Pradhan Mantri Surakshit Matritva Abhiyan: A Deep Dive into Operational Guidelines

The Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) is a critical initiative by the Government of India to ensure quality antenatal care (ANC) services for pregnant women. This article offers a detailed look at the operational framework of the scheme, focusing on its implementation, private sector engagement, and the mechanisms for ensuring its success.

Understanding the Need for PMSMA

The PMSMA was launched to address the need for assured, comprehensive, and quality antenatal care services, particularly during the second and third trimesters of pregnancy. The program recognizes the importance of early identification and management of high-risk pregnancies to reduce maternal deaths. It also emphasizes the role of private sector obstetricians and physicians in providing voluntary services at public health facilities.

Key Components of the Operational Framework

1. Implementation Approach:

   • The scheme operates on the 9th of every month, providing fixed-day ANC services.

   • It is a collaborative effort involving government and private healthcare providers.

   • It focuses on creating a supportive environment for pregnant women to access quality care.

2. Private Sector Engagement:

   • Aims to involve private obstetricians and physicians in providing voluntary services.

   • Aims to create a streamlined process for private providers to register and participate in the program.

   • Provides a framework for acknowledging and recognizing the contributions of private sector volunteers.

3. Implementation Planning and Program Management:

   • State Level Committee (PSC): Responsible for overseeing the program at the state level.

   • District Level Committee (PDC): Responsible for implementing and monitoring the program at the district level.

   • PMSMA Site Guidelines: Provides guidance on the infrastructure, human resources, and logistics required at PMSMA sites.

   • Beneficiary Flow: Outlines the process for managing patient flow at PMSMA clinics.

   • Financial Aspects: Details the funding mechanisms and budgetary provisions for the scheme.

   • Monitoring and Supervision: Provides guidelines for regular monitoring and evaluation of the program.

Detailed Operational Guidelines

The operational guidelines provide detailed instructions for various aspects of the program:

• Estimation of PMSMA Clinic Load: Guidance on estimating the number of pregnant women expected at PMSMA clinics.

• Identification of PMSMA Facilities: Criteria for selecting suitable public health facilities for conducting PMSMA.

• Planning for Human Resources: Guidelines for assessing and deploying necessary staff, including doctors, nurses, and lab technicians.

• Drug and Diagnostics: Ensuring the availability of essential drugs and diagnostic tests at PMSMA sites.

• Transportation Facilities: Providing transportation support to beneficiaries and private providers.

• Tracking High-Risk Pregnancies: Using MCP cards with red stickers to identify and track high-risk pregnancies.

• Completing the Loop: Linking PMSMA centers with CEmONC facilities for assured referral and follow-up.

• Community Awareness and Mobilization: Strategies for creating awareness about PMSMA and mobilizing participation.

Essential Elements of Service Delivery

• Registration: Recording the details of pregnant women and providing them with MCP cards.

• Examination: Conducting thorough examinations by medical officers, including vital signs, and obstetric assessments.

• Diagnostics: Providing essential lab tests and USG when required.

• Treatment: Offering appropriate treatment and referral for high-risk cases.

• Counselling: Providing counseling on diet, rest, danger signs, breastfeeding, and family planning.

Monitoring and Supervision

The program emphasizes robust monitoring and supervision at all levels:

• State Level: Designated teams from MoHFW and the State Health Department monitor PMSMA activities.

• District Level: District-level committees oversee the program’s implementation and ensure accountability.

• Data Collection: Regular collection and analysis of data on coverage, service delivery, and outcomes.

• Grievance Redressal: Mechanisms for addressing grievances and complaints are established.

Budgetary Considerations

• Funds for PMSMA are allocated under JSSK, Free Drugs and Diagnostics, IEC, and referral transport heads.

• Districts can propose additional funds for activities like sensitization, meetings, and IEC campaigns.

• States can propose funds for state-level sensitization and meetings.

Recognition of Efforts

• The scheme encourages the recognition of efforts of private providers and government functionaries through awards and felicitation at various levels.

• State PMSMA committees develop criteria for awards and recognitions.

Conclusion

The Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) is a well-structured and comprehensive program that seeks to improve maternal health outcomes in India. By focusing on quality antenatal care, private sector engagement, and robust monitoring, the scheme is making significant strides towards ensuring safe and healthy pregnancies for all women.