The National Rural Health Mission (NRHM)'s reproductive and child health (RCH) programme phase II, aiming to reduce infant mortality , maternal mortality and total fertility rates in the country especially in the rural areas, has started showing results as the maternal mortality ratio (MMR) has come down considerably from 301 per 100,000 live births during the years 2001-2003 to 254 per 100,000 live births in the period of 2004-06. This translates into approximately 67000 maternal deaths per year in the country.
Based on the official estimates of Registrar General of India (RGI), Kerala with just 95 per 100,000 live births is at the top of the list of states, followed by Tamil Nadu with 111 per 100,000 live births. Assam with 480 per 100,000 live births is at the lowest of the table followed by Uttar Pradesh with 420 per 100,000 live births.
The Reproductive and Child Health Programme phase II (RCH-II), under the umbrella of the NRHM, aims to improve access for rural people, especially poor women and children to equitable, affordable accountable and effective primary health care, with a special focus on 18 States, with the ultimate objective of reducing infant mortality, maternal mortality and total fertility rates.
The key strategies and interventions under the NRHM for reduction of maternal mortality ratio are: Janani Suraksha Yojana (JSY), a cash benefit scheme to promote institutional delivery with a special focus on below poverty line (BPL) and SC/ST pregnant women; operationalizing round the clock facilities for delivery services in the 24X7 primary health centres (PHCs) and first referral units (FRUs) including district hospitals, sub-district hospitals, community health centres and other institutions; ugmenting the availability of skilled manpower through various skill-based trainings of skilled birth attendants; and training of MBBS doctors in life saving anesthetic skills and emergency obstetric care including caesarean section.
Other strategies include provision of ante-natal and post natal care services including prevention and treatment of anaemia by supplementation with iron and folic acid tablets during pregnancy and lactation; organizing village health and nutrition days (VHNDs) at anganwadi centres to impart health and nutrition education to pregnant and lactating mothers; and systems strengthening of health facilities through flexible funds at sub centres (PHCs) and community health centres (CHCs) and district hospitals.