified; 188 labor rooms and 160 maternity operation theatres are Laqshya certified at the national level. Maternal and Child Health (MCH) wings have also been sanctioned at District Hospitals/ District Women’s Hospitals and other facilities at sub-district levels. As on date, 650 dedicated MCH Wings with more than 42,000 additional beds have been sanctioned.

The latest programme has been the SUMAN Initiative, launched in October 2019, which aims to provide assured, respectful and quality healthcare, at no cost and zero tolerance for denial of services women. Under SUMAN, all existing schemes for maternal and neonatal health have been brought under one umbrella to create a comprehensive initiative.

In universal healthcare, AB-HWCS screen all 30+ population for non-communicable diseases (NCDS). Till date, more than 1.03 crore women have been screened for breast cancer and over 69 lakh for cervical cancer.

Programme and facilities need skilled human resource and thus Dakshata was launched in 2015. It is a strategic 3-day training capsule for building the skills of health care providers for quality intrapartum care. Till date, 16,400 health care providers have received the trainings.

The Ministry also took the policy decision to roll out ‘Midwifery Services Initiative’, which aims to create a cadre of Nurse Practitioners in Midwifery who are skilled in accordance to competencies prescribed by the International Confederation of Midwives (ICM). For these training programs, the Government has established five National Skill Labs – ‘’Daksh’’ functioning at National Institute of Health and Family Welfare (NIHFW), Lady Hardinge, Safdarjung, Jamia Hamdard and Trained Nurse Association of India institute in 2014 in Delhi –NCR, and 104 standalone skills labs in different states. Till date around 3,375 health personnel have been trained at National skills lab and around 33,751 at State skills labs.

The collective efforts have borne fruits: The Maternal Mortality Ratio (MMR) of India has declined by eight points in one year as per the latest Special Bulletin on MMR. This decline is important as it translates to nearly 2,000 additional pregnant women saved annually. MMR has declined from 130/lakh live births in 2014-16 to 122/lakh live births in 2015-17 (6.2% decline). India is on track to achieving the Sustainable Development Goal (SDG) target for reducing MMR by 2025, five years ahead of timeline. This has been possible with sharp rise in institutional deliveries in India – from 47% in 2007-08 to over 78.9% in 2015-16 based on the National Family Health Survey (NFHS-4) while safe delivery has simultaneously climbed from 52.7% to 81.4%. Under JSY, pregnant women going to a public health institution for delivery are provided cash entitlement in one go. Janani Shishu Suraksha Karyakaram (JSSK) entitles women delivering in public health institutions to have no expense delivery, including caesarean section. The scheme was expanded to cover complications during ante-natal and post-natal period and also sick infants up to 1 year of age.

Also, Maternal Death Surveillance and Response (MDSR), have played a significant role. The States are being closely monitored under this to identify not just the medical causes but also some of the socio-economic, cultural determinants as well as the gaps in the system, which contribute to these deaths.

Besides these, laws have been passed to empower and protect the rights of women viz. Pre-conception and Pre-natal Diagnostic Techniques Act, 1994 which was enacted by the Parliament to stop female foeticide and arrest the declining sex ratio in India.

Also, women are not only the beneficiaries of the programmes, but are also an important part of the team delivering healthcare services to society. This army of frontline health workers includes Accredited Social Health Activists (ASHAS), Auxiliary Nurse Midwives (ANMS), staff nurses and women doctors. The government initiatives thus provide employment opportunities for women and foster women empowerment.