Schemes under Ministry of Health and Family Welfare

  1. Introduction
  2. Aim
  3. Approach
  4. Key features
  5. Benefits and significance
  6. Eligibility
  7. IMA Suggestions
  8. State’s Response

Introduction

  • Launched as recommended by the National Health Policy 2017, to achieve the vision of Universal Health Coverage (UHC).
  • This initiative has been designed on the lines as to meet SDG and its underlining commitment, which is “leave no one behind”.

Aim

  • to undertake path breaking interventions to holistically address health (covering prevention, promotion and ambulatory care), at primary, secondary and tertiary level.
  • Includes the on-going centrally sponsored schemes – Senior Citizen Health Insurance Scheme (SCHIS) and Rashtriya Swasthya Bima Yojana (RSBY).

Approach

  • Ayushman Bharat adopts a continuum of care approach, comprising of two inter-related components, which are:
    • Health and Wellness Centres (HWCs).
    • Pradhan Mantri Jan Arogya Yojana (PM-JAY).

Key Features of PM-JAY

  • The world’s largest health insurance/ assurance scheme fully financed by the government.
  • It provides cover of 5 lakhs per family per year, for secondary and tertiary care hospitalization across public and private empaneled hospitals in India.
  • Coverage: Over 10.74 crore poor and vulnerable entitled families (approximately 50 crore beneficiaries) are eligible for these benefits.
  • Provides cashless access to health care services for the beneficiary at the point of service.

Benefits and significance

  • Helps reduce catastrophic expenditure for hospitalizations, which pushes 6 crore people into poverty each year.
  • Helps mitigate the financial risk arising out of catastrophic health episodes.

Eligibility

  • No restrictions on family size, age or gender.
  • All pre–existing conditions are covered from day one.
  • Covers up to 3 days of pre-hospitalization and 15 days post-hospitalization expenses such as diagnostics and medicines.
  • Benefits of the scheme are portable across the country.
  • Services include approximately 1,393 procedures covering all the costs related to treatment, including but not limited to drugs, supplies, diagnostic services, physician’s fees, room charges, surgeon charges, OT and ICU charges etc.
  • Public hospitals are reimbursed for the healthcare services at par with the private hospitals.

Suggestions made by Indian Medical Association (IMA):

  • Government hospitals should be removed from the ambit of the scheme as services there are already free of cost.
  • The government should fund public hospitals directly.
  • Under this scheme, it is being done through insurance companies by paying 15 per cent to them.
  • India should not continue the insurance route for healthcare delivery as the administrative cost and the “unholy nexus” with insurance companies point towards profit maximization rather than quality health care delivery.
  • Need of the hour: “Tax funded” universal health coverage rather than the “for profit” insurance model.

Why some states have not implemented the health protection plan and what is holding back its 100 per cent implementation?

  • Few states including Delhi, Telangana, West Bengal and Odisha are not covered.
  • Health is a state subject, and so far these states have declined joining the central government-led scheme.
  • Delhi government argues that it’s existing health scheme has wider coverage and is “10 times bigger than Ayushman Bharat”.
  • Odisha has pointed out certain flaws, saying that the existing Biju Swastya Kalyan Yojana has special provisions like an extra Rs 2 lakh cover for women, which the Ayushman scheme lacks.
  • Telangana too has raised concerns about the rather “narrow ambit” of PM-JAY, saying that its Aarogyasri scheme. benefits more people.
  • West Bengal opted out, refusing to pay its share of the expenditure.

Janani Suraksha Yojana

  1. Introduction
  2. Background on JSY
  3. Objective
  4. Target Group and benefits

Introduction

  • Janani Suraksha Yojana (JSY) is a safe motherhood intervention under the National Rural Health Mission (NHM).
  • The scheme is under implementation in all states and Union Territories (UTs), with a special focus on Low Performing States (LPS).
  • Janani Suraksha Yojana was launched in April 2005 by modifying the National Maternity Benefit Scheme (NMBS).
  • The NMBS came into effect in August 1995 as one of the components of the National Social Assistance Programme (NSAP).
  • The scheme was transferred from the Ministry of Rural Development to the Department of Health & Family Welfare during the year 2001-02.
  • The NMBS provides for financial assistance of Rs. 500/- per birth up to two live births to the pregnant women who have attained 19 years of age and belong to the below poverty line (BPL) households.
  • When JSY was launched the financial assistance of Rs. 500/- , which was available uniformly throughout the country to BPL pregnant women under NMBS, was replaced by graded scale of assistance based on the categorization of States as well as whether beneficiary was from rural/urban area.
  • States were classified into Low Performing States and High Performing States on the basis of institutional delivery rate i.e. states having institutional delivery 25% or less were termed as Low Performing States (LPS) and those which have institutional delivery rate more than 25% were classified as High Performing States (HPS).
  • Accordingly, eight erstwhile EAG states namely Uttar Pradesh, Uttarakhand, Madhya Pradesh, Chhattisgarh, Bihar, Jharkhand, Rajasthan, Odisha and the states of Assam & Jammu & Kashmir were classified as Low Performing States.
  • The remaining States were grouped into High Performing States.

Background on JSY

  • About 56,000 women in India die every year due to pregnancy related complications.
  • Similarly, every year more than 13 lakh infants die within 1year of the birth and out of these approximately 2/3rd of the infant deaths take place within the first four weeks of life.
  • Out of these, approximately 75% of the deaths take place within a week of the birth and a majority of these occur in the first two days after birth.
  • In order to reduce the maternal and infant mortality, Reproductive and Child Health
  • Programme under the National Health Mission (NHM) is being implemented to promote institutional deliveries so that skilled attendance at birth is available and women and new born can be saved from pregnancy related deaths.
  • Several initiatives have been launched by the Ministry of Health and Family Welfare (MoHFW) including Janani Suraksha Yojana (JSY) a key intervention that has resulted in phenomenal growth in institutional deliveries.

Objective

  • Reducing maternal and infant mortality by promoting institutional delivery among pregnant women.

Target Group and benefits

  • The scheme focuses on poor pregnant woman with a special dispensation for states that have low institutional delivery rates, namely, the states of Uttar Pradesh, Uttarakhand, Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Assam, Rajasthan, Orissa, and Jammu and Kashmir.
  • While these states have been named Low Performing States (LPS), the remaining states have been named High Performing states (HPS).
  • The scheme also provides performance based incentives to women health volunteers known as ASHA (Accredited Social Health Activist) for promoting institutional delivery among pregnant women.
  • Under this initiative, eligible pregnant women are entitled to get JSY benefit directly into their bank accounts.

