Reduction of MMR has been the priority agenda of the State Govt. Madhya Pradesh is showing the steady trend of decline in the MMR which is evident from various survey data. The MMR of MP was 310 in 2010-11 AHS and with the constant decline in MMR, it is now 227 as per AHS 2012-13 and 221 as SRS 2011-13. Mamta Abhiyan phase-I was launched on 11th April 2013 which shows a strong political and programmatic commitment for reduction of MMR. Phase- I focused on strengthening of infrastructure, Human resource, Supportive services at facilities (Drugs, Diet, Diagnostic, cleanliness and security). Subsequently Phase-II was launched on 26 June 2014 to focus on improving quality of services through supportive supervision, Generating awareness among the community through IEC and BCC.
        MP envisions achieving the goal of reduction of MMR to 100 by 2017 as per the 12th five year plan. Under RMNCH+A, identification of 17 high priority districts (HPDs) which are low performing in terms of process indicators (HMIS) are the focus districts in terms of HR, Infrastructure for achieving overall improvement in health indicators of MP. Analysis at State level has been done and weak areas have been identified for planning district specific interventions for improving the particular area as per RMNCH 5x5 matrix.
Performance Status of Service Delivery Indicator
S.N. Indicators AHS 2010-11 AHS 2011-12 AHS 2012-13
1. Currently Married Pregnant Women aged 15-49 years registered for ANC (%) 66.5 70 71.6
2. Mothers who received any Antenatal Check-up (%) 88.6 91.1 92.7 88.6 91.1 92.7
3. Mothers who had Antenatal Check-up in First Trimester (%) 66.5 70 73.3
4. Mothers who received 3 or more Antenatal Care (%) 68.1 70.7 71.7
5. Mothers who received at least one Tetanus Toxoid (TT) injection (%) 94.8 90.6 91.8
6. Mothers who consumed IFA for 100 days or more (%) 1 7.5 18.9 19.5
7. Mothers whose Blood Pressure (BP) taken (%) 64.3 70.1 73.1
8. Mothers whose Blood taken for Hb (%) 53.2 56.5 60.5
9. Mothers who had Full Antenatal Check-up (%) 13.3 15.3 16.2
10. Mothers who received ANC from Govt. Source (%) 49.5 49.8 51.0
11. Mothers who underwent Ultrasound (%) 30.7 36.8 41.5
12. Institutional Delivery (%) 76.1 79.7 82.6
13. Delivery at Home (%) 23.5 20 17.1
14. Delivery at home conducted by skilled health personnel (%) 26 31.1 38.3
15. Delivery at Government Institution (%) 65.5 68.7 71.3
16. Delivery at Private Institution (%) 10.5 10.9 11.2
17. Caesarean out of total delivery taken place in Government Institutions (%) 3.8 4.3 5.0
18. Caesarean out of total delivery taken place in Private Institutions (%) 30.9 31.2 31.1
19. Less than 24 hrs. Stay in institution after delivery (%) 27.2 23.1 21.8
20. Mothers who received Post-natal Check-up within 48 hrs. of delivery (%) 74.2 77.8 80.5
21. Mothers who received Post-natal Check-up within 1 week of delivery (%) 76.6 80.3 84.8
22. Mothers who did not receive any Post-natal Check-up (%) 22.1 18.6 14.1
23. Mothers who availed financial assistance for delivery under JSY (%) 61.1 69.3 72.9
Maternal Health Key Strategies

• Increasing accessibility of essential and emergency obstetric and new born care services.
• Improved access and quality of skilled delivery care.
• Improved coverage and quality of antenatal, intranatal and postnatal care with focus on anaemia prevention & management.
• Strengthening referral transport services.
• Improving accessibility of safe abortion services.
• Availability of blood transfusion facilities at functional level 3 institutions.
• Strengthening of trainings of ANM and SNs for SBA skills.
• Skills enhancement of Service providers.
• Supervision monitoring for quality assurance of services.

Maternal Health Major Interventions

• Operationalization of MCH centres as Delivery Points
• Provision of Quality ANC/PNC Services along with identification of High Risk Cases
• Implementation of PPH programme for home delivery cases
• Improving reporting and review of maternal deaths through MDR Software
• Janani Shishu Suraksha Karyakram (JSSK)
• Janani Suraksha Yojana (JSY)
• RTI/STI & Safe Abortion (MTP)
• Blood Bank & Blood Storage
• Skill Lab. at SIHMC Gwalior, DH Bhopal, DH Rewa and RHWTC Indore
• Double Fortified Salt for BPL families to reduce anemia prevalence in all ages
• IFA Supplementation and distribution of Albendazol tablet in pregant women and women in reproductive age group.
• Mass media campaign for promotion of Safe abortion services.

        With the launch of National Rural Health Mission many positive changes have take place in terms of Public Health, Infrastructure and service delivery in the State of M.P., but still there is scope for improvement in the quality of services being rendered. High MMR, IMR and TFR are the most challenging issue for the State
        Considering the WHO concept of all pregnancies to be considered at risk the State is moving forward with the approach of making EmOC facilities easily available and accessible along with referral transport facilities along with strengthening of ANC /PNC services, ensuring cashless delivery services through implementation of Janani Shishu Suraksha Karyakram, Janani Express and Janani Suraksha Yojana. To overcome infrastructure constraint and ensure quality maternity services, model maternity wings are being established in the DH of the State and maternity wing drive is initiated to ensure uniform pattern of service delivery with available resources in maternity wing
        Rational deployment of specialists, MOs, SNs and ANMs is being done to address manpower issues in delivery points along with performance based incentives to doctors and SNs in high focus districts. Establishment of obst. ICCU in medical colleges has been taken on priority for better management of referral cases.
        Efforts to operationalise GRAM AAROGYA KENDRA in very village to improve service delivery of MH services at community level have also being taken on priority.
        For focused efforts in operationalization of health facilities as delivery point and in turn to provide maternal and child health services to all segment of the community, state had identified 1596 institutes to be developed as delivery points. The capacity building of service providers is being taken care by imparting training on basic and comprehensive emergency obstetric care. The deliberations in AMPOGS Xth conference on labour will beneficial for both private and public sector obstetrician in rendering quality intrapartum care.
        The department envisions significant dent in maternal and neo natal mortality with intensive focus on care of women during delivery.

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