11 PARLIAMENT OF INDIA LOK SABHA COMMITTEE ON EMPOWERMENT OF WOMEN (2017-2018) (SIXTEENTH LOK SABHA) ORIGINAL REPORT ‘WOMEN’S HEALTHCARE: POLICY OPTIONS’ LOK SABHA SECRETARIAT NEW DELHI January, 2017/Pausa, 1938 (Saka) COMMITTEE ON EMPOWERMENT OF WOMEN (2017-2018) (SIXTEENTH LOK SABHA) ‘WOMEN’S HEALTHCARE: POLICY OPTIONS’ Presented to Lok Sabha on 3.1.2018 Laid in Rajya Sabha on 3.1.2018 LOK SABHA SECRETARIAT NEW DELHI January, 2017/Pausa, 1938 (Saka) E.W.C. No. 101 PRICE: Rs._____ © 2015 BY LOK SABHA SECRETARIAT Published under ……………………………………… CONTENTS Page Nos. Composition of the Committee on Empowerment of Women (2015-2016)...................................................................................................... (iii) Composition of the Committee on Empowerment of Women (2016-2017).................................................................................................... (iv) Composition of the Committee on Empowerment of Women (2017-2018).................................................................................................... Introduction..................................................................................................... (vi) REPORT PART I NARRATION ANALYSIS I. Introductory………………………………………………………………..... .. II. Women Healthcare responsibilities: Centre and States ...................... ... III. Janani Suraksha Yojana, Maternal Health and institutional deliveries..... .. IV. Insurance coverage of pregnant women and cash incentives under MBP .. V. Role played by Accredited Social Health Activists (ASHAs), their trainings .. and wages...………………………………………………………………... VI. Anemia in mothers and children.......………………………………... .. VII. Prevalence and Control of Malnutrition............................. .. VIII. Obstetric Care and Women Health.................................. .. IX. Contraception and Women's Health........................................................... .. X. Women's health & Non-communicable diseases ……… .. XI. Mental Health & Women …….………………………….... .. (i) 4 PART II Observations/Recommendations of the Committee………………….................... 20 ANNEXURE I. Institutional Delivery & MMR…………………………… …. II. Institutional Delivery …………………………………………… … III. State-wise prevalence of anaemia in women of reproductive age group ... (15-49)……………………………………………………………………..…… IV. Percentage of Women having below normal body mass Index (BMI) ……………. ….. V. Ante-Natal Care service Status ………………………..…………………… …. VI. Post-Natal care services ……………………………..……………………… ….. APPENDICES I. Minutes of the 4th sitting held on 18.11.2015……....................… .. II. Minutes of the 9th sitting held on 11.05.2016...…………………... .. III. Minutes of the 3rd sitting held on 11.11.2016.........................……. .. IV. Minutes of the 10th sitting held on 02.06.2017.............................. .. V. Minutes of the 4th sitting held on 21.12.2017……………………….. ... (ii) 5 COMPOSITION OF THE COMMITTEE ON EMPOWERMENT OF WOMEN (2015-2016) Shrimati Bijoya Chakravarty - Chairperson Members Lok Sabha 2. Shrimati Anju Bala 3. Shrimati Renuka Butta 4. Km. Sushmita Dev 5. Shrimati Rama Devi 6. Shrimati Jyoti Dhurve 7. Shrimati Bhavana Gawali 8. Shrimati Raksha Khadse 9. Shrimati Poonamben Hematbhai Maadam 10.$ vacant 11.# vacant 12. Shrimati Jayshreeben Patel 13. Shrimati Riti Pathak 14. Shrimati Satabdi Roy (Banerjee) 15. Shrimati Mala Rajya Laxmi Shah 16. Shrimati Supriya Sule 17. Shrimati Rita Tarai 18. Shrimati P. K. Sreemathi Teacher 19. Shrimati Savitri Thakur 20. Shrimati R. Vanaroja Rajya Sabha 21*. Shri Prabhat Jha 22. Shrimati Vandana Chavan 23. Shrimati Kanimozhi 24.% Vacant 25. Shri Anubhav Mohanty 26. Shrimati Kahkashan Perween 27. @ Vacant 28*. Ms. Dola Sen 29. Shri A.V. Swamy 30. Shrimati Wansuk Syiem * Nominated to the Committee w.e.f. 20.06.2016 $ Smt. Mehbooba Mufti, MP (LS) resigned w.e.f. 04.07.2016. # Smt. Anupriya Patel appointed as Minister w.e.f. 05.07.2016 @ Smt. Kanak Lata Singh, retired w.e.f. 04.07.2016 % Smt. Mohsina Kidwai retired w.e.f. 29.06.2016 (iii) 6 COMPOSITION OF THE COMMITTEE ON EMPOWERMENT OF WOMEN (2016-2017) Shrimati Bijoya Chakravarty - Chairperson Members Lok Sabha 2. Shrimati Anju Bala 3. Shrimati Renuka Butta 4. Km. Sushmita Dev 5. Shrimati Rama Devi 6. Shrimati Jyoti Dhurve 7. Shrimati Bhavana Gawali 8. Shrimati Darshanaben Jardosh 9. Shrimati Raksha Khadse 10. Shrimati Poonamben Hematbhai Maadam 11. Shrimati Jayshreeben Patel 12. Shrimati Riti Pathak 13. Sadhvi Savitri Bai Phoole 14. Shrimati Satabdi Roy (Banerjee) 15. Shrimati Mala Rajya Laxmi Shah 16. Shrimati Supriya Sule 17. Shrimati Rita Tarai 18. Shrimati P. K. Sreemathi Teacher 19. Shrimati Savitri Thakur 20. Shrimati R. Vanaroja Rajya Sabha 21. Shrimati Vandana Chavan 22. Shri Prabhat Jha 23. Shrimati