Janani Shishu Suraksha Karyakaram

  1. Introduction
  2. Situation
  3. The New Initiative
  4. Free entitlements
  5. Key features of the scheme

Introduction

  • Government of India has launched the Janani Shishu Suraksha Karyakaram (JSSK) on 1st June, 2011.
  • The scheme is to benefit pregnant women who access Government health facilities for their delivery.
  • Moreover it will motivate those who still choose to deliver at their homes to opt for institutional deliveries.
  • All the States and UTs have initiated implementation of the scheme.

Situation

  • High out of pocket expenses being incurred by pregnant women and their families in the case of institutional deliveries in form of drugs, User charges, diagnostic tests, diet, for C –sections.

The New Initiative

  • In view of the difficulty being faced by the pregnant women and parents of sick new- born along-with high out of pocket expenses incurred by them on delivery and treatment of sick- new-born, Ministry of Health and Family Welfare (MoHFW) has taken a major initiative to evolve a consensus on the part of all States to provide completely free and cashless services to pregnant women including normal deliveries and caesarean operations and sick new born (up to 30 days after birth) in Government health institutions in both rural and urban areas.

The following are the Free Entitlements for pregnant women:

  • Free and cashless delivery
  • Free C-Section
  • Free drugs and consumables
  • Free diagnostics
  • Free diet during stay in the health institutions
  • Free provision of blood
  • Exemption from user charges
  • Free transport from home to health institutions
  • Free transport between facilities in case of referral
  • Free drop back from Institutions to home after 48hrs stay
  • The following are the Free Entitlements for Sick newborns till 30 days after birth.This has now been expanded to cover sick infants:
  • Free treatment
  • Free drugs and consumables
  • Free diagnostics
  • Free provision of blood
  • Exemption from user charges
  • Free Transport from Home to Health Institutions
  • Free Transport between facilities in case of referral
  • Free drop Back from Institutions to home

Key features of the scheme

  • The initiative entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery, including caesarean section.
  • The entitlements include free drugs and consumables, free diet up to 3 days during normal delivery and up to 7 days for C-section, free diagnostics, and free blood wherever required.
  • This initiative also provides for free transport from home to institution, between facilities in case of a referral and drop back home.
  • Similar entitlements have been put in place for all sick newborns accessing public health institutions for treatment till 30 days after birth.
  • This has now been expanded to cover sick infants:
  • The scheme aims to eliminate out of pocket expenses incurred by the pregnant women and sick new borne while accessing services at Government health facilities.
  • The scheme is estimated to benefit more than 12 million pregnant women who access Government health facilities for their delivery.
  • Moreover it will motivate those who still choose to deliver at their homes to opt for institutional deliveries.
  • All the States and UTs have initiated implementation of the scheme

  • Introduction
  • Target age group
  • Health conditions to be screened
  • Mechanisms for screening at Community & Facility level:
  1. Screening at Anganwadi Centre
  2. Screening at Schools – Government and Government aided
  3. Composition of mobile health team

Introduction

  • Rashtriya Bal Swasthya Karyakram (RBSK) is a new initiative aiming at early identification and  early  intervention  for  children  from  birth  to  18  years to cover 4 ‘D’s viz. Defects at  birth,  Deficiencies,  Diseases,  Development  delays  including 
  • It is important to note that the 0 – 6 years age group will be specifically managed at District  Early  Intervention  Center  ( DEIC ) level  while  for  6 -18  years  age  group,  management  of conditions  will  be  done  through  existing  public  health facilities.
  • DEIC will act as referral linkages for both the age groups.
  • First level of screening is to be done at all delivery points through existing Medical Officers, Staff Nurses and ANMs.
  • After 48 hours till 6 weeks the screening of newborns will be done by ASHA at home as a part of HBNC package.
  • Outreach  screening  will  be  done  by  dedicated  mobile  block  level  teams  for  6  weeks  to  6 years at anganwadis centres and 6 – 18 years children at school.
  • Once the child is screened and referred from any of these points of identification, it would be ensured that the necessary treatment/intervention is delivered at zero cost to the family.

Target age group

  • The services aim to cover children of 0 -6 years of  age  in  rural  areas  and  urban  slums  in addition  to  children  enrolled  in  classes  I to XII in  Government  and  Government  aided 
  • It is expected that these services will reach to about 27 crores children in a phased manner.
  • The broad category of age group and estimated beneficiary is as shown below in the table.
  • The children have been grouped in to three categories owing to the fact that different sets of tools would be used and also different set of conditions could be prioritized.

Health conditions to be screened

  • Child Health Screening and Early Intervention Services under RBSK envisages to cover 30 selected health conditions for Screening, early detection and free management.
  • States and UTs may also include diseases  namely hypothyroidism,  Sickle  cell  anaemia  and  Beta Thalassemia  based  on  epidemiological  situation  and availability  of  testing  and  specialized support facilities within State and UTs.

Selected Health Conditions for Child Health Screening & Early Intervention Services

  1. Neural tube defect
  2. Down’s Syndrome
  3. Cleft Lip & Palate / Cleft palate alone
  4. Talipes (club foot)
  5. Developmental dysplasia of the hip
  6. Congenital cataract
  7. Congenital deafness
  8. Congenital heart diseases
  9. Retinopathy of Prematurity
  10. Anaemia especially Severe anaemia
  11. Vitamin A deficiency (Bitot spot)
  12. Vitamin D Deficiency, (Rickets)
  13. Severe Acute Malnutrition
  14. Goiter
  15. Skin conditions (Scabies, fungal infection and Eczema)
  16. Otitis Media
  17. Rheumatic heart disease
  18. Reactive airway disease
  19. Dental conditions
  20. Convulsive disorders
  21. Vision Impairment
  22. Hearing Impairment
  23. Neuro-motor Impairment
  24. Motor delay
  25. Cognitive delay
  26. Language delay
  27. Behavior disorder (Autism)
  28. Learning disorder
  29. Attention deficit hyperactivity disorder
  30. Congenital Hypothyroidism, Sickle cell anemia, Beta thalassemia (Optional)

Mechanisms for screening at Community & Facility level

  • Child screening under RBSK is at two levels community level and facility level. While facility  based  new  born  screening  at  public  health  facilities  like  PHCs / CHCs/ DH, will be by existing health manpower like Medical Officers, Staff Nurses & ANMs, the community level screening  will be conducted  by  the  Mobile health teams  at  Anganwadi  Centres  and  Government and Government aided Schools.

Screening at Anganwadi Centre

  • All pre-school children below 6 years of age would be screened by Mobile Block Health teams for deficiencies, diseases, developmental delays including disability at the Anganwadi centre at least twice a year.
  • Tool for screening for 0-6 years is supported by pictorial, job   aids   specifically   for   developmental   For developmental delays children would be screened using age specific tools specific and those suspected would be referred to DEIC for further management.

