Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Seeking a more progressive abortion lawop-ed snap


From UPSC perspective, the following things are important :

Prelims level : Not much.

Mains level : Paper 2- Shortcomings in the Medical Termination of Pregnancy Act 1971 and need of the more progressive abortion law in the country.


The Medical Termination of Pregnancy Bill doesn’t do enough to secure women’s choices and interests.

Deaths due to unsafe abortion and previous attempts to legislate

  • Deaths due to unsafe abortions: Recent reports have shown that more than 10 women die every day due to unsafe abortions in India.
    • And backward abortion laws only contribute to women seeking illegal and unsafe options.
  • The Cabinet has recently approved the Medical Termination of Pregnancy (Amendment) Bill, 2020 (MTP Bill, 2020) which will soon be tabled in Parliament.
    • It seeks to amend the Medical Termination of Pregnancy Act, 1971 (MTP Act) and follows the MTP Bills of 2014, 2017 and 2018, all of which previously lapsed in Parliament.

Provisions of the current law

  • Foetus-age based division: The MTP Act divides its regulatory framework for allowing abortions into categories, according to the gestational age of the foetus.
    • Up to 12 weeks: Under Section 3, for foetuses that are aged up to 12 weeks-
    • Only one medical practitioner’s opinion is required to the effect that the continuance of the pregnancy would pose a risk to the life of the mother or cause grave injury to her physical or mental health.
    • Or there is a substantial risk that if the child is born, it would suffer from such physical or mental abnormalities as to be seriously handicapped.
    • Between 12 weeks and 20 weeks: But if the foetus is aged between 12 weeks and 20 weeks-
    • At least two medical practitioners’ opinions conforming to either of the two conditions are required.
    • What beyond 20 weeks? Beyond 20 weeks, termination may be carried out where it is necessary to save the life of the pregnant woman.
  • Definition of grave injury: The MTP Act also specifies that ‘grave injury’ may be explained as
    • The anguish caused by a pregnancy arising out of rape, or the anguish caused by an unwanted pregnancy arising out of the failure of a contraceptive used by a married woman or her husband.

What are the issues with the current law?

  • Several issues arise from the current framework under the MTP Act.
  • First-Lac of autonomy of women: At all stages of the pregnancy, the healthcare providers, rather than the women seeking an abortion, have the final say on whether the abortion can be carried out.
    • It is true that factors such as failure of contraceptives or grave injury are not required to be proved under the MTP Act.
    • However, to get the pregnancy terminated solely based on her will, the woman may be compelled to lie or plead with the doctor.
    • Thus, at present, pregnant women lack autonomy in making the decision to terminate their pregnancy and have to bear additional mental stress, as well as the financial burden of getting a doctor’s approval.
    • On request abortion in 67 countries: Indian’s law is unlike the abortion laws in 67 countries, including Iceland, France, Canada, South Africa and Uruguay, where a woman can get an abortion ‘on request’ with or without a specific gestational limit (which is usually 12 weeks).
  • Second-Prejudice against unmarried women: The MTP Act embodies a clear prejudice against unmarried women.
    • According to ‘Explanation 2’ provided under Section 3(2) of the Act, where a pregnancy occurs due to failure of any birth control device or method used by any “married woman or her husband”, the anguish caused is presumed to constitute a “grave injury” to the mental health of the pregnant woman.
    • While the applicability of this provision to unmarried women is contested, there is always the danger of a more restrictive interpretation, especially when the final decision rests with the doctor and not the woman herself.
  • Third-Restriction of 20 weeks’ limit: Due to advancements in science, foetal abnormalities can now be detected even after 20 weeks.
    • Danger to mother’s life only condition after 20 weeks: The MTP Act presently allows abortion post 20 weeks only where it is necessary to save the life of the mother.
    • Problem with this restriction: The above restriction means that even if a substantial foetal abnormality is detected and the mother doesn’t want to bear life-long caregiving responsibilities and the mental agony associated with it, the law gives her no recourse unless there is a prospect of her death.

What does the bill fail to address?

  • While the MTP Bill, 2020, is a step in the right direction, it still fails to address most of the problems with the MTP
  • First, it doesn’t allow abortion on request at any point after the pregnancy.
  • Second, it doesn’t take a step towards removing the prejudice against unmarried women by amending the relevant provision.
  • And finally, it enhances the gestational limit for legal abortion from 20 to 24 weeks only for specific categories of women such as survivors of rape, victims of incest, and minors.
    • This means that a woman who does not fall into these categories would not be able to seek an abortion beyond 20 weeks, even if she suffers from a grave physical or mental injury due to the pregnancy.

What are the provisions for the case of foetal abnormality in the bill?

  • Limit irrelevant if the foetal abnormality is diagnosed by the Medical Board: The Bill does make the upper gestational limit irrelevant in procuring an abortion if there are substantial foetal abnormalities diagnosed by the Medical Board.
    • This means that even if there is no threat to the mother’s life, she would be able to procure an abortion as soon as a substantial foetal abnormality comes to light.
    • While this is an important step and would have in the past helped many women who fought long battles in Court without recourse.
    • Rules against unnecessary delays: It is crucial that this provision is accompanied by appropriate rules for the Medical Boards that guard against unnecessary delays, which only increase the risks associated with a late abortion.


  • Recognition of women’s right: The Supreme Court has recognised women’s right to make reproductive choices and their decision to abort as a dimension of their personal liberty (in  X v. Union of India,2017) and as falling within the realm of the fundamental right to privacy (in K.S. Puttaswamy v. Union of India, 2017). Yet, current abortion laws fail to allow the exercise of this right.
  • The bill does not do enough: While it is hoped that MTP Bill, 2020 will not lapse in Parliament like its predecessors, it is evident that it does not do enough to secure women’s interests, and there is still a long road ahead for progressive abortion laws.




Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[op-ed of the day] Amendments to Medical Termination of Pregnancy Act are a mixed bagop-ed snap


From UPSC perspective, the following things are important :

Prelims level : Not much.

Mains level : Paper 2- Medical Termination of Pregnancy Act amendment and issues involved.


The Union Cabinet’s approval of the amended Medical Termination of Pregnancy (MTP) Bill 2020 was reported on January 29. This amendment was long due and has made some anticipated changes demanded by women’s groups and courts, including the Supreme Court.

Why the amendment was necessitated?

  • Abortion (unsafe) accounts for almost 10 per cent of maternal deaths in India.
  • No provision to avoid unsafe abortion: The amended Act doesn’t have any new substantial provisions to avoid unsafe abortions.
    • The right to safe abortion (at least till 12 weeks, when it is safer) would have made the state responsible to provide safe abortion services.
  • Reduce the burden on judiciary: The proposed amendments will definitely reduce the burden on the judiciary, especially given the plethora of cases seeking permission for abortion beyond the prescribed duration of 20 weeks.
  • Two types of Court cases: The court cases are broadly two types.
    • The first group of cases: These are pregnancies that extend beyond 20 weeks of gestation as a result of rape, incest or of minor women.
    • The new Act rightly addresses these by extending prescribed period abortion to 24 weeks.
    • However, such cases form a minuscule proportion of the total number. For such cases, even the 24-week cap can be done away with, provided the abortions can be safely done.
    • The second group of cases
    • These are of pregnancies that become unwanted after congenital foetal anomalies are found upon testing.
    • With advancements in prenatal foetal screening/diagnostic technologies, more such cases are knocking at the doors of courts.
    • Marginal interval under the current act: Anomalies detected at 17-20 weeks provide only a marginal interval to conduct an abortion under the current Act.
    • The extension to 24 weeks seems to give cover to these cases for abortion services, reducing the burden on courts.

How the law could be misused?

  • Possibility of using any anomaly as a ground for abortion: The amendments have opened up the possibility for any congenital anomaly to be used as grounds for abortion.
    • Anomalies which are incompatible with life provide grounds for access to abortion at any time during pregnancy -not just 24 weeks of gestation-as long as the woman desires it and it doesn’t endanger her health.
    • But with advancements in diagnostic technologies, more anomalies will be detected, including those which are compatible with life.
  • Social acceptability and anomaly: What constitutes an anomaly changes depending on what is considered socially desirable.
    • Issue of raising children with disability: Technology-aided detection of “undesirability” could now find social support, as has been the case with female foetuses.
    • This raises concerns that raising children with disability, especially in the absence of state support and poor social attitudes, could go down a similar path.

The risk to the life of women

  • Abortion beyond 12 weeks carries serious health risks.
    • 12 weeks provision under current law: Current law requires the expert opinion of two registered medical practitioners for the abortion beyond 12 weeks.
      • Extending the limit to 20 weeks and risk involved: 12-week requirement has been delayed till 20 weeks, though the physiology of pregnancy and risks associated with procedures for second-trimester abortions haven’t changed significantly.
      • Possibility of more complications: Without the strengthening of public services, easing second-trimester abortions between 12-20 weeks opens the possibilities of more complications and endangers the life of the woman.


With congenital anomalies as a ground for abortion, the eugenic mindset of having socially desirable children could push more women into risky late abortions. The approach of medical boards advising courts in cases of late abortions under this Act will be critical to balancing women’s right to choose with risk to the woman and the motives for abortion. The rules framed under the Act must address this in no uncertain terms.



Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[pib] The Medical Termination of Pregnancy (Amendment) Bill, 2020Bills/Act/LawsPIB


From UPSC perspective, the following things are important :

Prelims level : Highlights of the bill

Mains level : MTP: Ethical and health issues surrounding it

The Union Cabinet has approved the Medical Termination of Pregnancy (Amendment) Bill, 2020 to amend the Medical Termination of Pregnancy Act, 1971.

About the Bill

  • The Medical Termination of Pregnancy (Amendment) Bill, 2020 is for expanding access of women to safe and legal abortion services on therapeutic, eugenic, humanitarian or social grounds.
  • It aims to increase upper gestation limit for termination of pregnancy under certain conditions and to strengthen access to comprehensive abortion care, under strict conditions, without compromising service and quality of safe abortion.

Salient features of proposed amendments:

  • Proposing requirement for opinion of one provider for termination of pregnancy, up to 20 weeks of gestation and introducing the requirement of opinion of two providers for termination of pregnancy of 20-24 weeks of gestation.
  • Enhancing the upper gestation limit from 20 to 24 weeks for special categories of women which will be defined in the amendments to the MTP Rules and would include ‘vulnerable women including survivors of rape, victims of incest and other vulnerable women (like differently-abled women, Minors) etc.
  • Upper gestation limit not to apply in cases of substantial foetal abnormalities diagnosed by Medical Board. The composition, functions and other details of Medical Board to be prescribed subsequently in Rules under the Act.
  • Anonymity of the person: Name and other particulars of a woman whose pregnancy has been terminated shall not be revealed except to a person authorised in any law for the time being in force.


  • It is a step towards safety and well-being of the women and many women will be benefitted by this.
  • Recently several petitions were received by the Courts seeking permission for aborting pregnancies at a gestational age beyond the present permissible limit on grounds of foetal abnormalities or pregnancies due to sexual violence faced by women.
  • The proposed increase in gestational age will ensure dignity, autonomy, confidentiality and justice for women who need to terminate pregnancy.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

ICDS ProgrammeGovt. Schemes


From UPSC perspective, the following things are important :

Prelims level : ICDS and its components

Mains level : Forms of malnutrition in urban areas and their preventive measures


Centre seeks to revamp the ICDS scheme in urban areas. For this NITI Aayog will develop draft policy, which will be circulated to the Ministries for consultations.

