1.

Training of MBBS doctors in anaesthetic skills for emergency obstetric care at First Referral Units (FRUs): To alleviate shortage of specialist manpower, the Government of India has launched a training programme in anaesthetic skills in Emergency Obstetric Care for qualified doctors at FRUs. The 18-week programme for the first batch has been pilot tested at the All India Institute of Medical Sciences (AIIMS), Delhi and is being disseminated to the states.

2.

Establishing blood storage centres at FRUs Timely treatment for complications associated with pregnancy can often not be given because of non-availability of blood transfusion services at FRUs. To help alleviate this problem, the Drugs and Cosmetics Act has been amended and guidelines for Blood Storage Centres (BSCs) have been prepared and disseminated to the states 

3.

Development of Guidelines for Antenatal Care and Skilled Attendance at Birth by ANMs and LHVs. The government has recently issued guidelines for ANMs/LHVs/Staff Nurses to use certain drugs for specific situations in emergency obstetric care. The guideline also outlines how ANMs/LHVs can perform simple procedures like active management of the third stage of labour, use of partograph for diagnosis etc., before referral. These guidelines have been developed to assist health personnel to effectively provide the requisite services both quantitatively and qualitatively. 

4.

Development of guidelines for operationalising a Primary Health Centre (PHC) to provide 24-hour delivery and newborn care under RCH-II in order to assist states to plan for and operationalise at least 50 per cent of the PHCs as 24-hour functional units in a phased manner. These PHCs will be responsible for providing round-the-clock delivery services including the management of common obstetric complications, emergency care of sick children and referrals. 

5.

Guidelines for Pregnancy Care and Management of Common Obstetric Complication by Medical Officers. The Government of India envisages that by 2010, 50 per cent of PHCs and all Community Health Centres should be operationalised as 24-hour delivery centres. These centres will also be responsible for providing pre-referral emergency care for women. GOI has, therefore, developed these guidelines for medical officers to help them provide services to women in labour and in obstetric emergencies and, thereby, reduce maternal mortality. 

6.

Janani Suraksha Yojna (JSY) under the overall umbrella of National Rural Health Mission (NRHM) has been introduced with the vision of reducing MMR and IMR and increasing institutional deliveries in families below the poverty line (BPL). JSY integrates the cash assistance with antenatal care during the pregnancy period, institutional care during delivery and immediate post-partum period in a health centre by establishing a system of coordinated care by field level health worker.. The main strategy is to achieve the envisaged vision by linking the cash assistance under JSY to institutional delivery. This centrally sponsored scheme provides 100 per cent central assistance to states /UTs for extending financial assistance @ Rs. 500 per pregnancy for first two live births to the women belonging to BPL families.

7.

In the new initiative, National Rural Health Mission, every village/large habitat will have a female Accredited Social Health Activist (ASHA) chosen by and accountable to the Panchayat to act as the interface between the community and the public healthcare system. ASHA will act as a link between the beneficiary at the village level, the Anganwadi worker and ANM. She will help and guide women to access the health facilities for antenatal care, institutional delivery, post-natal care and counselling on nutrition and family planning services. . 

8.

Vande Mataram Scheme: The scheme is under the Public Private Partnership initiative, with the involvement of the Federation of Obstetric and Gynaecological Society of India and private clinics. The aim is to reduce the maternal mortality and morbidity of pregnant mothers by involving and utilising the vast resources of specialists/trained workforce in the private sector. The scheme intends to provide free antenatal and postnatal check-up, counselling on nutrition, breastfeeding, spacing of birth, etc. This is a voluntary scheme wherein any OBG specialist, lady doctor/MBBS doctor, maternity home, nursing home can volunteer their services. 

9.

In addition to the central government programmes, several states have their own state-specific schemes aimed at safe motherhood. In Kerala, for instance, the Mahila Swasthya Sangh scheme was designed to motivate women to adopt measures to ensure maternal well-being. Refer to your state health department to learn more about these schemes.