Screening at Schools – Government and Government aided

  • School children age 6 to 18 years would be screened by Mobile Health teams for deficiencies, diseases, developmental delays including disability, adolescent health at the local schools at least once a year. The too used is questionnaire (preferably translated to local or regional language) and clinical examination.

Composition of mobile health team

  • The mobile health team will consist of four members- two Doctors (AYUSH) one male and one female, at least with a bachelor degree from an approved institution, one ANM/Staff Nurse and one Pharmacist with proficiency in computer for data management.

Rashtriya Kishor Swasthya Karyakram (RKSK)

  1. Introduction
  2. The Vision
  3. Objectives
  4. Target Groups
  5. Strategies

Introduction

  • The Ministry of Health & Family Welfare has launched a health programme for adolescents, in the age group of 10-19 years, which would target their nutrition, reproductive health and substance abuse, among other issues.
  • The Rashtriya Kishor Swasthya Karyakram was launched on 7th January, 2014.
  • The key principle of this programme is adolescent participation and leadership, Equity and inclusion, Gender Equity and strategic partnerships with other sectors and stakeholders.
  • The programme envisions enabling all adolescents in India to realize their full potential by making informed and responsible decisions related to their health and well-being and by accessing the services and support they need to do so.
  • To guide the implementation of this programme, MOHFW in collaboration with UNFPA has developed a National Adolescent Health Strategy.
  • It realigns the existing clinic-based curative approach to focus on a more holistic model based on a continuum of care for adolescent health and developmental needs.
  • The Rashtriya Kishor Swasthya Karyakram (National Adolescent Health Programme), will comprehensively address the health needs of the 243 million adolescents. It introduces community-based interventions through peer educators, and is underpinned by collaborations with other ministries and state governments.

The Vision

  • The strategy envisions that all adolescents in India are able to realise their full potential by making informed and responsible decisions related to their health and well-being, and by accessing the services and support they need to do so.
  • The implementation of this vision requires support from the government and other institutions, including the health, education and labour sectors as well as adolescents’ own families and communities.
  • Building an agenda for adolescent health requires an escalation in the visibility of young people and an understanding of the challenges to their health and development.
  • It needs implementation of approaches that will ensure a successful transition to adulthood.
  • This requires that the multi-dimensional health needs and special concerns of adolescents are understood and addressed in national policies and a range of programmes at different levels.

Objectives

  • Improve nutrition
  • Reduce the prevalence of malnutrition among adolescent girls and boys
  • Reduce the prevalence of iron-deficiency anaemia (IDA) among adolescent girls and boys
  • Improve sexual and reproductive health
  • Improve knowledge, attitudes and behaviour, in relation to SRH
  • Reduce teenage pregnancies
  • Improve birth preparedness, complication readiness and provide early parenting support for  adolescent parents
  • Enhance mental health
  • Address mental health concerns of adolescents
  • Prevent injuries and violence
  • Promote favourable attitudes for preventing injuries and violence (including GBV) among adolescents
  • Prevent substance misuse
  • Increase adolescents’ awareness of the adverse effects and consequences of substance misuse
  • Address NCDs
  • Promote behaviour change in adolescents to prevent NCDs such as hypertension, stroke, cardio-vascular diseases and diabetes

Target Groups

  • The new adolescent health (AH) strategy focuses on age groups 10-14 years and 15-19 years with universal coverage, i.e. males and females; urban and rural; in school and out of school; married and unmarried; and vulnerable and under-served.

Strategies

Strategies/interventions to achieve objectives can be broadly grouped as:

  • Community based interventions
  • Peer Education (PE)
  • Quarterly Adolescent Health Day (AHD)
  • Weekly Iron and Folic Acid Supplementation Programme (WIFS)
  • Menstrual Hygiene Scheme (MHS)
  • Facility based interventions
  • Strengthening of Adolescent Friendly Health Clinics (AFHC)
  • Convergence
  • Within Health & Family Welfare – FP, MH (incl VHND), RBSK, NACP, National Tobacco Control Programme, National Mental Health Programme, NCDs and IEC
  • With other departments/schemes – WCD (ICDS, KSY, BSY, SABLA), HRD (AEP, MDM), Youth Affairs and Sports (Adolescent Empowerment Scheme, National Service Scheme, NYKS, NPYAD)
  • Social and Behaviour Change Communication with focus on Inter Personal Communication.

  1. Introduction
  2. About the campaign
  3. Target beneficiaries
  4. Public Health Facilities to access services under PMSMA
  5. Provision of services during PMSMA

Introduction

  • As India strives towards achieving the Sustainable Development Goals (SDGs) and looks ahead to the post – 2015 era, progress in reducing maternal mortality becomes an important frontier.
  • Every pregnancy is special and every pregnant woman must receive special care.
  • Any pregnant woman can develop life-threatening complications with little or no advance warning, so all pregnant women need access to quality antenatal services to detect and prevent life- threatening complications during childbirth.
  • With the implementation of several schemes, significant progress was observed in the maternal health care service indicators like institutional deliveries and Ante Natal Care (ANC) coverage.
  • As per latest data of the Rapid Survey on Children (2013 – 14), the institutional deliveries in India are 78.7%. Inspite of this massive increase in the number of pregnant women coming to institutions for delivery, till date only 61.8% women receive first ANC in first trimester (RSOC) and the coverage of full ANC (provision of 100 IFA tablets, 2 tetanus toxoid injections and minimum 3 ANC visits) is as low as 19.7 % ( RSOC ).
  • Despite availability of treatment guidelines, mechanisms for monitoring and supportive supervision, regular training of health care providers at different levels across the country and the existence of outreach platforms like Village Health and Nutrition Day (VHND), the desired coverage and quality of maternal health services is still a matter of concern. Maternal mortality with MMR of 167 per 1,00,000 live births still remains high even with improved access to maternal health care services.
  • Timely detection of risk factor during pregnancy and childbirth can prevent deaths due to 5 preventable causes.
  • This can only be possible if the complete range of the required services is accessed by the pregnant women.
  • With the objective to provide quality ANC to every pregnant woman the Government of India has launched the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), a fixed day ANCs given every month across the country.
  • This is to be given in addition of the routine ANC at the health facilit.

About the campaign

  • Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) is a fixed day strategy, every month across the country during which a range of quality maternal health services are envisaged to be provided as part of Antenatal Care.
  • Under the campaign, a minimum package of antenatal care services is to be provided to the beneficiaries on the 9th day of every month at the Pradhan Mantri Surakshit Matritva Clinics to ensure that every pregnant woman receives at least one checkup in the 2nd/ 3rd trimester of pregnancy.
  • If the 9th day of the month is a Sunday / a holiday, then the Clinic should be organized on the next working day.

