Government Organization
What is the program?
- 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.
- Hon’ble Prime Minister highlighted the aim and purpose of introduction of the Pradhan Mantri Surakshit Matritva Abhiyan in the 31st July 2016 episode of Mann Ki Baat.
- 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.
- For Individual HRP tracking, MoHFW launched e-PMSMA (Extended -Pradhan Mantri Surakshit Matritva Abhiyan) on January 2022. Furthermore, for tracking Individual High-Risk Pregnancy (HRP), Ministry has developed additional feature in existing PMSMA portal.
Rationale for the program
- Data indicates that Maternal Mortality Ratio (MMR) in India was very high in the year 1990 with 556 women dying during child birth per hundred thousand live births as compared to the global MMR of 385/lakh live births
- Maternal Mortality Ratio (MMR) of India has declined by 459 points from 556 per one lakh live births in 1990 to 97 in 2018-2020 as per Sample Registration System (SRS). A decline of 83% has been achieved in MMR since 1990, which is higher than the global decline of 45%
- While India has made considerable progress in the reduction of maternal and infant mortality, every year approximately 24000 (MMEIG 2020 Report) women still die due to pregnancy-related causes and approximately 5.40 lakh infants die within the first 28 days of life (SRS 2020)
- Many of these deaths are preventable and many lives can be saved if quality care is provided to pregnant women during their antenatal period and high risk factors such as severe anemia, pregnancy-induced hypertension etc are detected on time and managed well.
Goal & Objectives of PMS
Goal of the PMSMA
Pradhan Mantri Surakshit Matritva Abhiyan envisages to improve the quality and coverage of Antenatal Care (ANC) including diagnostics and counselling services as part of the Reproductive Maternal Neonatal Child and Adolescent Health (RMNCH+A) Strategy.
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
- PMSMA is based on the premise — that if every pregnant woman in India is examined by a physician and appropriately investigated at least once during the PMSMA and then appropriately followed up — 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.
- A minimum package of antenatal care services (including investigations and drugs) would be provided to the beneficiaries on the 9th day of every month at identified public health facilities (PHCs/ CHCs, DHs/ urban health facilities etc) in both urban and rural areas in addition to the routine ANC at the health facility/ outreach.
- 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
- A National Portal for PMSMA and a Mobile application have been developed to facilitate the engagement of private/ voluntary sector.
- ‘IPledgeFor9’ Achievers Awards have been devised to celebrate individual and team achievements and acknowledge voluntary contributions for PMSMA in states and districts across India.
For further details kindly refer to the detailed operational framework for the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA).
Key features of E-PMSMA
- Name- based line listing of HRPs
- Provision of additional PMSMA Session (Max 4 times in a month)
- Individual tracking of HRP up to healthy outcome (till 45th day after delivery)
- SMS alert to beneficiary as well as to the ASHA for registration of HRP & follow-up visits
Budgetary Considerations
Funds for following activities can be obtained through the National Health Mission annual programme implementation plans under RCH / NHM flexible pool:
- Transportation facilities to PW residing in difficult / inaccessible areas, in blocks with home deliveries >20% under JSSK (preferably in a group).
- Funds for USG services under Free Diagnostics Initiative / JSSK funds.
- Districts can receive Rs. 50000- Rs. 200000 / year for undertaking activities such as sensitization of stakeholders, meetings of committees, IEC campaigns etc.
- States can receive Rs. 3 lacs -5 lacs / year for undertaking activities such as sensitization of stakeholders, meetings of committees, IEC campaigns etc.
Budgetary Provision in E-PMSMA
- Case based incentive to ASHA
- Rs. 100/- per HRP may be provided to ASHA for mobilization of HRPs for a maximum of three follow up ANC visits to PMSMA clinics/nearest facility for check up by a doctor/Obstetrician
- Rs. 500/- per HRP may be provided to ASHA on achieving a healthy outcome for both mother and baby at 45th day after delivery after due verification by concerned ANM and MO.
- Case-based incentives to beneficiaries
- Once a pregnant woman is diagnosed as an HRP, Rs.100/-per visit may be provided to meet transportation costs for attending a maximum of three PMSMA sessions/nearest facility for follow up ANC checkups by a doctor/Obstetrician.
Pregnant Women
What benefits would pregnant women receive
- Case-based incentives to beneficiaries
- Once a pregnant woman is diagnosed as an HRP, Rs.100/-per visit may be provided to meet transportation costs for attending a maximum of three PMSMA sessions/nearest facility for follow up ANC checkups by a doctor/Obstetrician.