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New scheme, a boon for mothers
PMSMA, which aims to provide quality antenatal care to pregnant women has had far reaching implications but the numbers must grow to expand the benefit
The significance attached to empower women came to the fore yet again when on Sunday, Prime Minister Narendra Modi assigned the defence Ministry portfolio to Nirmala Sitharaman. Time and again Prime Minister Modi has emphasised on the need to embolden women and has termed it as a critical prerequisite to national transformation. Under the leadership of Prime Minister Modi, the focus has shifted from women development to women-led-development and the women lot have been at the centre of many welfare innovative programmes, including the Pradhan Mantri Jan Dhan Yojana (PMJDY) and the Pradhan Mantri Ujjwala Yojana.
Another programme that’s unique and has far reaching implications for the society is the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), which is now close to completing a year. Prime Minister Modi had highlighted the aim and the purpose of PMSMA in the July 31, 2016, episode of his radio programme, Mann ki Baat, and it was followed in November by Union Minister of Health and Family Welfare JP Nadda. The programme aims to provide universal, free of cost assured, comprehensive and quality antenatal care to all pregnant women on the ninth of every month. PMSMA guarantees a minimum package of antenatal care services to women in their second/third trimesters of pregnancy at designated Government health facilities.
The programme follows a systematic approach for engagement with the 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. Till date, over 4,000 volunteers have enrolled for this programme with 12,118 facilities engaged in providing the facilities. The uniqueness of the programme lies in its innovative approach in breaking old paradigms and posing faith in the private sector while at the same time exhorting it to partner in it.
Sanjeev Bagai, vice chairman and director, Manipal Dwarka Hospital, terms this programme as “a visionary intervention by Prime Minister to bring much-needed access to care and compassion for pregnant women in rural and remote areas of the country.” He adds, “nothing could be more cruel than allowing our pregnant sisters to die for want of medical care, and in one stroke the programme promises to end this age-old scourge — however, we all must strengthen hands of the Government to partner in such preventive intervention and truly ensure health for all.”
Bagai has a point. With close to 45,000 women dying annually due to pregnancy-related causes, India has the dubious distinction of accounting for 17 per cent of the global maternal deaths and most of these are preventable if women receive antenatal care and plan in advance for births. Unfortunately, less than 19 per cent of such women obtain all encompassing prenatal attention. According to the World Health Organisation, 37 per cent of such deaths are caused by postpartum hemorrhage followed by sepsis or infection at 11 per cent, unsafe abortion eight per cent, hypertension disorders and obstructed labor account for five per cent. Anaemia is also a cause.
Adolescent and illiterate mothers and those dwelling in virtually inaccessible areas. They have much higher chance of dying at child birth. On the other hand, mothers in the lowest economic bracket also have twice the mortality rate than women in the average Indian household. While these are challenges that can be overcome, shortage of health specialists in rural regions constitutes a colossal barrier. It is in this context that the PMSMA is a welcome step as it seeks to address these issues.
Under PMSMA, a pregnant woman receives fixed-day assured, comprehensive and quality maternal care from medical specialists on the ninth of every month with the number symbolising nine months of pregnancy. Prenatal care services provided include iron, folic and calcium supplements; investigation for haemoglobin, HIV and syphilis; screening of women in their second and third trimesters at Government health facilities — even at the level of primary health centre, community health centre plus district hospital and at urban establishments. The minimum package includes an ultrasound during the second trimester.
At present, prenatal care is provided by accredited social health activists, auxiliary nurse midwives and anganwadi workers in remote places. With this campaign in place, specialised services are being provided by obstetricians, gynaecologists, radiologists and physicians at Government health facilities at least once every month. The role of private practitioners in providing services for free in faraway places is a boon, and Bagai calls it, an “enormous service to human kind.” So far, over 70 lakh pregnant women have received antenatal check-up and about four lakh high-risk cases detected. This number shall need to grow to expand the benefit of this revolutionary programme.
(The writer is a strategic communications professional)
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