Target beneficiaries

  • The programme aims to reach out to all Pregnant Women who are in the 2nd & 3rd Trimesters of pregnancy.

Public Health Facilities to access services under PMSMA

Rural Areas – Primary Health Centers, Community Health Centers, Rural Hospitals, Sub – District Hospital – District Hospital – Medical College HospitalUrban Areas – Urban Dispensaries,  Urban Health Posts, Maternity Homes


Provision of services during PMSMA

  • All the beneficiaries visiting the Facility are first registered in a separate register for Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA).
  • After registration, ANM & SN ensures that all basic laboratory investigations are done before the beneficiary is examined by the OBGY /Medical Officer.
  • The report of the investigations should ideally be handed over within an hour and before the beneficiaries are meeting the doctors for further checkups.
  • This will ensure identification of High Risk status (like anemia, gestational diabetes, hypertension, infection etc.) at the time of examination and further advice.
  • In certain cases, where additional investigations are required, beneficiaries are to be advised to get those investigations done and share the report during next PMSMA or during her routine ANC check – up visit.
  • Lab Investigations – USG, & all basic investigations – Hb , Urine Albumin, RBS (Dip stick), Rapid Malaria test, Rapid VDRL test, Blood Grouping, CBC ESR, USG
  • Following are details of specific services which will be provided during Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) :
  • A detailed history of all the beneficiaries needs to be taken and then examined and assessed for any danger signs, complications or any high risk status.
  • Blood Pressure, per abdominal examination and examination for fetal heart sounds should be done for all the beneficiaries coming for ANC check – up.
  • If a woman visiting a public health facility requires a specific investigation, sample should be collected at the facility itself and transported to the appropriate centre for testing. ANM/ MPW should be responsible for transporting the collected sample, conveying the results to the pregnant women and appropriate follow up.
  • After examination by ANM/Staff Nurse, Medical Officer to also examine and attend to every beneficiary attending PMSMA .
  • All identified high risk pregnancies should be referred to higher facilities and JSSK help desks that have been set up at these facilities should be responsible for guiding the referred women once they reach the facilities. MCP cards to be issued to all beneficiaries.
  • All identified High Risk women including those with complications to be managed and treated by OBGY/CEmOC/BEmOC Specialist).
  • If needed, such cases should be referred to higher level facilities and a referral slip with probable diagnosis and treatment given should be mentioned on the slip.
  • One ultrasound is recommended for all pregnant women during the 2nd/ 3rd trimester of pregnancy.
  • If required, USG services may be made available in a PPP mode and expenditure booked under JSSK.
  • Before leaving the facility every pregnant women to be counselled, may be individually or in groups, on nutrition, rest, safe sex, safety, birth preparedness, identification of danger signs, institutional delivery and Post – partum Family Planning ( PPFP ) .
  • Filling out the MCP cards at these clinics should be mandatory and a sticker indicating the condition and risk factor of the pregnant women should be added onto MCP card for each visit:
  1. Green Sticker – for women with no risk factor detected
  2. Red Sticker – for women with high risk pregnancy
  3. Blue – for women with Pregnancy Induced Hypertension
  4. Yellow – pregnancy with co-morbid conditions such as diabetes, hypothyroidism, STIs

Counselling session to focus on the following topics:

  1. Care during pregnancy.
  2. Danger signs during pregnancy.
  3. Birth preparedness & Complication readiness, contact details to be used in case of need
  4. Family Planning
  5. Importance of nutrition including iron – folic acid consumption and calcium supplementation.
  6. Rest
  7. Safe sex
  8. Institutional delivery.
  9. Identification of referral transport.
  10. Entitlements under Janani Suraksha Yojana (JSY)
  11. Entitlements and service guarantee under Janani Shishu Suraksha Karyakram (JSSK)
  12. Post – natal care.
  13. Breastfeeding and complementary feeding.
  14. Those pregnant women with unwanted pregnancies need to be provided with safe abortion care services after proper counselling.

Referral Transport Mechanism for High risk women:

During PMSMA, 108 /102 /State owned ambulances/Private empanelled ambulances can also be used for referring those cases identified as high risk.

Surakshit Matritva Aashwasan (Suman)

  1. About the Scheme
  2. Eligibility
  3. Features and Benefits
  4. Need and Significance
  5. Definition
  6. Stats

About the scheme

  • It aims to provide dignified and quality health care at no cost to every woman and newborn visiting a public health facility.
  • Under the scheme, the beneficiaries visiting public health facilities are entitled to several free services.
  • These include at least four ante natal check-ups that also includes one checkup during the 1st trimester, at least one checkup under Pradhan Mantri Surakshit Matritva Abhiyan, Iron Folic Acid supplementation, Tetanus diptheria injection.

Eligibility

  • All pregnant women, newborns and mothers up to 6 months of delivery will be able to avail several free health care services

Features and benefits

  • The scheme will enable zero expense access to the identification and management of complications during and after the pregnancy.
  • The government will also provide free transport to pregnant women from home to the health facility and drop back after discharge (minimum 48 hrs).
  • The pregnant women will be able to avail a zero expense delivery and C-section facility in case of complications at public health facilities.
  • The scheme will ensure that there is zero-tolerance for denial of services to such patients.

Need for and significance of the scheme

  • The scheme aims to bring down the maternal and infant mortality rates in the nation and to stop all preventable maternal and newborn deaths.
  • The scheme provides a positive and stress-free birth experience to the mother and newborn.

Definition

  • The World Health Organization (WHO) defines quality of care for mothers and newborns as “the extent to which health care services provided to individuals and patient populations improve desired health outcomes. In order to achieve this, health care must be safe, effective, timely, efficiently integrated, equitable and people-centered.”

Stats

  • According to government, India’s maternal mortality rate has declined from 254 per 1,00,000 live births in 2004-06 to 130 in 2014-16. Between 2001 and 2016, the infant mortality rate came down from 66 per 1,000 live births to 34.

Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)

  1. About the Scheme
  2. Components
  3. Objective
  4. Implementation
  5. Phases

About PMSSY

  • PMSSY was announced in 2003 with objectives of correcting regional imbalances in the availability of affordable/ reliable tertiary healthcare services and also to augment facilities for quality medical education in the country.
  • The PMSSY is implemented by the Ministry of Health and Family Welfare.

Components

  • It has two components:
  • Setting up new AIIMS (All India Institute of Medical Sciences).
  • Upgradation of government medical colleges in various states.

