As per a notice issued by the family planning department under the National Health Mission (NHM) and sent to all state mission directors on 14 February, the number of high-risk pregnancy categories has been increased from 10 to 24.
“This step has been taken to save more lives—both mother and the newborn. The addition (of new categories) means a covid- positive woman will be covered under the programme,” said a senior official aware of the matter.
As per the health ministry, states where the highest of pregnant women in their second or third trimester received antenatal care under the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) in January are Uttar Pradesh (153,766), Andhra Pradesh (29,085), Bihar (24,446), West Bengal (16,202) and Karnataka (16,122).
So far, 47.34 million women have been covered under the programme.
The government launched PMSMA in 2016 to provide fixed-day, free-of-cost, assured, comprehensive and quality antenatal care on the ninth day of every month to all pregnant women in their second and third trimester. In January 2022, the ministry launched the extended PMSMA (e-PMSMA) to further strengthen high-risk pregnancy tracking.
The notice said, “Furthermore, for tracking individual high-risk pregnancy and provision of additional PMSMA sessions, the ministry has developed additional features in the existing PMSMA portal: name based line-listing of high-risk pregnancies (HRP), individual tracking of HRP up to healthy outcome (till 45th day after delivery), HRP categories has increased from 10 categories to 24 categories, additional tab for pregnant women check-up and HRP detection in other than 9th of every month, provision of additional PMSMA session over and above 9th day of every month (max four times in a month), ASHA profile generation, statistical representation of various services under PMSMA/e-PMSMA, sms alert to beneficiary as well as to the ASHA for registration of HRP and follow up visits.”
Before the additions were made, the ministry conducted a pilot study on extended PMSMA in Gujarat, Uttar Pradesh, Madhya Pradesh and Karnataka. As per the ministry, this was done to identify challenges in implementing the additional PMSMA components and address any issues or technical glitches. Accordingly, the suggestions/feedback are incorporated in the portal.
“Furthermore, as decided, the same services would be implemented across all states/UTs. In order to enable appropriate follow ups, tracking, and management of all high-risk pregnancies, it is therefore requested to give instruction to all concerned for reporting of the aforementioned extra features on a regular basis in the PMSMA portal,” the notice read.
Some of the high-risk conditions of pregnancy are severe anaemia (haemoglobin less than 7gm/dl), pregnancy-induced hypertension, pre-eclampsia, pre-eclampsic toxemia, syphilis/HIV positive, gestational diabetes mellitus, hypothyroidism, young primi ( less than 20 years) or elderly gravida (more than 35 years), twin / multiple pregnancy, low lying placenta, placenta previa, positive bad obstetric history (history of still birth, abortion, congenital malformation, obstructed labour, premature birth etc.)
The maternal mortality rate in India has declined by 6.36% between 2000 and 2020, which is higher than the global decline, women and child development minister Smriti Irani told the Rajya Sabha during the last Parliament session, citing the UN Maternal Mortality Estimation Inter-Agency Group (MMEIG) 2020 report.
“The maternal mortality rate (MMR) of India has declined from 384 in 2000 to 103 (per 100,000 births) in 2020, whereas the global MMR has declined from 339 in 2000 to 223 in 2020. The average annual rate of reduction in global MMR during the 2000–2020 periods was 2.07%, while India’s MMR has declined by 6.36%, which is higher than the global decline,” she said.
Dr Hrishikesh Pai, former head of the Federation of Obstetric and Gynaecological Societies of India, said the programme has been doing well and has helped to decrease mortality rate in India. “The target set by India by 2030 for MMR is 70 per 100,000 and some of the states are really doing well, such as Kerala and Maharashtra. It is good that more factors have been included in the high risk pregnancy categories,” he added.
An email sent to the Union health and family welfare seeking response went unanswered at press time.
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Published: 23 Feb 2024, 10:10 PM IST