Integrated Child Development Services (ICDS)

  • The ICDS is a government programme in India which provides food, preschool education, primary healthcare, immunization, health check-up and referral services to children under 6 years of age and their mothers.
  • The scheme was launched in 1975, discontinued in 1978 by the government of Morarji Desai, and then relaunched by the Tenth Five Year Plan.
  • Tenth FYP also linked ICDS to Anganwadi centres established mainly in rural areas and staffed with frontline workers.
  • The ICDS provide for anganwadis or day-care centres which deliver a package of six services including:
  1. Immunization
  2. Supplementary nutrition
  3. Health checkup
  4. Referral services
  5. Pre-school education(Non-Formal)
  6. Nutrition and Health information


  • For nutritional purposes ICDS provides 500 kilocalories (with 12-15 grams of protein) every day to every child below 6 years of age.
  • For adolescent girls it is up to 500 kilo calories with up to 25 grams of protein every day.
  • The services of Immunisation, Health Check-up and Referral Services delivered through Public Health Infrastructure under the Ministry of Health and Family Welfare.

Revamp for Urban Areas

  • Health and ICDS models that work in rural areas may not work in urban areas because of higher population density, transportation challenges and migration.
  • Children in urban areas were overweight and obese as indicated by subscapular skinfold thickness (SSFT) for their age.
  • The first-ever pan-India survey on the nutrition status of children, highlighted that malnutrition among children in urban India.
  • It found a higher prevalence of obesity because of relative prosperity and lifestyle patterns, along with iron and Vitamin D deficiency.
  • According to government data from 2018, of the 14 lakh anganwadis across the country there are only 1.38 lakh anganwadis in urban areas.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Pulse Polio ProgrammePriority 1


From UPSC perspective, the following things are important :

Prelims level : Polio and its vaccine

Mains level : Pulse Polio Programme

The beginning of this year’s Pulse Polio Programme was inaugurated from the Rashtrapati Bhavan itself.  To prevent the virus from coming to India, the government has since March 2014 made the Oral Polio Vaccination (OPV) mandatory for those travelling between India and polio-affected countries.

The Pulse Polio Programme

  • India launched the Pulse Polio immunisation programme in 1995, after a resolution for a global initiative of polio eradication was adopted by the World Health Assembly (WHA) in 1988.
  • Children in the age group of 0-5 years are administered polio drops during national and sub-national immunisation rounds (in high-risk areas) every year.

India is polio-free

  • According to the Ministry of Health, the last polio case in the country was reported from Howrah district of West Bengal in January 2011.
  • The WHO on February 24, 2012, removed India from the list of countries with active endemic wild polio virus transmission.
  • Two years later, the South-East Asia Region of the WHO, of which India is a part, was certified as polio-free.


What is Polio?

  • The WHO defines polio or poliomyelitis as a highly infectious viral disease, which mainly affects young children.
  • The virus is transmitted by person-to-person, spread mainly through the faecal-oral route or, less frequently, by a common vehicle (e.g. contaminated water or food) and multiplies in the intestine, from where it can invade the nervous system and can cause paralysis.
  • Initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs. In a small proportion of cases, the disease causes paralysis, which is often permanent.
  • There is no cure for polio, it can only be prevented by immunization.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[op-ed snap] Children of lesser godsop-ed snap


From UPSC perspective, the following things are important :

Prelims level : Not much.

Mains level : Paper 2- Health.


The deaths of nearly 200 children in Kota, from largely preventable diseases, lays bare the condition of the healthcare system in India.

Where does India stand?

  • According to UNICEF’s ‘State of World’s Children 2019’ report, India reported the maximum number of deaths of children under five in the world in 2018.
  • 8,82,000 children under five died that year.
  • That means around 2,416 deaths per day.
  • The death of children due to largely-preventable illnesses is a matter of serious concern and calls for urgent introspection.

Factors that govern child health

  • Most of the children who died in Gorakhpur, Muzaffarpur and Kota belong to the lowest strata of the society.
  • It won’t be wrong to conclude that they were victims of structural violence.
  • This structural violence is unleashed through a multitude of social, political and economic factors apathy of healthcare professionals, poor health services/infrastructure
  • And low rates of female literacy, economic inequality, the rigid caste system, social apartheid, lack of political will and patriarchy play role.
  • As a society, we have stopped looking at the deaths of our citizens through the prism of compassion and concern.
  • Structural violence influences the nature and distribution of extreme suffering.

What is being done in the wrong way?

  • The government is considering the takeover of 750 district hospitals by private medical colleges through a public-private partnership (PPP) model.
  • This, despite ample evidence about the failure of the model in the country’s healthcare system.
  • Nobel laureate Kenneth Arrow demonstrated that profit and private involvement in healthcare lead to an erosion of trust.
  • An Individual’s demand for medical services is irregular and unpredictable, the involvement of a private market model for such services can be disastrous.
  • The U.S.’s experiences in the PPP model in healthcare have shone a light on the deficits in transparency and highlighted the lack of care of vulnerable groups.


  • What urgently a sincere engagement by the state in matters concerning peoples’ health.
  • We need to question the government’s priorities in a country where nearly a million children die every year
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[pib] Comprehensive Lactation Management CentresPIB


From UPSC perspective, the following things are important :

Prelims level : Comprehensive Lactation Management Centres

Mains level : Breastfeeding and its significance


Breast Milk Banks in India are known as Comprehensive Lactation Management Centres (CLMC) and Lactation Management Unit (LMU) depending on the level of health facilities where these units are established.

Comprehensive Lactation Management Centres (CLMC)

  • CLMC works as per the National Guidelines on Establishment of Lactation Management Centres in Public Health Facilities.
  • The foremost endeavour of the health care providers in a health centre is to conserve the natural act of breastfeeding.
  • Lactation Management Centres are in no way intended to lessen the importance of mother’s own milk or the practice of breastfeeding.
  • If mother’s own milk is insufficient or not available for any unavoidable reason, Donor Human Milk (DHM) is the next best alternative to bridge the gap.
  • The Government has set a target of ensuring 70 per cent infants to have access to breast milk by the year 2025. Target will subsequently be increased to 100 per cent.

Why need such banks?

  • It is universally accepted that breast milk is the optimum exclusive source of nutrition for the first six months of life, and may remain part of the healthy infant diet for the first two years of life and beyond.
  • Despite advances in infant formulas, human breast milk provides a bioactive matrix of benefits that cannot be replicated by any other source of nutrition.
  • When the mother’s own milk is unavailable for the sick, hospitalized newborn, pasteurized human donor breast milk should be made available as an alternative feeding choice followed by commercial formula.
  • There is a limited supply of donor breast milk in India and it should be prioritized to sick, hospitalized neonates who are the most vulnerable and most likely to benefit from exclusive human milk feeding.

Related facts

  • Asia’s first milk bank was established in 1989 at Sion Hospital, Mumbai.
  • In 2017, the first public milk bank, called the Vatsalya — Maatri Amrit Kosh, was established at Lady Hardinge Medical College.
  • It was established in collaboration with the Norwegian government and the Oslo University as part of the Norway–India Partnership Initiative (NIPI).
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Golden RicePriority 1


From UPSC perspective, the following things are important :

Prelims level : Golden rice, Fortified rice

Mains level : Malnutrition elimination strategies

Bangladesh is set to becoming the first country to approve plantation of Golden Rice variety to counter Vitamin A deficiency.

Golden Rice

  • In the late 1990s, German scientists developed a genetically modified variety of rice called Golden Rice.
  • It is a variety of rice (Oryza sativa) produced through genetic engineering to biosynthesize beta-carotene, a precursor of vitamin A, in the edible parts of rice.
  • It differs from its parental strain by the addition of three beta-carotene biosynthesis genes.
  • The parental strain can naturally produce beta-carotene in its leaves, where it is involved in photosynthesis.

Why golden rice?

  • Golden Rice is intended to produce a fortified food to be grown and consumed in areas with a shortage of dietary vitamin A.
  • It was claimed to be able to fight Vitamin A deficiency, which is the leading cause of blindness among children and can also lead to death due to infectious diseases such as measles.
  • Rice is naturally low in the pigment beta-carotene, which the body uses to make Vitamin A. Golden rice contains this, which is the reason for its golden colour.
  • The claim has sometimes been contested over the years, with a 2016 study from Washington University in St Louis reporting that the variety may fall short of what it is supposed to achieve.

Why in Bangladesh?

  • Advocates of the variety stress how it can help countries where Vitamin A deficiencies leave millions at high risk.
  • In Bangladesh, over 21 per cent of the children have vitamin A deficiency.
  • The Golden Rice that is being reviewed in Bangladesh is developed by the Philippines-based International Rice Research Institute.
  • According to the institute, this rice variety will not be more expensive than the conventional variety.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[pib] Intensified Mission Indradhanush (IMI) 2.0PIB


From UPSC perspective, the following things are important :

Prelims level : Mission Indradhanush

Mains level : Immunization programme in India

Union Minister of Health and Family Welfare have reviewed the preparedness within States for rollout of Intensified Mission Indradhanush (IMI) 2.0.

Intensified Mission Indradhanush 2.0

  • IMI was launched from Vadnagar in 2017 and immunization has been given a strong push in the Gram Swaraj Abhiyaan and Extended Gram Swaraj Abhiyaan.
  • The IMI 2.0 aims to achieve targets of full immunization coverage in 272 districts in 27 States and shall be implemented in the block level (652 blocks) in Uttar Pradesh and Bihar.
  • In October 2017, the PM Modi launched IMI, an ambitious plan to accelerate progress.
  • It aimed to achieve 90% full immunization coverage with focus towards districts and urban areas with persistently low levels.
  • IMI was built on MI, using additional strategies to reach populations at high risk, by involving sectors other than health.
  • It was an effort to shift routine immunization into a Jan Andolan, or a “peoples’ movement”.

Salient features of IMI 2.0

  • Immunization activity will be in four rounds over 7 working days excluding the RI days, Sundays and holidays.
  • Enhanced immunization session with flexible timing, mobile session and mobilization by other departments.
  • Enhanced focus on left-outs, dropouts, and resistant families and hard to reach areas.
  • Focus on urban, underserved population and tribal areas.
  • Inter-ministerial and inter-departmental coordination.
  • Enhance political, administrative and financial commitment, through advocacy.
  • IMI immunization drive, consisting of 4 rounds of immunization will be conducted in the selected districts and urban cities from Dec 2019 to March 2020.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Outreach of the Maternity schemes in IndiaPriority 1


From UPSC perspective, the following things are important :

Prelims level : PMMVY

Mains level : Maternity benefits in India

The Pradhan Mantri Matru Vandana Yojana (PMMVY) scheme has been able to reach less than a third of the eligible beneficiaries reveals RTI Act.


  • The PMMVY is targeted only at women delivering their first child.
  • A cash amount of ₹6,000 is transferred to the bank account of the beneficiary in three instalments upon meeting certain conditions.
  • These include early registration of pregnancy, having at least one ante-natal check-up and registration of childbirth.

Outreach of PMMVY

  • PMMVY is a vital programme to support lactating mothers and pregnant women by compensating them for loss of wages during their pregnancy
  • Almost 61% of beneficiaries registered under the between April 2018 and July 2019 (38.3 lakh out of the total 62.8 lakh enrolled) received the full amount of ₹6,000 promised under the scheme, according to an RTI reply.
  • However, the researchers assert that since the scheme failed to reach at least 49% of all mothers who would have delivered their first child (an estimated total of 123 lakh for 2017), the scheme was able to benefit only 31% of its intended beneficiaries.

Why such low outreach?

  • Several factors impeded proper implementation of the programme that aims to fight malnutrition among children.
  • These include an application form of about 23 pages, a slew of documents such as mother-child protection card, Aadhaar card, husband’s Aadhaar card and bank passbook aside from linking their bank accounts with Aadhaar.
  • The requirement to produce the husband’s Aadhaar card results in excluding women who may be living with men they are not married to, single mothers and those who may be staying at their natal home.
  • Women must also have the address of their marital home on their Aadhaar card, which often results in newlyweds being either left out or forced to go from door-to-door when pregnant and needing rest and care.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

SAANS InitiativePrelims Only


From UPSC perspective, the following things are important :

Prelims level : SAANS

Mains level : Pneumonial deaths in India

Union Minister for Health and Family Welfare has launched SAANS, a campaign aimed at reducing child mortality due to pneumonia, which contributes to around 15% deaths annually of children under the age of five.