The project cost for upgradation of each medical college institution is shared by the Centre and the state.


Objectives

  • The Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) aims at correcting the imbalances in the availability of affordable healthcare facilities in the different parts of the country in general, and augmenting facilities for quality medical education in the under-served States in particular.
  • The scheme was approved in March 2006.

Implementation

First Phase

  • The first phase in the PMSSY has two components – setting up of six institutions in the line of AIIMS; and upgradation of 13 existing Government medical college institutions.
  • It has been decided to set up 6 AIIMS-like institutions, one each in the States of Bihar (Patna), Chattisgarh (Raipur), Madhya Pradesh (Bhopal), Orissa (Bhubaneswar), Rajasthan (Jodhpur) and Uttaranchal (Rishikesh) at an estimated cost of Rs 840 crores per institution. These States have been identified on the basis of various socio-economic indicators like human development index, literacy rate, population below poverty line and per capital income and health indicators like population to bed ratio, prevalence rate of serious communicable diseases, infant mortality rate etc. Each institution will have a 960 bedded hospital (500 beds for the medical college hospital; 300 beds for Speciality/Super Speciality; 100 beds for ICU/Accident trauma; 30 beds for Physical Medicine & Rehabilitation and 30 beds for Ayush) intended to provide healthcare facilities in 42 Speciality/Super-Speciality disciplines. Medical College will have 100 UG intake besides facilities for imparting PG/doctoral courses in various disciplines, largely based on Medical Council of India (MCI) norms and also nursing college conforming to Nursing Council norms.
  • In addition to this, 13 existing medical institutions spread over 10 States will also be upgraded, with an outlay of Rs. 120 crores (Rs. 100 crores from Central Government and Rs. 20 crores from State Government) for each institution.

These institutions are

  • Government Medical College, Jammu, Jammu & Kashmir
  • Government Medical College, Srinagar, Jammu & Kashmir
  • Kolkatta Medical College, Kolkatta, West Bengal
  • Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh
  • Institute of Medical Sciences, BHU, Varanasi, Uttar Pardesh
  • Nizam Institute of Medical Sciences, Hyderabad, Telangana
  • Sri Venkateshwara Institute of Medical Sciences, Tirupati, Andhra Pradesh
  • Government Medical College, Salem, Tamil Nadu
  • B.J. Medical College, Ahmedabad, Gujarat
  • Bangalore Medical College, Bengaluru, Karnataka
  • Government Medical College, Thiruvananthapuram, Kerala
  • Rajendra Institute of Medical Sciences (RIMS), Ranchi
  • Grants Medical College & Sir J.J. Group of Hospitals, Mumbai, Maharashtra.

Second Phase

  • In the second phase of PMSSY, the Government has approved the setting up of two more AIIMS-like institutions, one each in the States of West Bengal and Uttar Pradesh and upgradation of six medical college institutions namely
  1. Government Medical College, Amritsar, Punjab
  2. Government Medical College, Tanda, Himachal Pradesh
  3. Government Medical College, Madurai, Tamil Nadu
  4. Government Medical College, Nagpur, Maharashtra
  5. Jawaharlal Nehru Medical College of Aligarh Muslim University, Aligarh
  6. Pt. B.D. Sharma Postgraduate Institute of Medical Sciences, Rohtak
  • The estimated cost for each AIIMS-like institution is Rs. 823 crore. For upgradation of medical college institutions, Central Government will contribute Rs. 125 crore each.

Third Phase

  • In the third phase of PMSSY, it is proposed to upgrade the following existing medical college institutions namely
  1. Government Medical College, Jhansi, Uttar Pradesh
  2. Government Medical College, Rewa, Madhya Pradesh
  3. Government Medical College, Gorakhpur, Uttar Pradesh
  4. Government Medical College, Dharbanga, Bihar
  5. Government Medical College, Kozhikode, Kerala
  6. Vijaynagar Institute of Medical Sciences, Bellary, Karnataka
  7. Government Medical College, Muzaffarpur, Bihar
  • The project cost for upgradation of each medical college institution has been estimated at Rs. 150 crores per institution, out of which Central Government will contribute Rs. 125 crores and the remaining Rs. 25 crore will be borne by the respective State Governments.

Labour Room Quality Improvement Initiative

  1. About the Scheme
  2. Aim
  3. Goal
  4. Objectives
  5. Strategies
  6. Scope
  7. Institutional Arrangement
  8. Targets

Introduction

  • It’s a multipronged approach focused at Intrapartum and immediate postpartum period.

Aim

  • To reduce preventable maternal and newborn mortality, morbidity and stillbirths associated with the care around delivery in Labour room and Maternity Operation Theatre and ensure respectful maternity care.

About the Scheme

  • After launch of the National Health Mission (NHM), there has been substantial increase in the number of institutional deliveries.
  • However, this increase in the numbers has not resulted into commensurate improvements in the key maternal and new-born health indicators.
  • It is estimated that approximately 46% maternal deaths, over 40% stillbirths and 40% newborn deaths take place on the day of the delivery.
  • A transformational change in the processes related to the care during the delivery, which essentially relates to intrapartum and immediate postpartum care, is required to achieve tangible results within short period of time.
  • ‘LaQshya’ programme of the Ministry of Health and Family Welfare aims at improving quality of care in labour room and maternity Operation Theatre (OT).

Objectives

  • To reduce maternal and newborn mortality & morbidity due to APH, PPH, retained placenta, preterm, preeclampsia & eclampsia, obstructed labour, puerperal sepsis, newborn asphyxia, and sepsis, etc.
  • To improve Quality of care during the delivery and immediate post-partum care, stabilization of complications and ensure timely referrals, and enable an effective two-way follow-up system.
  • To enhance satisfaction of beneficiaries visiting the health facilities and provide Respectful Maternity Care (RMC) to all pregnant women attending the public health facility.

Strategies

  • Reorganizing/aligning Labour room & Maternity Operation Theatre layout and workflow as per ‘Labour Room Standardization Guidelines’ and ‘Maternal & Newborn Health Toolkit’ issued by the Ministry of Health & Family Welfare, Government of India.
  • Ensuring that at least all government medical college hospitals and high case- load district hospitals have dedicated obstetric HDUs as per GoI MOHFW Guidelines, for managing complicated pregnancies that require life-saving critical care.
  • Ensuring strict adherence to clinical protocols for management and stabilization of the complications before referral to higher centres.

Scope

Following facilities would be taken under LaQshya initiative on priority:

  1. All government medical college hospitals.
  2. All District Hospitals & equivalent healthy facilities.
  3. All designated FRUs and high case load CHCs with over 100 deliveries/60 (per month) in hills and desert areas.

