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

Aug, 21, 2019

Breast milk banks to ensure all infants get protective cover


  • 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.
Jul, 30, 2019

Non-pneumatic Anti-Shock Garment (NASG)


  • 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.
Jul, 25, 2019

[op-ed of the day] Having the last word on ‘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.


Jul, 20, 2019

Chandipura Virus


  • 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.
Jul, 17, 2019

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


  • 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.
Jul, 11, 2019

[op-ed of the day] A demographic window of opportunity

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.
Dec, 15, 2018

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


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
Dec, 03, 2018

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


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%
Nov, 29, 2018

[op-ed snap] Without maternity benefits


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
Aug, 03, 2018

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


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.
Jul, 26, 2018

[pib] POSHAN Abhiyan (National Nutrition Mission)


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.
Jun, 12, 2018

PM’s maternity scheme benefits 23.6 lakh


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. 
Jun, 07, 2018

Maternal mortality ratio in the country drops from 167 to 130


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
May, 05, 2018

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


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
Apr, 28, 2018

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


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
Apr, 06, 2018

[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
Nov, 17, 2016

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
Mar, 28, 2016

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
Feb, 12, 2016

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
Feb, 02, 2016

Beti Bachao Beti Padhao Scheme for 61 more districts

  1. Initially launched in 100 districts with adverse child sex ratio.
  2. Encouraged by results, the scheme is being extended to 61 more districts.
  3. Beti Bachao Beti Padhao is the flagship programme of the Ministry of Women and Child Development.
Jan, 22, 2016

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.
Jan, 20, 2016

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.
Oct, 15, 2015

Let’s leave no child behind

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.

May, 03, 2015

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.
May, 03, 2015

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.
May, 03, 2015

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.
Apr, 19, 2015

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.
Apr, 03, 2015

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.
Mar, 15, 2015

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.

Feb, 02, 2015

Sukanya Samridhi Yojana launched

  1. ‘Sukanya Samridhi Account’ scheme launched under “Beti Bachao, Beti Padhao”.
  2. Bank A/C to be opened till the age of 10 – initial amount Rs. 1000 – max. deposit = Rs. 1.5 lakh. She can withdraw 50% of the money after reaching age of 18.
  3. Interest rate = 9.1% – No income tax for one year.
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