  • SAANS stands for ‘Social Awareness and Action to Neutralise Pneumonia Successfully’.
  • It aims to mobilise people to protect children from pneumonia, and train health personnel and other stakeholders to provide prioritised treatment to control the disease.
  • Under the campaign, a child suffering from pneumonia can be treated with pre-referral dose of anti-biotic amoxicillin by ASHA workers.
  • Health and wellness centres can use pulse oximeter (device to monitor oxygen saturation) to identify low oxygen levels in the blood of a child, and if required, treat him by use of oxygen cylinders.

Pneumonia deaths in India

  • As per HMIS data, under-five mortality rate in the country is 37 per 1000 live births, of which 5.3 deaths are caused due to pneumonia.
  • The government aims to achieve a target of reducing pneumonia deaths among children to less than three per 1,000 live births by 2025.
  • The HMIS data for 2018-19 ranked Gujarat second in the number of child deaths due to pneumonia, after Madhya Pradesh.
  • The State ranked fifth in infant mortality due to pneumonia.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

The Lancet Countdown on Health and Climate ChangeIOCR


From UPSC perspective, the following things are important :

Prelims level : About the report

Mains level : Childrens susceptiblity to climate change in India

Climate change is already damaging the health of the world’s children and is set to shape the well-being of an entire generation according to a major new report published in The Lancet.

The Lancet Countdown on Health and Climate Change

  • The report is a comprehensive yearly analysis tracking progress across 41 key indicators, demonstrating what action to meet Paris Agreement targets — or business as usual — means for human health.
  • The project is collaboration between 120 experts from 35 institutions, including the World Health Organisation, the World Bank, University College London, and the Tsinghua University in Beijing.

Highlights of the report

  • The report notes that as temperatures rise, infants will bear the greatest burden of malnutrition and rising food prices — average yield potential of maize and rice has declined almost 2% in India since the 1960s, with malnutrition already responsible for two-thirds of under-5 deaths.
  • Also, children will suffer most from the rise in infectious diseases — with climatic suitability for the Vibrio bacteria that cause cholera rising 3% a year in India since the early 1980s, the study warns.
  • Diarrhoeal infections, a major cause of child mortality, will spread into new areas, whilst deadly heatwaves, similar to the one in 2015 that killed thousands of people in India, could soon become the norm.

A note of caution

  • This report shows that the public health gains achieved over the past 50 years could soon be reversed by the changing climate.
  • If the world follows a business-as-usual pathway, with high carbon emissions and climate change continuing at the current rate, a child born today will face a world on average over 4˚C warmer by their 71st birthday, threatening their health at every stage of their lives.
  • Nothing short of a 7.4% year-on-year cut in fossil CO2 emissions from 2019 to 2050 will limit global warming to the more ambitious goal of 1.5°C.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[pib] Bharatiya Poshan Krishi KoshPIB


From UPSC perspective, the following things are important :

Prelims level : Bharatiya Poshan Krishi Kosh

Mains level : Malnutrition elimination strategies in India

The Union Minister of Women and Child Development (WCD) has announced Bharatiya Poshan Krishi Kosh (BPKK).

Bharatiya Poshan Krishi Kosh

  • The Harvard Chan School of Public Health through its India Research Center and the Bill and Melinda Gates Foundation will document and evaluate promising regional dietary practices.
  • The BPKK will be a repository of diverse crops across 128 agro-climatic zones in India for better nutritional outcomes.
  • In consultation with Ministry of WCD and Bill & Melinda Gates Foundation, the project team will select around 12 high focus states which are representative of the geographical, social, economic, cultural and structural diversities of India.
  • In each of the states or group of states the team will identify a local partner organization which has relevant work experience in Social and Behavior Change Communication (SBCC) and nutrition for developing the food atlas.

Why such move?

  • The, two other approaches are required to complement the Government’s efforts to promote healthy dietary practices.
  • One, addressing the challenge of malnutrition at such a vast scale requires a basic understanding of the social, behavioural and cultural practices that promote and reinforce healthy dietary behaviours both at the individual and community level.
  • Two, creating the first ever data base that links relevant agro-food system data at the district, with an aim to map the diversity of native crop varieties that will be more cost-effective and sustainable over the long run.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

State of the World’s Children Report 2019IOCR


From UPSC perspective, the following things are important :

Prelims level : State of the World’s Children Report 2019

Mains level : Read the attached story

  • UNICEF released its State of the World’s Children report for 2019.

Highlights of the report

  • The UNICEF report found that one in three children under the age of five years
  • Around 200 million children worldwide — are either undernourished or overweight.

Children in India

  • In India, every second child is affected by some form of malnutrition.
  • The report said 35% of Indian children suffer from stunting due to lack of nutrition, 17% suffer from wasting, 33% are underweight and 2% are overweight.
  • According to government figures, stunting and wasting among children in the country has reduced by 3.7 per cent and the number of underweight children have reduced by 2.3 per cent from 2016 to 2018.

Other details

  • One in five children under age 5 has vitamin A deficiency, which is a severe health problem in 20 states.
  • Every second woman in the country is anaemic, as are 40.5% children.
  • One in ten children are pre-diabetic.
  • Indian children are being diagnosed with adult diseases such as hypertension, chronic kidney disease and diabetes.

India’s among its neighbors

  • Among countries in South Asia, India fares the worst (54%) on prevalence of children under five who are either stunted, wasted or overweight.
  • Afghanistan and Bangladesh follow at 49% and 46%, respectively. Sri Lanka and the Maldives are the better performing countries in the region, at 28% and 32%, respectively.
  • India also has the highest burden of deaths among children under five per year, with over 8 lakh deaths in 2018.
  • It is followed by Nigeria, Pakistan and the Democratic Republic of Congo, at 8.6 lakh, 4.09 lakh and 2.96 lakh deaths per year, respectively.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Government launches SUMAN scheme, assures free medicines for pregnant womenGovt. Schemes


From UPSC perspective, the following things are important :

Prelims level : SUMAN scheme

Mains level : Nothing much


The central government launched the Surakshit Matritva Aashwasan (SUMAN) scheme aiming zero preventable maternal and newborn deaths in India.


    • Under the scheme, pregnant women, mothers up to 6 months after delivery, and all sick newborns will be able to avail of free healthcare benefits.
    • The beneficiaries visiting public health facilities are entitled to several free services. 
    • These include at least four antenatal 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 
      • other components of comprehensive ANC package
      • six home-based newborn care visits
    • There will be zero expense access to the identification and management of complications during and after the pregnancy. 
    • The government will also provide free transport from home to health institutions.
    • There will be assured referral services with the scope of reaching health facility within one hour of any critical case emergency and Drop back from institution to home after due discharge (minimum 48 hrs). 
    • The pregnant women will have a zero expense delivery and C-section facility in case of complications at public health facilities.
    • It will ensure respectful care with privacy and dignity, with early initiation and support for breastfeeding, zero dose vaccination and free and zero expense services for sick newborns and neonates.


    • It will help in bringing down maternal and infant mortality rates in the country. 
    • According to the 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.
    • WHO defines the 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.”
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Rheumatic feverPriority 1


From UPSC perspective, the following things are important :

Prelims level : Penicillin, Rheumatic fever

Mains level : Child healthcare in India

  • The government is planning to procure penicillin centrally for three years and give it to all children between 5-15 years who are diagnosed with rheumatic fever.
  • The drug will be dispensed through primary health centres or administered by ASHAs.

Rheumatic fever

  • A rare but potentially life-threatening disease, rheumatic fever is a complication of untreated strep throat caused by bacteria called group A streptococcus.
  • The main symptoms — fever, muscle aches, swollen and painful joints, and in some cases, a red rash — typically begin two to four weeks.
  • The knees, ankles, elbows, and wrists are the joints most likely to become swollen from rheumatic fever.
  • The pain often migrates from one joint to another.
  • However, the greatest danger from the disease is the damage it can do to the heart.

Why a concern?

  • India has a high burden of rheumatic fever and rheumatic heart disease — the latter often goes undiagnosed and leads to many maternal deaths at the time of childbirth.
  • Studies indicate the prevalence of rheumatic heart disease in India to be about 2/1000 population.
  • However surveys conducted in school children in the age group of 5-16 years by ICMR gives overall prevalence of 6/1000.
  • Rheumatic fever is endemic in India and remains one of the major causes of cardiovascular disease, accounting for nearly 25-45% of acquired heart disease.

Reviving Penicillin

  • Penicillin, discovered in 1928, is still the first line antibiotic in many western countries, but it gradually went out of the Indian market even though some of its more expensive derivatives continue to be prescribed.
  • Penicillin appears to reduce the attack rate in rheumatic fever by as much as 80%.
  • Penicillin went out of production in India because of unrealistic price control.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[op-ed snap] Sexual and reproductive health data need to be accurate to form effective basis for policyop-ed snap


From UPSC perspective, the following things are important :

Prelims level : Nothing much

Mains level : Reproductive Health


On World Contraception Day, there is a need to talk about reproductive health practices and the rights of people in India. 

Reproductive health

  • The government has been vocal about the need for a small and healthy family to contribute to India’s socio economic growth in the long term.
  • To achieve this vision, there is a need for Sexual and Reproductive Health and Rights (SRHR), which are fundamental for family planning and the overall well-being of individuals.

Family planning

  • India’s family planning programme dates back to the 1950s and it has made significant progress. 
  • The recent emphasis on increasing spacing between children and providing access to the basket of contraceptive choices poses the promise of universal access to reproductive health services.
  • The NFHS 4 shows that the use of modern contraceptive methods (mCPR) continues to be around 48% since 2006. 
  • In the states which showed mCPR decline, sterilisation contributed to more than 70% of contraceptive use. 
  • Further, according to NFHS 4, female sterilisation in India continues to be around 37% since 2006, despite health complications and deaths, highlighting the gender inequality in contraceptive use. 
  • This could be because of lack of accessibility or awareness of other contraceptive methods and requires immediate redressal.
  • According to NHFS 4.36% females and only 0.3% males underwent sterilisation which showcases the level of the disparity. 
  • With male sterilisation on rapid decline, Ministry of Health and Family Welfare released the National Health Policy 2017 which aims uptake of male sterilisation to 30%.

The issue of data

  • India has a vast repository of health and demographic data. But such a repository can also be confusing. 
  • Contraceptive use data from large-scale surveys show different levels in selected geographies, making planning challenging. 
  • These inaccuracies could be due to errors in data collection. But the errors in data collection impact the quality of data, which compromises the survey findings.
  • Researchers have pointed out that data quality gets affected due to factors like interviewer bias, which leads to incorrect data entry. 
  • The level of the bias has been found to be higher in the states that recorded a decline in mCPR. It reflects that the findings were influenced due to errors in data collection. 
  • Also, there is difficulty in distinguishing between methods like sterilisation and hysterectomy for some interviewers, which leads to incorrect reporting.
  • Research shows that state-level decline in the utilisation of mCPR and decline in sterilisation acceptance could lead to a reduction in the use of mCPR.

Way ahead

  • There is a need to address data quality issues and introduce technological interventions in data collection, training, and capacity-building of survey officials. 
  • The role of the National Data Quality Forum (NDQF), a multi-institutional initiative hosted by Indian Council of Medical Research (ICMR) becomes crucial in addressing the gaps between data collection and analysis and using that data for advocacy and policy making.
    • NDQF aims at improving data quality for better and efficient research, identify discordance and errors, and establish protocols and good practices for improving data quality. 
    • It plans to create an integrated platform to share new ideas, develop advanced techniques with the use of Artificial Intelligence (AI) and technology, for improving data quality in health and demographic research for effective policy planning.
  • The onus should be on making data collection inclusive of people, choice, agency, awareness, and decision-making. 
  • It is also crucial to address women’s reproductive rights.