Institutional Arrangement

  • Under the National Health Mission, the States have been supported in creating Institutional framework for the Quality Assurance – State Quality Assurance Committee (SQAC), District Quality Assurance Committee (DQAC), and Quality Team at the facility level.
  • These committees will also support implementation of LaQshya interventions.
  • For specific technical activities and program management, special purpose groups have been suggested, and these groups will be working towards achievement of specific targets and program milestones in close coordination with relevant structure.

Targets

Immediate (0-4 Months)

  • 80% of the selected Labour rooms & Maternity OTs assess their quality and staff competence using defined NQAS checklists and OSCE.
  • 80% of Labour rooms & Maternity OTs have setup functional quality circles and facility level quality tea ms.

Short Term (up to 8 Months)

  • 80% of Labour Room and OT Quality Circles are oriented to latest labour room protocols, quality improvement processes and respectful maternity care (RMC).
  • 50% of deliveries take place in presence of the Birth Companions.
  • 60% of deliveries conducted using safe birth checklist and Safe Surgery Checklist in Labour Room & Maternity OT respectively.
  • 60% of the deliveries are conducted using real-time par to graph.
  • 30% increase in Breast Feeding within one hour of delivery
  • 80% labour rooms and Maternity OTs take microbiological samples from defined areas every month.
  • 30% reduction in surgical site infection ratein r/o planned surgery in the Maternity OT.

Intermediate Term (Up to 12 Months)

  • 30% in crease in antenatal corticosteroid administration in case of preterm labour.
  • 30% reduction in pre-eclampsia, eclampsia& PIH related mortality.
  • 30% reduction in APH/PPH related mortality.
  • 20% reduction in new-born asphyxia related admissions in SNCUs for inborn deliveries.
  • 20% reduction in newborn sepsis rate in SNCUs for inborn deliveries.
  • 20% reduction in Stillbirth rate.
  • 80% of all beneficiaries are either satisfied or highly satisfied
  • 60% of the labour rooms are reorganized as per ‘Guidelines for Standardisation of Labour Rooms at Delivery Points’.
  • 80% of lab our rooms have staffing as per defined norms.
  • 100% compliance to administration of Oxytocin, immediately after birth.
  • 30% improvement in OSCE scores of labour room staff.
  • 100% Maternal death, Neonatal Death audit and clinical discussion on near miss/maternal and neonatal complications
  • 80% Labour Room and OTs are reporting zero stock-outs of drugs and consumables.
  • Long Term (up to 18 Months)
  • 60% of labour rooms achieve quality certification against the NQAS.
  • 50% of labour rooms are linked to Obstetrics HDU/ICU.
  • 15% improvement in short term & Intermediate targets.
  • After 18 months, this initiative would be continued through sustained mentoring.

National AIDS control programme

  1. Introduction
  2. NACP – IV – Objectives
  3. Key strategies
  4. Key priorities under NACP IV
  5. Package of services provided under NACP IV
  6. Prevention Services
  7. Care, Support & Treatment Services
  8. New Initiatives under NACP IV

Introduction

  • The National AIDS Control Programme (NACP), launched in 1992, is being implemented as a comprehensive programme for prevention and control of HIV/ AIDS in India.
  • Over time, the focus has shifted from raising awareness to behaviour change, from a national response to a more decentralized response and to increasing involvement of NGOs and networks of People living with HIV (PLHIV).
  • The NACP I started in 1992 was implemented with an objective of slowing down the spread of HIV infections so as to reduce morbidity, mortality and impact of AIDS in the country.
  • In November 1999, the second National AIDS Control Project (NACP II) was launched to reduce the spread of HIV infection in India, and (ii) to increase India’s capacity to respond to HIV/AIDS on a long-term basis.
  • NACP III was launched in July 2007 with the goal of Halting and Reversing the Epidemic over its five-year period.
  • NACP IV, launched in 2012, aims to accelerate the process of reversal and further strengthen the epidemic response in India through a cautious and well defined integration process over the next five years.

NACP – IV – Objectives

  • Reduce new infections by 50% (2007 Baseline of NACP III)
  • Provide comprehensive care and support to all persons living with HIV/AIDS and
  • treatment services for all those who require it.

Key strategies

  • Intensifying and consolidating prevention services, with a focus on HIgh Risk Groups (HRGs) and vulnerable population.
  • Increasing access and promoting comprehensive care, support and treatment
  • Expanding IEC services for (a) general population and (b) high risk groups with a focus on behaviour change and demand generation.
  • Building capacities at national, state, district and facility levels
  • Strengthening Strategic Information Management System

Key priorities under NACP IV

  • Preventing new infections by sustaining the reach of current interventions and effectively addressing emerging epidemics
  • Prevention of Parent to Child transmission
  • Focusing on IEC strategies for behaviour change in HRG, awareness among general population and demand generation for HIV services
  • Providing comprehensive care, support and treatment to eligible PLHIV
  • Reducing stigma and discrimination through Greater involvement of PLHA (GIPA)
  • De-centralizing rollout of services including technical support
  • Ensuring effective use of strategic information at all levels of programme
  • Building capacities of NGO and civil society partners especially in states with emerging epidemics
  • Integrating HIV services with health systems in a phased manner
  • Mainstreaming of HIV/ AIDS activities with all key central/state level Ministries/ departments will be given a high priority and resources of the respective departments will be leveraged. Social protection and insurance mechanisms for PLHIV will be strengthened.

Package of services provided under NACP IV

Prevention Services

  • Targeted Interventions for High Risk Groups and Bridge Population (Female Sex Workers (FSW), Men who have Sex with Men (MSM), Transgenders/Hijras, Injecting Drug Users (IDU), Truckers & Migrants)
  • Needle-Syringe Exchange Programme (NSEP) and Opioid Substitution Therapy (OST) for IDUs
  • Prevention Interventions for Migrant population at source, transit and destination
  • Link Worker Scheme (LWS) for HRGs and vulnerable population in rural areas
  • Prevention & Control of Sexually Transmitted Infections/Reproductive Tract Infections (STI/RTI)

Blood Safety

  • HIV Counseling & Testing Services 8. Prevention of Parent to Child Transmission
  • Condom promotion
  • Information, Education & Communication (IEC) & Behaviour Change Communication (BCC).
  • Social Mobilization, Youth Interventions and Adolescent Education Programme
  • Mainstreaming HIV/AIDS response
  • Work Place Interventions

