🧭June 8, 2025 Post 2: 👶 Nine Moons of Care: 9 Years of PMSMA’s Lifeline | High Quality Mains Essay | Prelims MCQs
👶 Nine Moons of Care: 9 Years of Pradhan Mantri Surakshit Matritva Abhiyan–PMSMA’s Lifeline
NATIONAL HERO
🗓️ Post Date: June 8, 2025
📚 Thematic Focus: GS2 / Health | Maternal Care | Government Schemes
🪶 Opening Whisper:
On the ninth day of each month, a silent promise echoes across India’s villages — that no mother shall walk alone through birth’s sacred journey.
🔍 Key Highlights
🩺 What is PMSMA?
- Launched: June 2016 by the Ministry of Health & Family Welfare (MoHFW)
- Objective: Provide free, assured, and quality antenatal care (ANC) to all pregnant women during 2nd and 3rd trimesters
- Target Day: Services delivered on the 9th of every month
- Aligned with RMNCAH+N under National Health Mission (NHM)
🧪 Key Features
(See infographic for visual summary)
- Monthly checkups at public facilities
- Services by OBGY specialists, radiologists, physicians
- Minimum package: Investigations (e.g. 2nd trimester ultrasound), Iron-Folic Acid (IFA), and calcium
- Special focus:
• Unregistered or missed ANC women
• High-risk pregnancies (HRPs)
• Dropouts - HRP Identification:
• 🟢 Green sticker – no risk
• 🔴 Red sticker – high risk - Distribution of Mother and Child Protection Cards and Safe Motherhood booklets
📈 Impact
- Over 6.19 crore pregnant women examined as of 2025
- MMR dropped from 130 → 80 per lakh live births (2014–23)
🧭 Extended PMSMA (E-PMSMA) – Since 2022
- Name-based line listing of High-Risk Pregnancies (HRPs)
- Up to 4 PMSMA sessions per month if required
- SMS alerts to both beneficiaries and ASHAs
- Individual tracking till 45 days postpartum
- Financial incentives to promote safe delivery
🤝 Convergence with Other Maternal Health Initiatives
| Scheme | Objective | Reach |
|---|---|---|
| Janani Suraksha Yojana (JSY) | Institutional delivery via cash incentives | 11.07 crore beneficiaries |
| JSSK | Free delivery + neonatal care | 16.60 crore beneficiaries |
| LaQshya | Improve care in labour rooms | All district hospitals targeted |
| SUMAN | Respectful maternity care | 90,015 facilities notified |
| POSHAN Abhiyaan | Focused nutrition for women & children | 6.97 crore events held |
| PMMVY | ₹5,000 direct benefit to lactating & pregnant mothers | Nationwide rollout |
🧭 GS Mains Mapping
Paper: GS Paper 2
Topics Covered:
- Health Infrastructure
- Public Healthcare Schemes
- Maternal and Child Health
- Social Empowerment through Health
- Government Policies and Welfare Measures
💭 A Thought Spark — by IAS Monk
“A nation’s strength lies not in steel or soil, but in the secure heartbeat of a mother who is not afraid to give birth.”
The Pradhan Mantri Surakshit Matritva Abhiyan has quietly ensured that millions of such heartbeats are protected — not just in clinics, but in the promise of dignity.
High Quality Mains Essay For Practice :
Word Limit 1000-1200
Ensuring Safe Motherhood in India: A Nine-Year Review of the Pradhan Mantri Surakshit Matritva Abhiyan
Introduction
India’s journey toward maternal health equity has been long and complex, marked by persistent socio-economic inequalities, infrastructure challenges, and cultural barriers. Within this landscape, the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)—launched in June 2016—emerged as a crucial intervention in ensuring safe and dignified antenatal care for all pregnant women. Now in its ninth year, the scheme has touched the lives of more than 6.19 crore women, while playing a notable role in reducing India’s Maternal Mortality Ratio (MMR) from 130 to 80 per lakh live births between 2014–23.
This essay evaluates PMSMA’s conceptual foundations, implementation strategy, outcomes, and challenges while situating it within India’s broader maternal health framework and global Sustainable Development Goals (SDGs).
Understanding the PMSMA Vision
The Ministry of Health and Family Welfare (MoHFW) launched PMSMA under the National Health Mission (NHM), targeting the delivery of comprehensive, quality antenatal care (ANC), particularly during the second and third trimesters of pregnancy. Unlike previous fragmented approaches, PMSMA aimed at convergence, standardization, and community engagement. A unique feature was the designation of the 9th day of every month as a dedicated check-up day across all public health facilities—creating a predictable, calendar-based model for women and healthcare providers alike.