The focus should be on improving data for identifying the issues in contraceptive use and addressing gender inequality in SRHR in India. 

Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Issues in debate around setting an age limit for IVFPriority 1


From UPSC perspective, the following things are important :

Prelims level : IVF

Mains level : Ethical issues surrounding IVF

Oldest women gave birth with IVF

  • A 74-year-old woman from AP was recently recorded as the oldest in the world to give birth to twins through in-vitro fertilization or IVF.
  • The medical community has expressed ethical and medical concerns over conception at such an advanced age.

Why this is a concern

  • The average life expectancy of an Indian woman is 70 and of a man 69 and the medical community has expressed concerns over future of children born to such an elderly couple.
  • Medical technology has reached a stage where we can get even a 90-year-old pregnant. But there are complications that can risk human life.
  • Pregnancy in old age poses multiple risks — hypertension, diabetes, convulsions, bleeding, and cardiac complications to name a few.
  • The womb of an older woman has to be prepared by injecting hormones for the foetus to grow for nine months.
  • Also, a woman of that age cannot breastfeed.

Can a doctor face action?

  • Internationally this pregnancy is being condemned. Everything could have gone wrong. It sets a wrong precedent said doctors organization.
  • Several experts have demanded punitive action, saying the Indian Council of Medical Research (ICMR) should deregister his Andhra Pradesh centre.
  • But with no law in place — a Bill is pending — the assisted reproductive technology (ART) industry continues to operate in a grey zone.
  • In 2005, when ICMR drafted guidelines for ART, it had not set an age limit keeping in mind that reproductive rights were a fundamental right for a woman.
  • The guidelines have been amended after an elderly woman in Haryana gave birth through IVF. Since the Bill on ART has not been passed yet, legal action against such clinics is impossible.
  • ART clinics are expected to self-regulate.

The Assisted Reproductive Technologies (Regulation) Bill, 2010

  • Globally, an estimated 15% of couples are infertile.
  • The ART Regulation Bill, 2010, states that in the Indian social context, children are “old-age insurance”.
  • The Bill proposes the upper age limit at 45 for women and 50 for men to undergo the IVF procedure.
  • As of now, several centres rely on ICMR’s 2017 guidelines that recommend the same age limits. Even for adoption, the total age of the couple must not exceed 110 years.
  • With increasing life expectancy, doctors are in talks with the government to increase the IVF age limit to 50-52 years for women.
  • Until then, several experts self-regulate, some counsel senior citizens to drop the idea, and others refuse them IVF treatment.

The counter-view

  • Societal pressure to have children, the fear of living without support in old age, and the loss of an only child often encourage couples.
  • A lot of couples tell that they want an heir to pass their life’s earnings to.
  • Some doctors argue that childbirth is a personal decision and each individual has the right to make that choice after counselling.
  • Still, a doctor has to conduct tests for the heart, bone structure, diabetes, blood pressure to judge the feasibility of pregnancy.

Laws in other countries

  • Most countries that have a law range the upper limit for IVF between 40 and 50 years.
  • In the US, the upper limit for IVF is 50, and for ovum donation, 45.
  • In Australia, guidelines prohibit IVF beyond menopause (52 years).
  • In the UK, 42 is the age limit for women to seek free insurance under National Health Service. In Canada, the age limit is 43.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[pib] Pradhan Mantri Matru Vandana YojanaPIB


From UPSC perspective, the following things are important :

Prelims level : PMMVY

Mains level : Success of PMMVY

  • Pradhan Mantri Matru Vandana Yojana (PMMVY), a flagship scheme of the Government for pregnant women and lactating mothers has achieved a significant milestone by crossing one crore beneficiaries.


  • PMMVY is a direct benefit transfer (DBT) scheme under which cash benefits are provided to pregnant women in their bank account directly to meet enhanced nutritional needs and partially compensate for wage loss.
  • Implementation of the scheme started with effect from 01.01.2017.
  • Under the ‘Scheme’, Pregnant Women and Lactating Mothers (PW&LM) receive a cash benefit of Rs. 5,000 in three installments on fulfilling the respective conditionality.
  • They include early registration of pregnancy, ante-natal check-up and registration of the birth of the child and completion of first cycle of vaccination for the first living child of the family.
  • The eligible beneficiaries also receive cash incentive under Janani Suraksha Yojana (JSY). Thus, on an average, a woman gets Rs. 6,000.

Performance by states

  • Madhya Pradesh, Andhra Pradesh, Himachal Pradesh, Dadra & Nagar Haveli and Rajasthan are the top five States/UT in the country in implementation of PMMVY.
  • Odisha and Telangana are yet to start implementation of the scheme.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

The burden of malnutrition in under-5 children in IndiaDOMR


From UPSC perspective, the following things are important :

Prelims level : Malnutrition

Mains level : U5 malnutrition and mortality in India

  • A report published in The Lancet Child & Adolescent Health gives comprehensive estimates of disease burden due to child and maternal malnutrition and the trends of its indicators in every state of India from 1990 to 2017.

Key findings

  • The death rate attributable to malnutrition in under-5 children in India has dropped by two-thirds from 1990 to 2017.
  • Malnutrition is, however, still the underlying risk factor for 68% of the deaths in under-five children in India.
  • The Disability-Adjusted Life Years (DALY) rate attributable to malnutrition in children varies 7-fold among the states — a gap between a high of 74,782 in Uttar Pradesh and a low of 11,002 in Kerala.
  • Other states with a high burden are Bihar, Assam and Rajasthan. followed by Madhya Pradesh, Chhattisgarh, Odisha, Nagaland and Tripura.

U5 mortality

  • The proportion of under-5 deaths attributable to malnutrition, which is 68.2% across India, ranges between a high of 72.7% in Bihar and a low of 50.8% in Kerala.
  • Rajasthan, Chhattisgarh and Uttar Pradesh are states with a high such proportion, while Meghalaya, Tamil Nadu, Mizoram and Goa have the lowest proportions of such deaths.
  • Among the malnutrition indicators, low birth weight is the largest contributor to child deaths in India, followed by child growth failure which includes stunting, underweight, and wasting.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

India Iodine Survey 2018-19 ReportDOMR


From UPSC perspective, the following things are important :

Prelims level : Highlights of the report

Mains level : Iodine related deficiencies in Children

  • Tamil Nadu has the lowest consumption of iodized salt despite being the third biggest producer of salt in the country, according to a first-of-its-kind national survey to measure the coverage of iodised salt.

Highlights of the Survey

  • The study shows that 76.3% of Indian households consumed adequately iodised salt, which is salt with at least 15 parts per million of iodine.
  • The five worst performers were Tamil Nadu (61.9%), Andhra Pradesh (63.9%), Rajasthan (65.5%), Odisha (65.8%) and Jharkhand (68.8%).
  • The survey was conducted by Nutrition International in collaboration with the AIIMS and the Indian Coalition for the Control of Iodine Deficiency Disorders (ICCIDD).
  • The survey tested the iodine content in samples of cooking salt from households to estimate the coverage of iodised salt.
  • The survey revealed that 13 out of 36 States have already achieved Universal Salt Iodisation or have 90% of households with access to adequately iodised salt.

Why such difference

  • The northeastern States are doing very well with respect to iodised salt consumption at the household level because of the distance they have from the three salt producing centres — Gujarat, Rajasthan and Tamil Nadu.
  • By and large most States get their salt from Gujarat and Rajasthan and because of the distance, it is sent by rail.
  • Salt-producing States have access to common (or non-iodised) salt and, therefore, they start consuming it since it is readily available.

Salt production in India

  • Rajasthan, which is the second largest producer of salt, also figured among the five worst covered States.
  • Gujarat produces 71% of salt in the country, followed by Rajasthan at 17% and Tamil Nadu at 11%.
  • The rest of the country accounts for a mere 1% of salt produced.

Significance of Iodised Salt

  • Iodine is a vital micro-nutrient for optimal mental and physical development of human beings.
  • Deficiency of iodine can result in a range of disabilities and disorders such as goitre, hypothyroidism, cretinism, abortion, still births, mental retardation and psychomotor defects.
  • Children born in iodine deficient areas may have up to 13.5 IQ points less than those born in iodine sufficient areas.
  • India made fortification of salt with iodine mandatory for direct human consumption in 1992. This was relaxed in 2000 and then reimposed in 2005.
  • In 2011, the Supreme Court, too, mandated universal iodisation for the control of iodine deficiencies.

Key recommendations

  • The key recommendation of the study is to sustain the momentum so that iodine coverage does not fall below current levels.
  • It also recommends that the States and the Centre work together to address the current gaps and look into issues that vary from one State to another, leading to adequately iodised salt not being produced.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

India’s Child Well-being ReportDOMRPriority 1


From UPSC perspective, the following things are important :

Prelims level : Highlights of the report

Mains level : Child healthcare in India

  • India’s Child Well-being Index was recently released.

India’s Child Well-being Report

  • The India child well-being index is a crucial report that can be mined both by the Government and civil organisations to achieve the goal of child well-being and we will use this report effectively.
  • The report is released by the NGO World Vision India and research institute IFMR LEAD.
  • One of the primary objectives of this index is to garner attention to the under-researched theme of child well-being in India, and inspire further academic and policy conversations on related issues.
  • This report provides insights on health, nutrition, education, and sanitation and child protection.
  • The report is an attempt to look at how India fairs on child well-being using a composite child well-being index.

Performance by the states

  • Kerala, Tamil Nadu, Himachal Pradesh and Puducherry topped the charts in the child well-being index, a tool designed to measure and tracks children’s well-being comprehensively.
  • Meghalaya, Jharkhand and Madhya Pradesh featured at the bottom.

24 indicators

  • Focusing on the three key dimensions, 24 indicators were selected to develop the computation of the child well-being index.
  • The dimensions of the index include healthy individual development, positive relationships and protective contexts.
  • The report highlights the multi-dimensional approach towards measuring child well-being — going beyond mere income poverty.

A policy trigger

  • The research has brought to the fore compelling insights on child well-being in India.
  • The report, meanwhile, calls for States to look at their respective scores on the dimensions of child well-being, and to prepare for priority areas of intervention with specific plans of action.
  • It also hopes to trigger policy level changes, seek better budgetary allocations and initiate discussions with all stakeholders, which can help in enhancing the quality of life of all children in the country.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Breast milk banks to ensure all infants get protective coverPrelims Only


From UPSC perspective, the following things are important :

Prelims level : Benefits of breast milk

Mains level : Read the attached story

  • A breast milk bank proposed by the Neonatology Forum (NNF), Kerala, is expected to provide solutions to all such babies who required intensive care at birth or are not able to be breastfed immediately for various other reasons.
  • There are many mothers who are not able to produce breast milk for various medical reasons.

About the milk bank

  • Any lactating mother can donate to the bank.
  • The milk stored in the bank will be pasteurised and would follow the international guidelines for safety.
  • Such milk becomes a blessing for working mothers who require joining work soon after their maternity leave.
  • Breast Milk Bank provides a cheaper option for the needy.


  • India faces the challenge of having the highest number of low birth weight babies with 20% mortality and morbidity in various hospitals.
  • Death of preterm babies is among three major causes of neonatal deaths. In all the neonatal intensive care units, about one-third of the babies would be preterm.
  • Feeding these babies with breast milk can significantly bring down the risk of infections.
  • These milk banks help the baby not just with the feed, but gives protection from many infections because of its inherent property to provide immunity to the infant.