Kanimozhi 24. Shri Anubhav Mohanty 25. Shrimati Rajani Patil 26. Shrimati Kahkashan Perween 27. Ms. Dola Sen 28. Shri A.V. Swamy 29. Shrimati Wansuk Syiem 30*. Shrimati Jharna Das Baidya * Shrimati Jharna Das Baidya has been nominated to the Committee with effect from 16th December, 2016. (iv) 7 COMPOSITION OF THE COMMITTEE ON EMPOWERMENT OF WOMEN (2017-2018) Shrimati Bijoya Chakravarty - Chairperson Members Lok Sabha 2. Shrimati Anju Bala 3. Shrimati Renuka Butta 4. Km. Sushmita Dev 5. Shrimati Rama Devi 6. Shrimati Jyoti Dhurve 7. Ms. Bhavana Gawali (Patil) 8. Shrimati Darshanaben Jardosh 9. Shrimati Raksha Khadse 10. Shrimati Poonamben Hematbhai Maadam 11. Shrimati Jayshreeben Patel 12. Shrimati Riti Pathak 13. Sushree Sadhvi Savitri Bai Phoole 14. Shrimati Satabdi Roy (Banerjee) 15. Shrimati Mala Rajya Laxmi Shah 16. Shrimati Supriya Sule 17. Shrimati Rita Tarai 18. Shrimati P. K. Sreemathi Teacher 19. Shrimati Savitri Thakur 20. Shrimati R. Vanaroja Rajya Sabha 21. Shrimati Jharna Das Baidya 22. Shrimati Vandana Chavan 23. Shri Prabhat Jha 24. Shrimati Kanimozhi 25. Shri Anubhav Mohanty 26. Shrimati Rajani Patil 27. Shrimati Kahkashan Perween 28. Ms. Dola Sen 29. Shri A.V. Swamy 30. Shrimati Wansuk Syiem (v) 8 Secretariat 1. Shri N. C. Gupta - Joint Secretary 2. Shri T. S. Rangarajan - Director 3. Shri Khakhai Zou - Additional Director 4. Shri Rajesh Mohan - Executive Officer 5. Shri Aritra Das - Sr. Executive Assistant (vi) 9 INTRODUCTION I, the Chairperson, Committee on Empowerment of Women, having been authorised by the Committee to submit the Report on their behalf, present this Tenth Report on ‘Women’s Health Care: Policy Options’. 2. Realizing the importance of various challenges faced by women and the various healthcare policy options in terms of better accessibility, affordability and availability and their overall impact on health indicators of women in the country, the Committee on Empowerment of Women (2014-15) selected this subject for detailed examination and Report to Parliament during the year 2015-16, the subject was further reselected during 2015-16 and 2016-17 for detailed examination. In order to gain firsthand knowledge on the subject, the Committee interacted with various jail authorities during the study visits. The Committee also took oral evidence of the Ministry on 20.06.2017. 3. The Committee wish to express their thanks to the representatives of the Ministry of Health and Family Welfare for appearing before the Committee for evidence and furnishing the information desired by the Committee in connection with the issues relating to the subject. 4. The Report was considered and adopted by the Committee at their sitting held on ..................... 5. For facility of reference and convenience, the observations and recommendations of the Committee have been printed in bold letters in Part II of the Report. NEW DELHI BIJOYA CHAKRAVARTY, 03 January, 2018 Chairperson, 13 Pausa, 1938 (Saka) Committee on Empowerment of Women. (vii) 10 REPORT PART I I. Introductory We are all aware that women's healthcare in this country was once in shambles, resulting in various depressing consequences for women and child health particularly and country's overall health scenario as a whole for long. Prevalence of chronic anemia, malnourishment, spread of communicable diseases, complications during or after pregnancy, inadequate antenatal, intranatal and postnatal care etc. all contributed to the wastage of precious human resources and stifled the country's progress even in the times not so distant back . 1.2 The situation, off-late, have undergone changes for better. Today women healthcare has been attracting due attention and importance it long deserved in our country. These changes are manifest not only in increased resources allocated to it, but, in the diversity of policy options undertaken for them and directed, particularly, to the special needs of marginalized women and children across the length and breadth of this vast country. However, the Committee believe that it is only a humble beginning and a long and winding road is yet to be covered before a comprehensive, equitable and accessible healthcare system is made available to them. 1.3 With the objective to reviewing the status of women's healthcare in the country and finding ways and means to empower them in terms of access, availability and affordability to healthcare facilities, the Committee on Empowerment of Women selected the subject ' Women's Healthcare: Policy Options' for detailed examination and presentation of report. During the course of examination of the subject, the Committee had studied in-depth the prevailing conditions of various healthcare schemes, approaches adopted by Government, both at the Centre and the States/UTs, the outcome