Care, Support & Treatment Services

  • Laboratory services for CD4 Testing and other investigations
  • Free First line & second line Anti-Retroviral Treatment (ART) through ART centres and Link ART Centres (LACs), Centres of Excellence (COE) & ART plus Centres.
  • Pediatric ART for children
  • Early Infant Diagnosis for HIV exposed infants and children below 18 months
  • HIV-TB Coordination (Cross- referral, detection and treatment of co-infections)
  • Treatment of Opportunistic Infections
  • Drop-in Centres for PLHIV networks

New Initiatives under NACP IV

  • Differential strategies for districts based on data triangulation with due weightage to vulnerabilities
  • Scale up of programmes to target key vulnerabilities
  • Scale up of Opioid Substitution Therapy (OST) for IDUs
  • Scale up and strengthening of Migrant Interventions at Source, Transit & Destinations including roll out of Migrant Tracking System for effective outreach
  • Establishment and scale up of interventions for Transgenders (TGs) by bringing in community participation and focused strategies to address their vulnerabilities
  • Employer-Led Model for addressing vulnerabilities among migrant labour e. Female Condom Programme
  • Scale up of Multi-Drug Regimen for Prevention of Parent to Child Transmission (PPTCT) in keeping with international protocols
  • Social protection for marginalised populations through mainstreaming and earmarking budgets for HIV among concerned government departments
  • Establishment of Metro Blood Banks and Plasma Fractionation Centre
  • Launch of Third Line ART and scale up of first and second Line ART

Demand promotion strategies specially using mid-media, e.g., National Folk Media Campaign & Red Ribbon Express and buses (in convergence with the National Health Mission)

QMission Indhradhanush

  1. Introduction
  2. Objective
  3. Implementation
  4. Areas Under Focus
  5. Mission Indhradhanush – Districts covered
  6. Strategy for Mission Indradhanush
  7. Intensified Mission Indradhanush (IMI)
  8. Intensified Mission Indradhanush (IMI) 3.0

Introduction

  • Mission Indradhanush (MI) was launched by the Ministry of Health and Family Welfare (MOHFW) on 25th December 2014 with the aim of expanding immunization coverage to all children across India.
  • Children across socio-economic, cultural and geographical spectrums in India, are being immunized under this program.
  • The initiative’s mammoth task is being fulfilled with the support of an integrated and committed task-force, ensuring full immunisation coverage.
  • Every MI activation is planned to the last detail; from planning where camps will be set up to which children need to get vaccinated and what vaccinations will be required for the camp.

Objective

  • The Mission Indradhanush aims to cover all those children who are either unvaccinated, or are partially vaccinated against vaccine preventable diseases.
  • India’s Universal Immunisation Programme (UIP) provide free vaccines against 12 life threatening diseases, to 26 million children annually.
  • The Universal Immunization Programme provides life-saving vaccines to all children across the country free of cost to protect them against Tuberculosis, Diphtheria, Pertussis, Tetanus, Polio, Hepatitis B, Pneumonia and Meningitis due to Haemophilus Influenzae type b (Hib), Measles, Rubella, Japanese Encephalitis (JE) and Rotavirus diarrhoea. (Rubella, JE and Rotavirus vaccine in select states and districts).

Implementation

  • Focused and systematic immunization drive will be through a “catch-up” campaign mode where the aim is to cover all the children who have been left out or missed out for immunization. Also the pregnant women are administered the tetanus vaccine, ORS packets and zinc tablets are distributed for use in the event of severe diarrhoea or dehydration and vitamin A doses are administered to boost child immunity.
  • Mission Indradhanush Phase I was started as a weeklong special intensified immunization drive from 7th April 2015 in 201 high focus districts for four consecutive months. During this phase, more than 75 lakh children were vaccinated of which 20 lakh children were fully vaccinated and more than 20 lakh pregnant women received tetanus toxoid vaccine.
  • The Phase II of Mission Indradhanush covered 352 districts in the country of which 279 are medium focus districts and remaining 73 are high focus districts of Phase-I. During Phase II of Mission Indradhanush, four special drives of weeklong duration were conducted starting from October 2015.
  • Phases I and II of the special drive had 1.48 crore children and 38 lakh pregnant women additionally immunized. Of these nearly 39 lakh children and more than 20 lakh pregnant women have been additionally fully immunized. Across 21.3 lakh sessions held through the country in high and mid-priority districts, more than 3.66 crore antigens have been administered.
  • Phase III of Mission Indradhanush was launched from 7 April 2016 covering 216 districts. Four intensified immunization rounds were conducted for seven days in each between April and July 2016, in these districts. These 216 districts have been identified on the basis of estimates where full immunization coverage is less than 60 per cent and have high dropout rates. Apart from the standard of children under 2, it also focussed on 5-year-olds and on increasing DPT booster coverage, and giving tetanus toxoid injections to pregnant women.
  • Overall, in the first three phases, 28.7 lakh immunisation sessions were conducted, covering 2.1 crore children, of which 55 lakh were fully immunised. Also, 55.9 lakh pregnant women were given the tetanus toxoid vaccine across 497 high-focus districts. Since the launch of Mission Indhradhanush, full immunisation coverage has increased by 5 per cent to 7 per cent. Mission Indradhanush has resulted in a 6.7 % annual expansion in the immunization cover.
  • Phase IV of Mission Indradhanush was launched from 7 February 2017 covering the North-eastern states of Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim and Tripura. It has been rolled out in rest of the country during April 2017.
  • The four phases of Mission Indradhanush have reached to more than 2.53 crore children and 68 lakh pregnant women with life-saving vaccines.
  • The Ministry is being technically supported by WHO, UNICEF, Rotary International and other donor partners. Mass media, interpersonal communication, and sturdy mechanisms of monitoring and evaluating the scheme are crucial components of Mission Indradhanush.

Areas Under Focus

The following areas are targeted through special immunization campaigns:

High risk areas identified by the polio eradication programme. These include populations living in areas such as:

  1. Urban slums with migration
  2. Nomads
  3. Brick kilns
  4. Construction sites
  5. Other migrants (fisherman villages, riverine areas with shifting populations etc.) and
  6. Underserved and hard to reach populations (forested and tribal populations etc.)
  7. Areas with low routine immunization (RI) coverage (pockets with Measles/vaccine preventable disease (VPD) outbreaks).
  8. Areas with vacant sub-centers: No ANM posted for more than three months.
  9. Areas with missed Routine Immunisation (RI) sessions: ANMs on long leave and similar reasons
  10. Small villages, hamlets, dhanis or purbas clubbed with another village for RI sessions and not having independent RI sessions.

Strategy for Mission Indradhanush

Mission Indradhanush will be a national immunization drive to strengthen the key functional areas of immunization for ensuring high coverage throughout the country with special attention to districts with low immunization coverage.