On WHO guidelines

  • The World Health Organisation has said that breast milk is “tailor made” for human infants.
  • If for some reason, mother is not able to feed the infant, her milk should be expressed and fed, according to WHO.
  • The Neonatology Forum had been following this diktat and insists that the newborns are aggressively breastfed in the first hour.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Non-pneumatic Anti-Shock Garment (NASG)Prelims Only


From UPSC perspective, the following things are important :

Prelims level : About NASG

Mains level : Maternity healthcare in India

  • Project Sahara, an initiative in the state of Gujarat uses a unique technique to prevent maternal mortality due to excess bleeding.

Non-pneumatic Anti-Shock Garment (NASG)

  • Most mothers after child delivery suffer from postpartum haemorrhage (PPH) that leads to continuous and excessive bleeding.
  • The rapid loss of blood because of PPH reduces the body’s blood pressure and can even cause death.
  • The non-pneumatic anti-shock garment (NASG) applies pressure to the lower body and abdomen, thereby forcing the blood that was getting accumulated in the pelvic area to other essential organs of the body.
  • The neoprene garment quickly stabilizes vitals and gives doctor enough time for treatment.

Why need NASG?

  • As such, in November 2018, Babu started a new project, called Sahara, that aimed at reducing haemorrhage-related maternal deaths by providing new mothers with a special suit —the NASG.
  • PPH-related deaths accounts for significant number of maternal mortality in India.
  • A lot of mothers become anaemic because of poor nutrition. This weakness compounds the damage caused by excessive and sudden bleeding.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[op-ed of the day] Having the last word on ‘population control’Mains Onlyop-ed snap


From UPSC perspective, the following things are important :

Prelims level : Nothing Much

Mains level : Better Ways to ensure Population Control

Note- Op-ed of the day is the most important editorial of the day. Aspirants should try to cover at least this editorial on a daily basis to have command over most important issues in news. It will help in enhancing and enriching the content in mains answers. Please do not miss at any cost.


On July 11, World Population Day, a Union Minister expressed alarm, in a Tweet, over what he called the “population explosion” in the country, wanting all political parties to enact population control laws and annulling the voting rights of those having more than two children.

Demographic transition – The Economic Survey 2018-19 notes that India is set to witness a “sharp slowdown in population growth in the next two decades”. The fact is that by the 2030s, some States will start transitioning to an ageing society as part of a well-studied process of “demographic transition” which sees nations slowly move toward a stable population as fertility rates fall with an improvement in social and economic development indices over time.


  • The demand for state controls on the number of children a couple can have is not a new one.
  • It feeds on the perception that a large and growing population is at the root of a nation’s problems as more and more people chase fewer and fewer resources.
  • This image is so ingrained in the minds of people that it does not take much to whip up public sentiment which in turn can quickly degenerate into a deep class or religious conflict that pits the poor, the weak, the downtrodden and the minorities against the more privileged sections.
1.Target free approach –The essence of the policy was the government’s commitment to “voluntary and informed choice and consent of citizens while availing of reproductive health care services” along with a “target free approach in administering family planning services”.

2.Lifecycle framework –  “lifecycle framework” which looks to the health and nutrition needs of mother and child not merely during pregnancy and child birth but “right from the time of conception till the child grows… carrying on till the adolescent stage and further”.

3.Offering More Choices – This argument is not about denying services but about offering choices and a range of services to mother and child on the clear understanding that the demographic dividend can work to support growth and drive opportunity for ordinary people only when the population is healthy.

Crucial connections

1.The health and education status – Thus, family health, child survival and the number of children a woman has are closely tied to the levels of health and education of the parents, and in particular the woman; so the poorer the couple, the more the children they tend to have.

2.Not particular to religion – This is a relation that has little to do with religion and everything to do with opportunities, choices and services that are available to the people.

3.Relation with poverty – The poor tend to have more children because child survival is low, son preference remains high, children lend a helping hand in economic activity for poorer households and so support the economic as well as emotional needs of the family.

Comparison –

1.On the basis of wealth – As the National Family Health Survey-4 (2015-16) notes, women in the lowest wealth quintile have an average of 1.6 more children than women in the highest wealth quintile, translating to a total fertility rate of 3.2 children versus 1.5 children moving from the wealthiest to the poorest.

2.On the basis of education – Similarly, the number of children per woman declines with a woman’s level of schooling. Women with no schooling have an average 3.1 children, compared with 1.7 children for women with 12 or more years of schooling. 

Control is not the desired way –

  • Demographers are careful not to use the word “population control” or “excess population”.
  • The NPP 2000 uses the world “control” just thrice: in references to the National AIDS Control Organisation; to prevent and control communicable diseases, and control of childhood diarrhoea.
  • This is the spirit in which India has looked at population so that it truly becomes a thriving resource; the life blood of a growing economy.
  • Turning this into a problem that needs to be controlled is exactly the kind of phraseology, mindset and possibly action that will spell doom for the nation.
  • Today, as many as 23 States and Union Territories, including all the States in the south region, already have fertility below the replacement level of 2.1 children per woman.
  • So, support rather than control works.


  • The damage done when mishandling issues of population growth is long lasting.
  • Let us not forget that the scars of the Emergency are still with us. Men used to be part of the family planning initiatives then but after the excesses of forced sterilisations, they continue to remain completely out of family planning programmes even today.
  • The government now mostly works with woman and child health programmes. Mistakes of the Emergency-kind are not what a new government with a robust electoral mandate might like to repeat.


Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Chandipura VirusPrelims Only


From UPSC perspective, the following things are important :

Prelims level : Chandipura Virus

Mains level : Not Much

  • Medical officers are on high alert after a 5 year old died of Chandipura Virus in Gujarat.

Chandipura virus

  • The Chandipura virus was discovered by 2 Pune-based virologists of the National Institute of Virology (NIV) in 1965.
  • The Chandipura Vesiculovirus (CHPV) predominantly affects children.
  • The virus spreads mainly through the bite of sand flies and sometimes through mosquitoes.
  • The symptoms include sudden high fever accompanied by headache, convulsions and vomiting, sometimes leading to unconsciousness.
  • Cases have mostly been reported during monsoon and pre-monsoon, when sand flies breed.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

“State of Food Security and Nutrition in the World” ReportPIB

  • The “State of Food Security and Nutrition in the World” was recently released.

About the report

  • It is published by the UN Food and Agriculture Organization (FAO) and other UN agencies including the WHO.
  • The report estimated that 820 million people worldwide did not have enough to eat in 2018, up from 811 million in the previous year.
  • At the same time, the number of overweight individuals and obesity continue to increase in all regions.

Highlights of the report

  • The number of people going hungry has risen for the third year running to more than 820 million. After decades of decline, food insecurity began to increase in 2015.
  • Africa and Asia account for more than nine out of ten of the world’s stunted children, at 39.5% and 54.9% respectively.
  • However at the same time, obesity and excess weight are both on the rise in all regions, with school-age children and adults affected particularly.

India scenario

  • The number of obese adults in India has risen by a fourth in four years, from 24.1 million in 2012 to 32.8 million in 2016.
  • While India’s undernourished population has dropped by roughly the same fraction in 12 years, from 253.9 million in 2004-06 to 194.4 million in 2016-18.

Compared with China

  • The report has a section on economic growth in China and India, and its effect on poverty.
  • Between 1990 and 2017, the two countries had an average GDP per capita growth rate of 8.6 per cent and 4.5 per cent respectively, the report said, citing World Bank.
  • In both countries, the increase in GDP per capita has been accompanied by poverty reduction.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[pib] LaQshya InitiativeGovt. SchemesPrelims Only


From UPSC perspective, the following things are important :

Prelims level : LaQshya Initiative

Mains level : Not Much

  • The Minister of State (Health and Family Welfare) informed about LaQshya Initiative in the Lok Sabha.

LaQshya Initiative

  • Government of India has launched “LaQshya” (Labour room Quality improvement Initiative) to improve quality of care in labour room and maternity operation theatres in public health facilities.
  • 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.


  • To reduce maternal and newborn mortality & morbidity due to hemorrhage, retained placenta, preterm, preeclampsia and eclampsia, obstructed labour, puerperal sepsis, newborn asphyxia, and newborn 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 facilities.

Following types of healthcare facilities have been identified for implementation of LaQshya program:

  1. Government medical college hospitals.
  2. District Hospitals & equivalent health facilities.
  3. Designated FRUs and high case load CHCs with over 100 deliveries/month ( 60 in hills and desert areas)
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[op-ed of the day] A demographic window of opportunityMains Onlyop-ed snap


From UPSC perspective, the following things are important :

Prelims level : Nothing Much

Mains level : Population control Policies

Note- Op-ed of the day is the most important editorial of the day. Aspirants should try to cover at least this editorial on a daily basis to have command over most important issues in news. It will help in enhancing and enriching the content in mains answers. Please do not miss at any cost.


Last month, the United Nations released the 26th revision of World Population Prospects and forecast that India will overtake China as the most populous country by 2027. The only surprise associated with this forecast is the way it was covered by the media. Is this good news or bad news? Is it news at all?

Most populous country

  • We have known for a long time that India is destined to be the most populous country in the world.
  • Population projections are developed using existing population and by adjusting for expected births, deaths and migration.
  • For short-term projections, the biggest impact comes from an existing population, particularly women in childbearing ages.
  • Having instituted a one-child policy in 1979, China’s female population in peak reproductive ages (between 15 and 39 years) is estimated at 235 million (2019) compared to 253 million for India.


  1. Failures of punitive actions
  • History tells us that unless the Indian state can and chooses to act with the ruthlessness of China, the government has few weapons in its arsenal.
  • Almost all weapons that can be used in a democratic nation, have already been deployed.
  • These include restriction of maternity leave and other maternity benefits for first two births only and disqualification from panchayat elections for people with more than two children in some States along with minor incentives for sterilisation.
  • Ground-level research by former Chief Secretary of Madhya Pradesh Nirmala Buch found that individuals who wanted larger families either circumvented the restrictions or went ahead regardless of the consequences.

2.Incentives for population control

  • Second, if punitive actions won’t work, we must encourage people to have smaller families voluntarily.
  • There are sharp differences in fertility among different socio-economic groups.
  • Total Fertility Rate (TFR) for the poorest women was 3.2 compared to only 1.5 for the richest quintile in 2015-16.
  • Desire to invest in their children’s future – Research with demographer Alaka Basu from Cornell University shows that it is a desire to invest in their children’s education and future prospects that seems to drive people to stop at one child.
  • Richer individuals see greater potential for ensuring admission to good colleges and better jobs for their children, inspiring them to limit their family size.
  • Thus, improving education and ensuring that access to good jobs is open to all may also spur even poorer households into having fewer children and investing their hopes in the success of their only daughter or son.
  • Accessible contraceptive  – Provision of safe and easily accessible contraceptive services will complete this virtuous cycle.

3.Population and policy

  • Third, we must change our mindset about how population is incorporated in broader development policies.
  • Population growth in the north and central parts of India is far greater than that in south India.
  • These policies include using the 1971 population to allocate seats for the Lok Sabha and for Centre-State allocation under various Finance Commissions.
  • In a departure from this practice, the 15th Finance Commission is expected to use the 2011 Census for making its recommendations.
  • This has led to vociferous protests from the southern States as the feeling is that they are being penalised for better performance in reducing fertility.
  •  Between the 1971 and 2011 Censuses, the population of Kerala grew by 56% compared to about 140% growth for Bihar, Uttar Pradesh and Madhya Pradesh.
  • A move to use the 2011 Census for funds allocation will favour the north-central States compared to Kerala and Tamil Nadu.
  • However, continuing to stay with a 1971 Census-based allocation would be a mistake.

