Eleventh Five Year Plan

88 Eleventh Five Year Planfinancial benefits to States that have improvedSRB. From 2007 onwards, the Annual HealthSurvey will include estimates of SRB at the districtlevel. Planning Commission will obtain independentestimates of the SRB at the district level eachyear. The States will be asked to monitor the SRB ofthe institutional deliveries, by parity, for each facilityas well as for the districts. Improvement in SRBwill be considered one of the indicators for arrivingat decisions on plan assistance to States.• Improve availability of data plus its access and qualityon SRB. The option of PHC level enumerationwill be considered to monitor the SRB on a routinebasis.• Provide financial support for capacity building,awareness generation and strict enforcement of PC& PNDT Act• Amend the PC & PNDT Act to provide for the independenceof the Appropriate Authorities at thedistrict level.• A National Research and Resource Centre in healthfor women will be developed under NRHM.ANTENATAL CARE (ANC)3.1.119 Universal screening of pregnant womenusing appropriate ANC is essential for the detectionof problems and risk during pregnancy for referralto appropriate hospital for treatment. Under theNRHM, efforts are being made to improve the coverage,content, and quality of ANC in order to substantiallyreduce maternal and perinatal morbidity andmortality. Every effort will be made to operationalizethe strategy for prevention and management ofanaemia during the Eleventh Five Year Plan so that thetarget of reducing anaemia among women and girlsby 50% is achieved by the end of 2012.3.1.120 Emphasis will be given to screening all womenduring pregnancy to detect those with problemsand referring them at the appropriate time to predesignatedinstitutions for management and safedelivery. This will reduce maternal and perinatalmorbidity and mortality.SAFE DELIVERY3.1.121 Since child birth at home costs less than thatat a private hospital or a public health facility, it isreasonable that families opt for home deliveries. Emphasiswill therefore be given on training TraditionalBirth Attendants (TBAs) and turn them into SkilledBirth Attendants (SBAs). They would ensure properdeliveries, whether at home or in an institution. Homedelivery by trained persons will be encouraged if thefamilies so desire. TBAs will be taught to recognizecomplications and refer them to hospitals. This strategywill help in reduction of maternal and neonataldeaths and perhaps pave the way for good ANC.3.1.122 Attention will be paid by ASHAs, AnganwadiWorkers (AWWs), and TBAs to make arrangementsfor transport to hospital for EmOC, early detection,and management of infections. All pregnant womenfrom poor households will be covered by social insuranceschemes to facilitate access to reliable maternalcare. In this context, all States will be encouraged toexperiment with schemes for maternity care (likeChiranjeevi scheme in Gujarat). Positive outcomeswill be upscaled and replicated. Every district will havefully equipped Mother and Child Hospital. The existingmaternal and child hospitals in the districts willalso be upgraded.3.1.123 It is now recognized globally that the countriessuccessful in bringing down maternal mortalityare the ones where the provision of skilled attendanceat every birth and its linkage with appropriate referralservices for complicated cases has been ensured. Thishas also been ratified by WHO. Guidelines for normaldelivery and management of obstetric complicationsat PHCs and CHCs for MO and guidelines for ANCand skilled birth attendance at birth for ANMs andLady Health Visitors (LHVs) have been formulated anddisseminated to the States. During the Eleventh FiveYear Plan, emphasis will be given to ensure the servicesof skilled birth attendant at child birth, both forhome deliveries and in institutional settings. Sincehome deliveries will remain the norm across manyStates, effort will be made to provide skilled birth attendanttraining to dais who are ubiquitous in everynook and corner of the country.ESSENTIAL AND EMERGENCY OBSTETRIC CARE3.1.124 Operationalization of FRUs and skilled attendanceat birth go hand in hand. Therefore simultaneous