The PMSMA aligns with the Reproductive, Maternal, Newborn, Child, and Adolescent Health plus Nutrition (RMNCAH+N) strategy, creating synergy among different health missions and schemes for maternal care, institutional delivery, and nutrition.
Core Components and Implementation Strategy
The program was built upon six critical pillars:
1. Assured Quality Antenatal Services
All women are guaranteed a minimum service package, including:
- Physical examination (blood pressure, weight, etc.)
- Laboratory testing (hemoglobin, blood sugar, urine)
- 2nd trimester ultrasound
- Medicines like IFA tablets and calcium supplements
2. Specialist Engagement
By involving OBGY specialists, radiologists, and physicians, the scheme bridges the gap between public and private health sectors. Voluntary private sector participation enhances service delivery, especially in rural and underserved areas.
3. Risk Identification and Follow-Up
A key innovation of PMSMA is color-coded risk classification:
- Green sticker: Low-risk pregnancy
- Red sticker: High-risk pregnancy (HRP)
Women with HRPs are given individualized care, repeat sessions if required, and referral to tertiary centers.
4. Community Mobilization
Accredited Social Health Activists (ASHAs) and ANMs play a vital role in identifying unregistered pregnancies, mobilizing dropouts, and educating women on the significance of timely ANC.
5. Record-Keeping and Tracking
Mother and Child Protection Cards, Safe Motherhood Booklets, and digital registers ensure continuity of care and reduce information gaps.
6. Monthly Cadence
The consistency of monthly check-ups on the 9th of each month facilitates routine building, public awareness, and system preparedness.
Quantitative Impact and Maternal Health Outcomes
The numbers reflect the transformative impact:
- 6.19 crore women screened across rural and urban centers
- Reduction of MMR by 50 points over a decade
- Significant improvement in early detection of anemia, gestational diabetes, hypertension, and fetal anomalies
- Increase in institutional deliveries and referrals to higher centers
The scheme also generated a visible culture of antenatal discipline—where even in remote blocks, the 9th of every month is now synonymous with maternal health day.
Extended PMSMA (E-PMSMA): Strengthening the Safety Net
In 2022, the government launched E-PMSMA to focus specifically on High-Risk Pregnancies (HRPs). The aim was not just diagnosis, but longitudinal care and safe outcomes.
Key features:
- Name-based line listing of HRPs
- Up to 4 ANC sessions per month for high-risk women
- SMS alerts to ASHAs and beneficiaries for follow-up
- Postpartum tracking till 45 days after delivery
- Financial incentivization for early registration and completion of care cycle
This robust tracking framework helps reduce maternal and neonatal mortality through timely intervention.
Convergence with Other Flagship Schemes
PMSMA has evolved in complementarity with other maternal health initiatives:
| Scheme | Role |
|---|---|
| Janani Suraksha Yojana (JSY) | Incentivizes institutional deliveries via conditional cash transfer. Over 11.07 crore women benefited. |
| Janani Shishu Suraksha Karyakram (JSSK) | Ensures free delivery and neonatal care—including transport, diagnostics, and medicines. |
| LaQshya | Focuses on improving quality in labour rooms and maternity operation theatres. |
| Surakshit Matritva Aashwasan (SUMAN) | Aims at respectful maternity care—both dignified and evidence-based. |
| POSHAN Abhiyaan | Offers integrated nutritional support to pregnant and lactating women. |
| PMMVY | Provides ₹5,000 direct benefit to promote nutrition and reduce wage loss during pregnancy. |
This ecosystem approach enables better referral linkages, resource pooling, and continuum of care from pregnancy to early childhood.
Challenges and Gaps
Despite success, several challenges remain:
1. Geographic Disparities
Access to PMSMA services remains uneven in tribal, hilly, and conflict-affected zones. Many women must travel long distances for ultrasounds or lab tests.
2. Private Sector Participation
While encouraged, voluntary private sector involvement is still low. More formal incentives and accountability mechanisms are needed.
3. Human Resource Crunch
Shortage of specialists and radiologists in rural areas hampers timely HRP identification. Multi-skilling of health staff and telemedicine may offer partial solutions.
4. Data Integration
Though E-PMSMA introduced name-based tracking, integration with digital health records and e-RCH portals is still incomplete.
5. Cultural Barriers and Stigma
Some communities still view pregnancy as a “natural process” needing no medical intervention, limiting participation. Behaviour change communication must intensify.
Suggestions and Way Forward
To consolidate and expand the gains of PMSMA, the following steps are vital:
- Universalization of E-PMSMA with greater resource allocation and workforce deployment.