Way Forward

  •  Investment in the education and health – In order to maximise the demographic dividend, we must invest in the education and health of the workforce, particularly in States whose demographic window of opportunity is still more than a decade away.
  • Staying fixated on the notion that revising State allocation of Central resources based on current population rather than population from 1971 punishes States with successful population policies is shortsighted.
  • This is because current laggards will be the greatest contributors of the future for everyone, particularly for ageing populations of early achievers.
  • Enhancing their productivity will benefit everyone.
  • It is time for India to accept the fact that being the most populous nation is its destiny.
  • It must work towards enhancing the lives of its current and future citizens.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[pib] Janani Suraksha YojanaGovt. SchemesPIB


From UPSC perspective, the following things are important :

Prelims level : Janani Suraksha Yojana

Mains level : Maternity healthcare in India

Janani Suraksha Yojana (JSY)

  • Janani Suraksha Yojana (JSY) is a safe motherhood intervention under the National Rural Health Mission (NHM).
  • It is being implemented with the objective of reducing maternal and infant mortality by promoting institutional delivery among pregnant women.
  • The scheme is under implementation in all states and Union Territories (UTs), with a special focus on Low Performing States (LPS).
  • It 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.

Various measures under JSY

  • The scheme focuses on the poor pregnant woman with special dispensation for States having low institutional delivery rates namely the States of UP, Uttaranchal, Bihar, Jharkhand, MP, Chhattisgarh, Assam, Rajasthan, Orissa and J&K.
  • While these States have been named as Low Performing States (LPS), the remaining States have been named as High performing States (HPS).
  • Exclusion criteria of age of mother as 19 years or above and up to two children only for home and institutional deliveries under the JSY have been removed.
  • Eligible mothers are entitled to JSY benefit regardless of any age and any number of children.
  • BPL pregnant women, who prefer to deliver at home, are entitled to a cash assistance of Rs 500 per delivery regardless of age of women and the number of children.
  • States are encouraged to accredit private health facilities for increasing the choice of delivery care institutions.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[op-ed snap] Breastfeeding Is Not Home Chore: A Wake-Up Call That Mindsets Need to Changeop-ed snap


Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources

From the UPSC perspective, the following things are important:

Prelims level: Not much

Mains level: The ordeal faced by new mothers in feeding their children in public and need of change in public perception


The taboo related to breastfeeding

  1. It was only last year when an Australian senator was said to have ‘made history’ when she breastfed her baby girl while addressing a Parliament session
  2. Recently, a Malayalam actress was shamed by huge number of people on social media for allowing a magazine to use a picture of her breastfeeding an infant child on its cover
  3. The larger issue of new mothers having to breastfeed their newborns in awkward spaces like changing rooms or toilets still persists
  4. The ordeal faced by many lactating mothers who are made to feel embarrassed when they breastfeed their infants in public is a clear indicator that the lack of dedicated spaces is an issue, but not the only one
  5. A much graver and larger issue is the existing perception about an absolutely natural life process

Raising a child a social process

  1. According to an African proverb, “It takes a village to raise a child.”
  2. This essentially means that it takes the efforts of an entire community of different people in order to create the right environment for a child to grow to her/his full potential
  3. The larger society needs to play a positive and conducive role in building an enabling environment for children
  4. This does not shift the responsibility of the child from the parents, but just highlights the role the society has to play – a shift in the attitude towards making public spaces child-friendly, is definitely one of them

Importance of breastfeeding

  1. For infants, breastfeeding is not only their way to deal with hunger but is also a process that helps calm them down when they are irritated or disturbed for any reason
  2. The World Health Organisation (WHO) recommends exclusive breastfeeding until babies are six months old, as children are most likely to achieve optimal growth and development at this age
  3. Depriving a child of her/his mother’s breast milk is not only likely to affect her/his nourishment but also make the child prone to longer-term health problems

Guidelines for child feeding

  1. The Infant and Young Child Feeding (IYCF) Guidelines 2016 prepared by the Indian Academy of Pediatrics say this about nursing in public (NIP): “Mothers should feel comfortable to nurse in public
  2. All efforts should be taken to remove hurdles impeding breastfeeding in public places, special areas/rooms shall be identified/ constructed or established in places like Bus stands, Railway stations, Airports etc.”
  3. In reality, however, these guidelines are often overlooked in public spaces and new mothers have to face not only rebuke and judgmental glances from people around but also major discomfort in terms of absent infrastructure

Way forward

  1. The need of the hour is to sensitise people and change mindsets, of making people understand that a baby’s hunger, nourishment or discomfort is not dependent on the availability of space or how it makes other people feel
  2. This message not only needs to be made loud and clear, but also widespread
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[op-ed snap] India’s maternity laws need serious tweakingop-ed snap


Mains Paper 2: Governance | mechanisms, laws, institutions & Bodies constituted for the protection & betterment of these vulnerable sections

From the UPSC perspective, the following things are important:

Prelims level: Maternity Benefit Act

Mains level: Proposed changes in the MBA 2017 and changes required for better outcomes


Problems in maternity laws

  1. When the provisions of the amendment to the Maternity Benefit Act came into force effective 1 April 2017, it was lauded by the industry as a progressive step towards improvement in securing the employment rights of women
  2. The law had its heart in the right place but unintentionally led to higher caution on the part of the employers, leading to lower levels of the hiring of women
  3. According to a private sector study, there could be significant job losses for women in India in the short to medium term

Reasons for job losses

  1. India offers one of the world’s most generous maternity leave policies
  2. But India is also probably the only country where the entire financial burden of the maternity leave is supposed to be borne by the employer
  3. In most countries, the cost of maternity leave is shared across the government, employer, insurance and other social security programmes

Proposed changes by the Labour Ministry

  1. The ministry of labour and employment has proposed changes in the law
  2. First, wages equivalent to only seven weeks shall be reimbursed by the government of India to employers who employ female workers and provide maternity benefits of 26 weeks’ paid leave
  3. Second, to enable an entity to avail the incentive, the female employees working in the entity concerned should be earning wages less than ₹15,000
  4. Third,  the female worker has to be a member of Employees’ Provident Fund Organization (EPFO) for at least one year and must not be covered under ESIC
  5. Fourth, provisions for crèches with certain prerequisites (caretakers, visits by mothers, suitable location)
  6. Last, the Maternity Benefit Act, 1961, as amended from time to time, is a state government legislation, implying thereby that state governments may amend the Act from time to time to extend benefits higher and incremental to the benefits recommended by the central government

Flaws in the proposed amendments

  1. The Employees’ State Insurance (ESIC) Act mandates that all employees earning wages of ₹21,000 or less shall be covered under the Act
  2. But the proposal to consider employees earning wages of ₹15,000 or less, with the conditions attached to it, does not seem justifiable
  3. This is owing to the fact that the women earning wages of ₹21,000 or less but are employed in non-implemented areas are not entitled to the benefits and the employer is forced to bear the entire cost
  4. The conditions set for 1 year enrolment into EPFO lack logic or reasoning considering a) entitlement to maternity benefits kicks in once an employee completes 80 days (less than three months) of continuous service, and b) an employee is entitled to the benefits under the proposed incentive only if she has been a contributing member of EPFO for at least a year and is not covered under ESIC
  5. Provisions of creche that are mandatory for commissioning mothers lack clarity

Desired changes

  1. The seven weeks reimbursement limit must be extended to a minimum of 13 weeks
  2. The period of wages of 13 weeks could also stand to be extended to all female employees who are not covered under ESIC, without any preconditions on wage ceiling or membership of the provident fund organization for one year, etc
  3. The government must set up crèches with all the attendant facilities proposed in the Maternity Benefit (Amendment) Act, 2017, and allow employees eligible for such benefits to use these crèches at a very nominal cost
  4. Bringing the Maternity Benefit Act under central legislation will also help maintain uniformity
  5. There can also be cost sharing between employer and government by way of reimbursement once the employer furnishes the proof of payment of maternity leave wage
  6. Provision of slab-based tax rebates offered by the government on actual maternity wages paid
  7. Setting up a government insurance scheme to pay for maternity wages
  8. Leave sharing in the form of 13 months maternity and 13 months paternity to negate any possibility of gender bias

Way forward

  1. Such changes in the Act will likely encourage employers to provide employment opportunities to women without any gender discrimination and thus bring women into the mainstream of India’s progress
  2. With such active steps, we have genuine hope of raising India’s overall female labour force participation from the present 26% to a competitive level like China’s 60%
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[op-ed snap] Without maternity benefitsop-ed snap


Mains Paper 2: Governance | Welfare schemes for vulnerable sections of the population by the Centre & States & the performance of these schemes

From the UPSC perspective, the following things are important:

Prelims level: Pradhan Mantri Matru Vandana Yojana (PMMVY)

Mains level: Hardships faced by women during and after pregnancy and need for better schemes


Maternity benefits under PMVVY

  1. Pradhan Mantri Matru Vandana Yojana (PMMVY) was announced by Prime Minister Narendra Modi on December 31, 2016
  2. The scheme largely defeats the purpose it is supposed to serve: according to a recent analysis, it excludes more than half of all pregnancies because first-order births account for only 43% of all births in India
  3. Further, the PMMVY provides little assistance to women who lose their baby, because the successive payments are made only if the corresponding conditionalities are met

Problems in the scheme

  1. Under the National Food Security Act (NFSA) of 2013, every pregnant woman is entitled to maternity benefits of ₹6,000, unless she is already receiving similar benefits as a government employee or under other laws
  2. PMVVY violates the NFSA in several ways
  3. First, the benefits have been reduced from ₹6,000 to ₹5,000 per child
  4. Second, they are now restricted to the first living child
  5. Third, they are further restricted to women above the age of 18 years
  6. The application process is cumbersome and exclusionary: a separate form has to be filled, signed and submitted for each of the three instalments, along with a copy of the applicant’s mother-child protection card, her Aadhaar card, her husband’s Aadhaar card, and the details of a bank account linked to her Aadhaar number
  7. The compulsory linking of the applicant’s bank account with Aadhaar often causes problems

Need of pregnant women

  1. The worst form of hardship reported by pregnant women is the inability to improve their nutritional intake or even to eat properly during pregnancy
  2. Women who were working for wages before pregnancy could not work during their pregnancy and earned zero wages
  3. Women need to spend money during delivery or pregnancy which they have to borrow
  4. It is common for the families of the respondents to sell assets or migrate to cover these costs
  5. The PMMVY could help protect poor families from these financial contingencies

Linking PMVVY with NFSA

  1. The provision for maternity entitlements in the NFSA is very important for women who are not employed in the formal sector
  2. The PMMVY, however, undermines this provision due to the dilution of the entitled amount and the exclusion criteria
  3. There is an urgent need for better implementation as well as for compliance of the scheme with the NFSA
  4. Maternity benefits should be raised to ₹6,000 per child at least, for all pregnancies and not just the first living child
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

India ranks 56th in early initiation of breastfeeding, say UNICEF, WHOIOCRPrelims Only


Mains Paper 2: Governance | Important International institutions

The following things are important from UPSC perspective:

Prelims Level: Highlights of the report

Mains level: Importance of breastfeeding


Breastfeeding scenario over the world

  1. A new report released by UNICEF and the World Health Organization (WHO) has ranked Sri Lanka at the top of the list of countries with early initiation of breastfeeding.
  2. The report released ahead of World Breastfeeding Week (August 1 to 7), says that only two in five newborns are breastfed within the first hour of life across the world.
  3. The first feed, or colostrum, is termed as the baby’s first vaccine and is extremely rich in nutrients and antibodies.
  4. Continuous and exclusive breastfeeding thereafter is also important.

Performance of the countries

  1. India ranks 56th among the 76 countries that were analyzed.
  2. Countries like Kazakhstan, Rwanda, Bhutan and Uruguay have fared much better than India, making it into the top 10.
  3. Azerbaijan, Pakistan and Montenegro are at the bottom.

