Maternal Health
Introduction
Maternal health is the health of women during pregnancy, child birth and in the postpartum period. It encompasses the health care dimensions of family planning, pre conception, prenatal and post natal care in order to ensure a positive and fulfilling experience and reduce maternal morbidity and mortality.
Maternal health has been a global concern because the lives of millions of women in reproductive age can be saved through maternal health care services. Despite efforts that has been made to strengthen maternal health care services, maternal mortality is still high. Women who remain healthy during pregnancy and child birth and thereafter are more likely to stay healthy later in life and have better birth outcomes influencing infancy, childhood and adulthood. Therefore, the health and wellbeing of women matter to every person, society, state and country and are essential for the achievement of the SDG goals.
According to the latest Sample Registration System (SRS) 2018-20 data, Odisha’s Maternal Mortality Ratio (MMR) has significantly reduced from 358 to 135 per one lakh live births. But this is still above the national average of 93. The Sustainable Development Goals (SDG) target aims to reduce MMR to below 70 by 2030.
State is continuing its effort in both community and facility levels for improvement of maternal health indicators and is implementing various National and State funded programmes to reduce deaths occurring due to preventable causes.
Maternal Health Activities implemented in the State
State of Odisha has implemented various maternal health activities to improve healthcare services and outcomes. Some of the major ongoing programs are highlighted below:
1. Janani Suraksha Yojana (JSY) –This activity is launched in April 2005 as demand promotion and conditional cash benefit scheme. It is a vital initiative implemented to promote institutional deliveries and reduce maternal and neonatal mortality rates. Under JSY, pregnant women in both rural and urban areas receive cash incentives to encourage them to give birth in a public and private accredited healthcare facility, ensuring access to skilled medical professionals and essential maternal care services. An amount of Rs. 1400/- and Rs. 1000/- is provided to institutional delivery cases in rural and urban areas respectively. The program also provides financial support to Accredited Social Health Activists (ASHAs) for their efforts in mobilizing pregnant women, ensuring regular antenatal check-ups, and promoting safe delivery practices. ASHAs are provided Rs. 600 for rural areas and Rs. 400 for urban areas for ANC check-up and mobilizing delivery cases for institutional delivery.
2. Janani Shisu Surakshya Karyakram (JSSK): It is a flagship program implemented in the State since June 2011 to provide free and comprehensive healthcare services to pregnant women, mothers, and infants. Under JSSK, beneficiaries receive free entitlements such as drugs, diagnostics, blood transfusions, referral transport, diet and free of user charges to promote institutional deliveries and ensure the well-being of both mother and child. The program aims to reduce out-of-pocket expenses, encourage health-seeking behaviour, and ensure quality care during pregnancy, childbirth, and the postnatal period. The beneficiaries of the program are all pregnant women, post natal cases up to 42 days of termination of pregnancy and sick infants up to 1 year (since 2013).
3. Village/Urban Health Sanitation and Nutrition Days (VHSND/UHSND):Village Health and Nutrition Day (VHND) programme is being implemented across the country since 2007, as a community platform, connecting the community and health system and facilitating convergent actions. It attempts to bring health, Early Childhood Development, nutrition and sanitation services to the doorstep and promote community engagement for improved health and wellbeing. Since 2019, VHND has been renamed as VHSND to reflect its intersectoral nature. VHSND/UHSND are monthly fixed-day services organized at the Anganwadi center level. These sessions provide primary healthcare services, including antenatal care, nutrition counselling, growth monitoring, and early childhood development. These sessions play a crucial role in promoting safe motherhood by offering services such as pregnancy registration, obstetric history taking, physical examinations, blood tests, and referrals for high-risk pregnancies. The regular conduction of VHSND has contributed to increased first trimester ANC registration and improved antenatal care indicators. This programme was initiated in the year 2007 and implemented across 30 districts. Annually around 568620 sessions are planned and 98% of the planned sessions are held every year. The target beneficiaries of these sessions are all pregnant women, PNC mothers, lactating mothers, children in the age group of 0-59 months and adolescents (10-19 yrs)& Women of Reproductive Age (WRA).
Trend of MMR
The latest publication of the SRS bulletin of 2019-2021, shows that Odisha has MMR of 135 per 1 lakh live births against national status of 93 / 1 lakh live births
Maternal Health Activities implemented in the State
State of Odisha has implemented various maternal health activities to improve healthcare services and outcomes. Some of the major ongoing programs are highlighted below:
1. Janani Suraksha Yojana (JSY) –This activity is launched in April 2005 as demand promotion and conditional cash benefit scheme. It is a vital initiative implemented to promote institutional deliveries and reduce maternal and neonatal mortality rates. Under JSY, pregnant women in both rural and urban areas receive cash incentives to encourage them to give birth in a public and private accredited healthcare facility, ensuring access to skilled medical professionals and essential maternal care services. An amount of Rs. 1400/- and Rs. 1000/- is provided to institutional delivery cases in rural and urban areas respectively. The program also provides financial support to Accredited Social Health Activists (ASHAs) for their efforts in mobilizing pregnant women, ensuring regular antenatal check-ups, and promoting safe delivery practices. ASHAs are provided Rs. 600 for rural areas and Rs. 400 for urban areas for ANC check-up and mobilizing delivery cases for institutional delivery.
2. Janani Shisu Surakshya Karyakram (JSSK): It is a flagship program implemented in the State since June 2011 to provide free and comprehensive healthcare services to pregnant women, mothers, and infants. Under JSSK, beneficiaries receive free entitlements such as drugs, diagnostics, blood transfusions, referral transport, diet and free of user charges to promote institutional deliveries and ensure the well-being of both mother and child. The program aims to reduce out-of-pocket expenses, encourage health-seeking behaviour, and ensure quality care during pregnancy, childbirth, and the postnatal period. The beneficiaries of the program are all pregnant women, post natal cases up to 42 days of termination of pregnancy and sick infants up to 1 year (since 2013).
3. Village/Urban Health Sanitation and Nutrition Days (VHSND/UHSND):Village Health and Nutrition Day (VHND) programme is being implemented across the country since 2007, as a community platform, connecting the community and health system and facilitating convergent actions. It attempts to bring health, Early Childhood Development, nutrition and sanitation services to the doorstep and promote community engagement for improved health and wellbeing. Since 2019, VHND has been renamed as VHSND to reflect its intersectoral nature. VHSND/UHSND are monthly fixed-day services organized at the Anganwadi center level. These sessions provide primary healthcare services, including antenatal care, nutrition counselling, growth monitoring, and early childhood development. These sessions play a crucial role in promoting safe motherhood by offering services such as pregnancy registration, obstetric history taking, physical examinations, blood tests, and referrals for high-risk pregnancies. The regular conduction of VHSND has contributed to increased first trimester ANC registration and improved antenatal care indicators. This programme was initiated in the year 2007 and implemented across 30 districts. Annually around 568620 sessions are planned and 98% of the planned sessions are held every year. The target beneficiaries of these sessions are all pregnant women, PNC mothers, lactating mothers, children in the age group of 0-59 months and adolescents (10-19 yrs)& Women of Reproductive Age (WRA).