The broad strategy, based on evidence and best practices, will include four basic elements-

  • Meticulous planning of campaigns/sessions at all levels: Ensure revision of microplans in all blocks and urban areas in each district to ensure availability of sufficient vaccinators and all vaccines during routine immunization sessions. Develop special plans to reach the unreached children in more than 400,000 high risk settlements such as urban slums, construction sites, brick kilns, nomadic sites and hard-to-reach areas.
  • Effective communication and social mobilization efforts: Generate awareness and demand for immunization services through need-based communication strategies and social mobilization activities to enhance participation of the community in the routine immunization programme through mass media, mid media, interpersonal communication (IPC), school and youth networks and corporates.
  • Intensive training of the health officials and frontline workers: Build the capacity of health officials and workers in routine immunization activities for quality immunization services.
  • Establish accountability framework through task forces: Enhance involvement and accountability/ownership of the district administrative and health machinery by strengthening the district task forces for immunization in all districts of India and ensuring the use of concurrent session monitoring data to plug the gaps in implementation on a real time basis.

The Ministry of Health and Family Welfare will establish collaboration with other Ministries, ongoing programmes and international partners to promote a coordinated and synergistic approach to improve routine immunization coverage in the country.


Intensified Mission Indradhanush (IMI)

  • The Intensified Mission Indradhanush (IMI) has been launched by the Government of India to reach each and every child under two years of age and all those pregnant women who have been left uncovered under the routine immunisation programme. The special drive will focus on improving immunization coverage in select districts and cities to ensure full immunization to more than 90% by December 2018.
  • With a sharpened focus on high priority districts and urban areas, under IMI, four consecutive immunization rounds will be conducted for 7 days in 173 districts – 121 districts and 17 cities in 16 states and 52 districts in 8 north eastern states – every month between October 2017 and January 2018. Intensified Mission Indradhanush will cover low performing areas in the selected districts and urban areas. These areas have been selected through triangulation of data available under national surveys, Health Management Information System data and World Health Organization concurrent monitoring data. Special attention will be given to unserved/low coverage pockets in sub-centre and urban slums with migratory population. The focus is also on the urban settlements and cities identified under National Urban Health Mission (NUHM).
  • ensified Mission Indradhanush will have inter-ministerial and inter-departmental coordination, action-based review mechanism and intensified monitoring and accountability framework for effective implementation of targeted rapid interventions to improve the routine immunization coverage. IMI is supported by 11 other ministries and departments, such as Ministry of Women and Child Development, Panchayati Raj, Ministry of Urban Development, Ministry of Youth Affairs among others. The convergence of ground level workers of various departments like ASHA, ANMs, Anganwadi workers, Zila preraks under National Urban Livelihood Mission (NULM), self-help groups will be ensured for better coordination and effective implementation of the programme.
  • Intensified Mission Indradhanush would be closely monitored at the district, state and central level at regular intervals. Further, it would be reviewed by the Cabinet Secretary at the National level and will continue to be monitored at the highest level under a special initiative ‘Proactive Governance and Timely Implementation (PRAGATI)’.
  • This Intensified Mission is driven based on the information received from gap assessment, supervision through government, concurrent monitoring by partners, and end-line surveys. Under IMI, special strategies are devised for rigorous monitoring of the programme. States and districts have developed coverage improvement plans based on gap self-assessment. These plans are reviewed from state to central level with an aim to reach 90% coverage by December 2018.
  • An appreciation and awards mechanism is also conceived to recognize the districts reaching more than 90% coverage. The criteria includes best practices and media management during crisis. To acknowledge the contribution of the partners/Civil Society Organization (CSOs) and others, Certificate of Appreciation will be given.

Intensified Mission Indradhanush (IMI) 3.0

  • The Government of India is committed to improve immunization coverage and achieve full immunization coverage of 90 percent. Launch of massive routine immunization campaigns, such as Mission Indradhanush (MI) and Intensified Mission Indradhanush (IMI), in part, reflects government’s efforts under Universal Immunization Program to reduce child mortality and morbidity. To boost the RI coverage in the country, Government is planning to introduce Intensified Mission Indradhanush 3.0 to ensure reaching the unreached with all available vaccines and accelerate the coverage of children and pregnant women in the identified districts and blocks from February 2021-March 2021.
  • The Intensified Mission Indradhanush 3.0 will have two rounds starting from February 22 and March 22, 2021 and will be conducted in pre-identified 250 districts/urban areas across 29 States/UTs in the country. As per the Guidelines released for IMI 3.0, the districts have been classified to reflect 313 low risk; 152 as medium risk; and 250 as high risk districts.
  • Focus of the IMI 3.0 will be the children and pregnant women who have missed their vaccine doses during the COVID-19 pandemic. They will be identified and vaccinated during the two rounds of IMI 3.0. Each round will be for 15 days each. Beneficiaries from migration areas and hard to reach areas will be targeted as they may have missed their vaccine doses during COVID19.
  • The present eighth campaign will target achieving 90% Full Immunization Coverage (FIC) in all districts of the country and sustain the coverage through immunization system strengthening and foster India’s march towards the Sustainable Development Goals.

  1. About the mission
  2. Objectives
  3. Focus
  4. Update
  5. Key facts

About Mission Parivar Vikas

  • The mission is being implemented in 146 high focus districts that house 44% of the country’s population, with the highest total fertility rates of 3 and more in the country.
  • The high focus districts are in the seven states of Uttar Pradesh, Bihar, Madhya Pradesh, Rajasthan, Jharkhand, Chhattisgarh and Assam.

Objectives

  • The main objective of the Mission Parivar Vikas family planning initiative is to bring down the Total Fertility Rate (TFR) to 2.1, which is when the population starts stabilizing, by the year 2025.

Focus

  • The key strategic focus of this initiative will be on improving access to contraceptives through delivering assured services, dovetailing with new promotional schemes, ensuring commodity security, building capacity (service providers), creating an enabling environment along with close monitoring and implementation.

Update

  • In a bid to keep a check on the increasing population in the country, The Ministry of Health and Family Welfare has launched two new contraceptives- MPA and Chhaya.

Key facts

  • The two new contraceptives, an injectable contraceptive MPA under the ‘Antara’ programme and a contraceptive pill, ‘Chhaya’, in the public health system will expand the basket of contraceptive choices to meet the emerging needs of couples.
  • The contraceptives are being launched under the government’s Mission Parivar Vikas, a central family planning initiative.
  • The contraceptives are safe and highly effective, the ‘Antara’ injectable being effective for three months and the ‘Chayya’ pill for one week, and will help meet the changing needs of couples and help women plan and space their pregnancies.