Low awareness holds India back

  1. Though nearly 80% of births are institutional deliveries in India, there are missed opportunities of early initiation of breastfeeding due to low awareness among healthcare staff.
  2. The early initiation period has doubled in NFHS 4 as compared to NFHS 3.
  3. But more progress can be made by capitalizing on opportunities and creating awareness at the community level.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[pib] POSHAN Abhiyan (National Nutrition Mission)PIBPrelims Only


Mains Paper 2: Governance | Welfare schemes for vulnerable sections of the population by the Centre and States and the performance of these schemes.

From UPSC perspective, the following things are important:

Prelims level: Particulars of the mission

Mains level: Holistic strategy to counter Malntrition


Poshan Abhiyan

  1. The Government of India has set-up POSHAN Abhiyaan (National Nutrition Mission) which was launched by the PM Modi on 8thMarch, 2018 from Jhunjhunu, Rajasthan.
  2. The programme through use of technology, ha a targeted approach and convergence strives to reduce the level of Stunting, Under-nutrition, Anemia and Low Birth Weight in Children, as also, focus on Adolescent Girls, Pregnant Women & Lactating Mothers for holistically addressing malnutrition.
  3. POSHAN Abhiyaan aims to ensure service delivery and interventions by use of technology, behavioural change through convergence and lays-down specific targets to be achieved across different monitoring parameters over the next few years.
  4. To ensure a holistic approach, all 36 States/UTs and 718 districts will be covered in a phased manner by the year 2020. Never before has nutrition been given such prominence at the highest level in the country.

Additional Information

  1. As part of this Abhiyaan, initiative to mobilize a peoples’ movement or Jan Andolan on Nutrition, the MoWCD has developed a Caller Tune and Ring Tone to popularize and create a connect with the Abhiyaan’s goal of Sahi Poshan Desh Roshan.
  2. It was decided that the activities to be carried in the month of September to celebrate as National Nutrition Month and this will be celebrated every year.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

PM’s maternity scheme benefits 23.6 lakhGovt. SchemesPriority 1


Mains Paper 2: Governance | Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

From UPSC perspective, the following things are important:

Prelims level: PMMVY

Mains level: Hurdles in implementing PMMVY


Programme picking up after a slow start +  Huge Backlog

  1. After initial hiccups in implementing the maternity benefit programme Pradhan Mantri Matru Vandana Yojana (PMMVY), the government has finally made some headway and provided cash incentives to nearly 23.6 lakh beneficiaries out of an estimated 51.6 lakh a year.
  2. However, until January 2018, the government programme had covered only 90,000 women — a mere 2% of the target.
  3. However, due to a huge backlog from last year, the government needed to provide cash benefits to over 100 lakh estimated beneficiaries by the end of the financial year 2017-18.

States are yet to come on board

  1. Many States like Tamil Nadu, Telangana, Odisha and West Bengal have not yet come on board to implement the scheme.
  2. These States account for nearly 25% of the total beneficiaries
  3. These states have their own maternity benefit schemes and have been reluctant to implement the PMMVY
  4. But they were bound to comply because the scheme was a by-product of the National Food Security Act.


Pradhan Mantri Matru Vandana Yojana (PMMVY)

  1. The maternity benefits under PMMVY are available to all Pregnant Women & Lactating Mothers (PW&LM) except those in regular employment with the Central Government or State Government or Public Sector Undertaking or those who are in receipt of similar benefits under any law.
  2. The scheme is being implemented on a 60:40 cost-sharing basis with the State governments.
  3. It is for first living child of the family as normally the first pregnancy of a woman exposes her to new kind of challenges and stress factors.
  4. The Government of India has approved Pan-India implementation of PMMVY in all districts of the country under which the eligible beneficiaries get Rs. 5,000/- under PMMVY
  5. The remaining cash incentive as per approved norms towards Maternity Benefit under Janani Suraksha Yojana (JSY) after institutional delivery so that on an average, a woman gets Rs. 6000/-
  6. The objectives of the scheme are:
  • Providing partial compensation for the wage loss in terms of cash incentives so that the woman can take adequate rest before and after delivery of the first living child; and
  • The cash incentives provided would lead to improved health seeking behaviour amongst the PW&LM. 
  • However, to address the problem of malnutrition and morbidity among children, the Anganwadi Services Scheme, which is universal, is available to all PW&LM including the second pregnancy.
  • Further, in order to address the malnutrition and morbidity during pregnancies a number of interventions are provided to the pregnant women viz. universal screening of pregnant women for Anaemia and Iron and Folic Acid (IFA) supplementation, Calcium supplementation in pregnancy, Deworming in pregnancy, Weight gain monitoring and Counselling on nutrition, family planning and prevention of diseases. 
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Maternal mortality ratio in the country drops from 167 to 130Priority 1


From UPSC perspective, the following things are important :

Prelims level : MMR stats and performance by states


Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources

From UPSC perspective, the following things are important:

Prelims level: MMR stats and performance by states

Mains level: Improvements in healthcare for women & children


Decline in MMR

  1. The latest Sample Registration System (SRS) data indicating the Maternal Mortality Ratio (MMR) has brought glad tidings.
  2. As per the data, MMR, (number of maternal deaths per 1,00,000 live births) has dropped from 167 in (2011-2013, the last SRS period) to 130 for the country.
  3. This 28% drop is an achievement arising from painstakingly reducing the MMR in each of the States.
  4. The SRS segments States into three groups:
  • Empowered Action Group (EAG) – Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Odisha, Rajasthan, Uttar Pradesh/Uttarakhand and Assam;
  • Southern States – Andhra Pradesh, Telangana, Karnataka, Kerala and Tamil Nadu; and
  • Others – the remaining States and union territories.
  1. Kerala remains at the top with an MMR of 46 (down from 61).
  2. Maharashtra retains its second position at 61, but the pace of fall has been much lower, dropping from 68 during 2011-13.
  3. Tamil Nadu at 66 (79), is in the third position.

The Way Forward: Hitting SDG Target

  1. India has bettered the MDG target of 139 for 2014-2016.
  2. This is the outcome of systematic work undertaken by the Centre and States under the NHM that has resulted in saving 12,000 more lives in 2015.
  3. Three States have already achieved the UN’s Sustainable Development Goal of MMR 70.
  4. Still fresh impetus is required to bring the MMR below 30 for all States except EAG, which might strive to bring it down to 12-140
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[op-ed snap] To safeguard our future: Aim to fully immunise childrenop-ed snap


Mains Paper 2: Governance | Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

From UPSC perspective, the following things are important:

Prelims level: Particulars of different infectious diseases, Mission Indradhanush. etc.

Mains level: The newscard highlights the threat to children from infectious diseases.



  1. Over the past few years, the government has taken tremendous strides in bringing health to the forefront
  2. The government aims to fully immunise 90 per cent of children by year-end

Part of this effort has been to ensure that every child receives vaccines to protect them from a range of infectious diseases

Threat from infectious diseases

  1. Diseases like pneumonia and diarrhea account for the death of nearly 3 lakh children every year in India
  2. What is most shocking is that most of these deaths are preventable through interventions, including immunisation

Effectiveness of vaccines in countering infectious diseases

  1. Vaccines are tools that protect children from dangerous infections
  2. They are globally recognised as one of the safest and most cost-effective medical interventions
  3. The challenge is building systems that reach the most remote rural areas or crowded city centers. Vaccines cannot help protect children if they don’t reach them

Why is this year important?

  1. The immunisation coverage was increasing by almost 7 per cent each year, and currently stood at 80 per cent
  2. The government’s Intensified Mission Indradhanush initiative aims to fully immunise 90 per cent of children by the end of the year
  3. At the same time, the Government of India have been working to introduce a series of new vaccines,
  4. including two to prevent pneumonia and diarrhea, and a combination vaccine against measles and rubella

Success of the Measles-Rubella vaccine: Achieving the target

  1. The Measles-Rubella vaccine was launched last year through a countrywide campaign, the largest of its kind in the world. As of February 2018, the campaign had immunised over 7 crore children
  2. In order to repeat our success with polio elimination we need sustained political action that prioritises the health and development of our children

The way forward

  1. There is no greater responsibility for a nation than to ensure the health of its children. Without action, young lives will continue to be lost
  2. Therefore, today, more than ever before, it is imperative that each and every citizen come together to ensure that our children grow up in a healthier and safer India, free from preventable disease and death
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[op-ed snap] What does it take to save a newborn’s life?op-ed snap


Mains Paper 2: Governance | Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

From UPSC perspective, the following things are important:

Prelims level: UNICEF, WHO’s Essential Newborn Care, etc.

Mains level: The newscard comprehensively deals with the issue of newborn deaths in India.



  1. Although India is undeniably on a path toward economic prosperity, losing millions of children every year to preventable deaths undermines this progress

The United Nations International Children’s Emergency Fund (Unicef) report

  1. It shows a grim state of the Indian health system for newborns
  2. With an average newborn mortality rate of 25.4 deaths for every 1,000 live births, India leads the list of lower middle-income countries with the highest number of newborn deaths
    (a staggering 6.4 million per year, or about a quarter of the world’s total)

Positive contribution of the national immunization programme

  1. With the inclusion of vaccines against diarrhoea and pneumonia in the national immunization programme, India was able to reduce the under-five mortality rate by 34% between 1990 and 2006

However, immunization programmes are unable to prevent these deaths

  1. Why: because causes of newborn deaths are different
  2. Some 80% of newborn deaths result from complications from labour and delivery: premature birth, low-birth weight, neonatal infections, and birth trauma
  3. Out of these, infections such as pneumonia and diarrhoeal diseases, account for half of all newborn deaths

What is the main issue?

  1. Every health system would be adequately funded, with ample staff, training and equipment to care for the community
  2. While asking for more resources is often warranted, we put poor populations at risk when we focus only on money instead of looking for ways to improve the capacity of the existing health system

World Health Organization’s (WHO’s) Essential Newborn Care

  1. Simple interventions around the time of birth(such as hand washing, cleaning the umbilical cord with a regular antiseptic, ensuring the newborn is warm, dry, and fed) are affordable and more effective than previously thought
  2. These interventions can reduce newborn death rates in low-resource settings
  3. Most of these strategies do not require a specialist
  4. These practices form the basis for the World Health Organization’s (WHO’s) Essential Newborn Care
  5. Essential Newborn Care is a set of activities that each newborn child needs, irrespective of place or condition at birth
  6. WHO offers brief training courses and provides simple checklists that ensure all the essential steps are carried out at the time of birth
  7. It strengthens the capacity of the health system by distributing essential responsibilities among a larger group of health workers and emphasizing shared responsibility for high-quality outcomes

Positive outcomes of WHO’s Essential Newborn Care in India

  1. Recent evidence from Karnataka revealed that WHO birth attendant training in Essential Newborn Care reduced perinatal mortality to 36 per 1,000 live births, from 52
  2. Stillbirth rates decreased by about 40%, to 14 per 1,000 live births, and early neonatal death fell by about one-fourth to 22 per 1,000 live births

Another solution for addressing the issue

  1. Better training of midwives can also reduce newborn deaths
  2. A comprehensive study on the role of midwives in obstetric care reported in the Lancet revealed that
  3. strengthening midwifery practices through education, training, and regulation(in low- and middle-income countries) has resulted in more efficient utilization of resources
  4. and improved outcomes for both pregnant mothers and newborn children

So why aren’t these various, relatively simple measures in wider practice?