- Public-private partnerships through formal MOUs, training, and service delivery contracts.
- Mobile medical units for inaccessible areas, with on-spot diagnostics and counselling.
- Integration with Ayushman Bharat Digital Mission (ABDM) for seamless tracking.
- Strengthen ASHA capacity with periodic incentives and digital monitoring tools.
- Culturally sensitive IEC campaigns leveraging local influencers to dismantle stigma.
Ultimately, maternal health cannot be seen in isolation. It must be woven into a broader framework of social protection, nutrition, education, and gender justice.
Conclusion
The Pradhan Mantri Surakshit Matritva Abhiyan is not merely a health scheme—it is a moral commitment to ensuring that no woman dies while giving life. Over nine years, it has created a culture of routine antenatal care, improved maternal outcomes, and demonstrated the power of calendar-driven governance backed by community outreach. As India approaches the SDG 2030 deadline of reducing global MMR to below 70 per lakh live births, PMSMA and its extended arms will be pivotal in making that goal a reality.
Quote to End With:
“A healthy mother is the first school of a healthy nation. Care for her is care for the future.”
Target IAS-26: Daily MCQs :
📌 Prelims Practice MCQs
Topic: Pradhan Mantri Surakshit Matritva Abhiyan
MCQ 1 – Type 1: How many of the above statements are correct?
Consider the following statements regarding PMSMA:
1. PMSMA provides free antenatal care services to all pregnant women, primarily during the first trimester.
2. The scheme ensures monthly checkups on the 9th of every month at public health facilities.
3. High-Risk Pregnancies (HRPs) are identified using a red sticker under PMSMA.
4. PMSMA is implemented by the Ministry of Women and Child Development.
How many of the above statements are correct?
A) Only two
B) Only three
C) All four
D) Only one
🌀 Didn’t get it? Click here (▸) for the Correct Answer & Explanation
✅ Correct Answer: A) Only two
🧠 Explanation:
1) ❌ False – It targets the 2nd and 3rd trimesters, not primarily the first.
2) ✅ True – Services are conducted on the 9th of every month.
3) ✅ True – HRPs are identified with red stickers.
4)❌ False – The scheme is implemented by the Ministry of Health and Family Welfare, not WCD.
MCQ 2 – Type 2: Two Statements Based
Consider the following two statements:
1. PMSMA integrates services of private doctors including OBGY specialists through voluntary participation.
2. The scheme mandates compulsory institutional delivery for all high-risk pregnancies.
Which of the above statements is/are correct?
A) Only 1 is correct
B) Only 2 is correct
C) Both are correct
D) Neither is correct
🌀 Didn’t get it? Click here (▸) for the Correct Answer & Explanation
✅ Correct Answer: A) Only 1 is correct
🧠 Explanation:
1) ✅ True – Private doctors voluntarily provide services during PMSMA check-up days.
2) ❌ False – Institutional delivery is encouraged but not mandated by law.
MCQ 3 – Type 3: Which of the statements is/are correct?
Which of the following statements are correct regarding the Extended PMSMA (E-PMSMA)?
1. It includes name-based line listing of High-Risk Pregnant women.
2. Financial incentives are provided to the family of the newborn child.
3. Beneficiaries and ASHAs receive SMS alerts for follow-ups.
4. Tracking continues until 6 months after delivery.
Select the correct code:
A) 1, 2 and 3 only
B) 1 and 3 only
C) 1, 3 and 4 only
D) 2, 3 and 4 only
🌀 Didn’t get it? Click here (▸) for the Correct Answer & Explanation
✅ Correct Answer: B) 1 and 3 only
🧠 Explanation:
1) ✅ True – E-PMSMA includes name-based tracking of HRPs.
2) ❌ False – Financial incentives are directed at the woman, not the family of the child.
3) ✅ True – SMS alerts are sent to both beneficiaries and ASHAs.
4) ❌ False – Tracking continues up to 45 days after delivery, not 6 months.
MCQ 4 – Type 4: Direct Fact
Under PMSMA, what do the green and red stickers signify?
A) Green – completed ANC, Red – incomplete ANC
B) Green – general pregnancy, Red – institutional delivery
C) Green – no risk, Red – high risk pregnancy
D) Green – anemia identified, Red – severe anemia
🌀 Didn’t get it? Click here (▸) for the Correct Answer & Explanation.
✅ Correct Answer: C) Green – no risk, Red – high risk pregnancy
🧠 Explanation:
*Under PMSMA, color stickers are used to classify the risk level of a pregnancy:
Green = low/no risk,
Red = high-risk case requiring special follow-up and care.