  1. One reason is resistance from professional societies. Doctors may worry about quality, safety, and the dilution of professional obligations
  2. But the fact is that these low-cost and high-impact interventions can save millions of lives

The way forward

  1. It is not reasonable, moral or practical, to wait until the capacity of the national health system develops sufficiently to handle this public health crisis
  2. Instead, we must empower and train healthcare providers who work in remote communities and serve populations that are unable to access safe and affordable obstetric care in the current health system
  3. Losing almost a million lives every year to preventable causes is a travesty of sound health policy
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

[pib] Executive Committee to provide policy support and guidance to States/ UTs under POSHAN Abhiyaan


From UPSC perspective, the following things are important:

Prelims level: POSHAN Abhiyaan

Mains level: Initiatives for mother and child health development


Related Ministry/Department: Ministry of Women and Child Development

  • An Executive Committee has been set up under the Chairpersonship of Secretary, Ministry of Women & Child Development to provide policy support and guidance to States/ UTs under POSHAN Abhiyaan from time to time.
  • A National Council on India’s Nutrition Challenges has also been set up under the Chairpersonship of Vice Chairman, NITI Aayog for policy direction, review, effective coordination and convergence between Ministries which have a sectoral responsibility for the challenge of nutrition.
  • POSHAN Abhiyaan under Innovation component envisages undertaking activities to be implemented intended to improve the service delivery system, capacity building of front line functionaries and community engagement for better nutritional outcomes.
  • The successful pilots may be taken up later-on for scaling up in similar contextual specificities on a broader platform
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Despite having maximum newborn deaths, India reduces under-five mortality rate by 66%


Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources

From UPSC perspective, the following things are important:

Prelims level: MDG, SDG, UNICEF, National Health Policy

Mains level: Status of child care in India

Reduction in under-five deaths

  1. India has notched up a 66 percent reduction in under-five deaths between 1990 to 2015
  2. Still, India has the largest number of babies dying in the world
  3. India is the only major country in the world to have a higher mortality for girls as compared to boys

Meeting MDG target

  1. India has almost met its Millennium Development Goal (MDG) target, though it is way past the MDG era
  2. With the current rate of decline, India is back on track to meet the Sustainable Development Goals (SDG) target for the under-five mortality of 25 per 1,000 live births by 2030
  3. This was highlighted in a UNICEF report named “Every Child Alive”
  4. Reducing child mortality s not only a part of the Sustainable Development Goals but also a part of the National Health Policy


Neonatal and Infant Mortality Rate

  • Infant mortality rate: Probability of dying between birth and exactly 1 year of age, expressed per 1,000 live births
  • Neonatal mortality rate: Probability of dying during the first 28 days of life, expressed per 1,000 live births
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Form nodal agency to check online pre-natal sex selection ads: SC

  1. The SC directed the govt to constitute a nodal agency to monitor and trigger search engines to crack down on online pre-natal sex determination advertisements
  2. The nodal agency should receive complaints under the Pre-Conception and Pre-Natal Diagnostic Techniques Act of 1994
  3. It should communicate the tip-offs to online search engines like Google, Yahoo and Microsoft, which would delete these advertisements
  4. Why: The court was hearing a petition filed in 2008 by Dr. Sabu Mathew George in the background of increasing instances of female foeticide
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

India’s rotavirus vaccine launched

  1. News: Health Ministry launched the country’s first, indigenous rotavirus vaccine to combat diarrhoeal deaths
  2. India’s Universal Immunisation Programme will now provide free vaccines against 12 life threatening diseases
  3. Reason: Diarrhoea caused by Rotavirus is one of the leading causes of severe diarrhoea and death among children less than 5 years of age
  4. Importance: It is a new milestone towards expanding the coverage of full immunisation in the country aimed at reducing child mortality
  5. Statistics: In India, between 80,000 to one lakh children die due to Rotavirus diarrhoea annually
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Beti Bachao Beti Padhao Scheme expanded in additional 61 districts

  1. Context: Ministry of Women and Child Development has expanded scheme in additional 61 districts, covering 11 states
  2. Why expansion? Recommended by the Standing Finance Committee (SFC), after seeing the overwhelming response by stakeholders in the form of various initiatives and innovations
  3. Historical context: 100 districts with low Child Sex Ratio were selected for the Scheme implementation for creating awareness and advocacy about the issue
  4. In last one year, scheme implemented under the overall guidance and supervision of concerned District Magistrate/Deputy Commissioners
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Beti Bachao delivers gains in Haryana but gaps remain

A joint initiative between the MoWCD, MoHFW and MoHRD, Beti Bachao was designed to reverse the trend of declining CSR in India.

  1. Within less than a year, Haryana’s sex ratio at birth has improved to 903 in December 2015 from 834 in Census 2011- the first time in a decade that it had crossed 900.
  2. The success is attributed to Beti Bachao-Beti Padhao campaign.
  3. Since the implementation of Beti Bachao started, there has been a visible increase in efforts to spread public awareness of the need for a healthy Child Sex Ratio.
  4. The problem is that it is not easy to change mindsets and even now there are agents who enter villages and help families get the sex of their child determined.
  5. Now that it has been controlled it in Haryana, the business has moved to neighbouring states of Delhi and Uttar Pradesh.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Fewer children dying in infancy, says National Family Health Survey

The Phase 1 results from the National Family Health Survey-4 for 2015-16, which covered 13 States and 2 Union Territories (UTs), are a reason to smile.

  1. In nearly every State, fewer children are dying in infancy, and across all States, more mothers are getting access to skilled ante-natal care.
  2. Other findings are that while anaemia is widespread, rates have declined.
  3. Currently, over half the children in 10 States and over half the mothers in 11 States continue to be anaemic.
  4. Consistent with the burden of non-communicable diseases in India, over-nutrition or obesity among adults has emerged as a major concern.
  5. The total fertility rates or the average number of children per woman, range from 1.2 in Sikkim to 3.4 in Bihar.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Let’s leave no child behindop-ed snap

Mission Indradhanush is a successful intervention in scaling up immunisation for full coverage


  • Around the world, vaccines are considered to be one of the most cost-effective solutions for preventing child mortality and morbidity.
  • The Universal Immunisation Programme (UIP) started in 1985, helped India make remarkable progress towards reducing child mortality rates in the country.
  • Through the UIP, India has achieved the momentous elimination of diseases such as polio, smallpox and, recently, maternal and neonatal tetanus.

Despite achieving a decline in child mortality, serious challenges still remain

  • Even a single child without the necessary vaccination has the potential to make other children in the vicinity vulnerable.
  • There are 89 lakh such children in our country who have missed one or more doses of vaccines.
  • A survey found that, in more than 60 per cent of instances, parents were either not aware about the benefits of immunisation or had apprehensions regarding its side effects.
  • In order to make the community aware of the importance of vaccination, a nationwide intervention was needed.

Initiative of Mission Indradhanush envisaged to scale-up immunisation in India.

  • Mission Indradhanush was launched in December 2014 to boost the reach of the routine immunisation programme, with the ultimate aim of immunising every Indian child by 2020.
  • The first round started on April 7, a World Health Day, focus of the initiative was to build sustainable health systems.
  • By keeping communication at the centre stage and enabling better monitoring and sharing of feedback between all levels of the health system.
  • Running a robust delivery mechanism is another challenge in scaling-up immunisation in a vast and diverse country such as India.
  • To streamline the vaccine-delivery system, an innovative cold supply chain management system is being implemented to enable health workers to monitor.

India stands committed to covering each and every child with the protection of full immunisation.

Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

About Mission Indradhanush – Extensive coverage (3/3)

  1. The broad strategy, based on evidence and best practices – 4 elements –
  2. Meticulous planning of campaigns/sessions at all levels
  3. Effective communication and social mobilization efforts
  4. Intensive training of the health officials and frontline workers
  5. Establish accountability framework through task forces
  6. WHO Country Office for India is collating preparedness status for Mission Indradhanush from 28 states and 201 high focus districts.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

About Mission Indradhanush – Extensive coverage (2/3)

  1. The implementation of the first phase of the Mission in 201 high focus districts will commence from 7th April 2015, World Health Day.
  2. Within the districts, the Mission will focus on the 400,000 high risk settlements identified by the polio eradication programme.
  3. These are the pockets with low coverage due to geographic, demographic, ethnic and other operational challenges.
  4. Example – Brick kilns, Construction sites, Areas with low routine immunization (RI) coverage, Small villages, hamlets, dhanis or purbas.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

About Mission Indradhanush – Extensive coverage (1/3)

  1. A special nationwide initiative to vaccinate all unvaccinated and partially vaccinated children under the Universal Immunization Programme by 2020.
  2. Initiative by Ministry of Health and Family Welfare.
  3. Focus – 7 life-threatening diseases (diphtheria, whooping cough, tetanus, polio, tuberculosis, measles and hepatitis B).
  4. In addition, vaccination against Haemophilus influenzae type B and Japanese Encephalitis is provided in select districts/states.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Beti Bachao Beti Padhao & a few more points


  1. It is a joint initiative of the Ministries of Women & Child Development & Human Resource & Dev.
  2. Twin objectives –  To protect a girl child’s right to life + To empower her with education and life skills.
  3. The BBBP, has initially chosen 100 Gender Critical districts.
  4. Monitorable targets – Improve the Sex Ratio at Birth (SRB) by 10 points a year & Reduce gender differentials in under 5 Child Mortality Rate.
  5. Further – Increase girl’s enrolment in secondary education | Provide toilets for girls.
  6. The BBBP Campaign is also to ensure effective implementation of PC & PNDT Act to curb sex-selective abortion.
  7. Improve the nutritional status of girls by reducing the number of underweight and anaemic girls under the age of 5.
  8. Strict implementation of Protection of Children from Sexual Offences (POCSO) Act, 2012.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

A note on the ‘Mission Indradhanush’ programme

  1. Launched for children who are partially vaccinated or unvaccinated.
  2. Mission Indradhanush will provide protection against 7 life-threatening diseases (Diphtheria, Whooping cough, Tetanus, Polio, Tuberculosis, Measles & Hepatitis B).
  3. The first phase will focus on 201 high priority districts from 4 states—Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh.
Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Mission Indradhanush for 7 vaccine-preventable diseases

  1. Mission Indradhanush: for vaccination against 7 preventable disease by 2020.
  2. The diseases are Diphtheria, Whooping cough, Tetanus, Polio, Tuberculosis, Measles and Hepatitis B.
  3. The aim is to cover all the children who have been left out or missed out for immunization.

Discuss: You would be knowing that our universal immunization program is to include 3 more vaccines against rotavirus, rubella and polio.


  • Aim: To generate awareness and improve efficiency of delivery of welfare services meant for women
  • Launched on 22 January 2015 with an initial corpus of Rs. 100 crore
  • Joint initiative of Ministries of Women & Child Development, Health & Human Resource Development

Districts Identified

The three criteria for selection of districts:

  1. Districts below the national average (87 districts/23 states);
  2. Districts above national average but shown declining trend (8 districts/8 states)
  3. Districts above national average and shown increasing trend (5 districts/5 states- selected so that these CSR levels can be maintained and other districts can emulate and learn from their experiences)
  • First Phase:

100 districts have been identified on the basis of low Child Sex Ratio as per Census 2011 covering all States/UTs as a pilot With at least one district in each state

  • Second Phase

The scheme has further been expanded to 61 additional districts selected from 11 States/UT having CSR below 918



  • Implement a sustained Social Mobilization and Communication Campaign to create equal value for the girl child & promote her education
  • Focus on Gender Critical Districts and Cities low on CSR for intensive & integrated action
  • Mobilize & Train Panchayati Raj Institutions/ Urban local bodies/ Grassroot workers as catalysts for social change
  • Ensure service delivery structures/ schemes & programmes are sufficiently responsive to issues Of gender and children’s rights
  • Enable Inter-sectoral and inter-institutional convergence at District/ Block/ Grassroot levels


  1. Centre: A National Task Force (NTF) headed by Secretary WCD
    State: A State Task Force (STF)
  2. District: District Task Force (DTF) headed by the District Collector/ Deputy Commissioner with representation of concerned departments
  3. Block: A Block Level Committee headed by SDM/ SDO/ BDO
  4. Gram Panchayat/ Municipality: Respective Panchayat Samiti/ Ward Samiti
  5. Village: Village Health Sanitation and Nutrition Committees
Published with inputs from Swapnil
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