Maternal & child health

Story hook

It is September 2017. In a small village in Bahraich district, Uttar Pradesh, Manju Devi, a 24-year-old mother of two, is about to deliver her third child. Her first two children were delivered at home by a Dai. The first died of birth asphyxia. The second is stunted — 102 cm tall at age 5 against the WHO median of 112. Manju herself weighs 41 kg at 9 months pregnant — anaemic, underweight, and never tested for gestational diabetes.

This time, her ASHA worker Mamta convinces her to deliver at the Bahraich CHC. Manju gets a Rs 1,400 JSY cash incentive, free transport via the Janani Shishu Suraksha Karyakram (JSSK), iron-folic-acid tablets, tetanus vaccine, and four antenatal visits. The baby is delivered by a skilled birth attendant. ASHA records the birth, registers the child on the POSHAN Tracker app, and visits the home for six post-natal contacts under HBNC (Home-Based Newborn Care).

Manju's third child — call her Riya — is the first not stunted, not wasted, not at risk of birth asphyxia.

That trajectory — Dai-at-home → CHC-with-ASHA-and-JSY → Anganwadi- and-POSHAN-Tracker — is the story of India's maternal + child health transformation since 2005. The result: MMR fell from 437 (1990) to 97 (NSO 2018-20); IMR fell from 80 (1990) to 28 (SRS 2022); U5MR fell from 126 (1990) to 32 (SRS 2022).

But India still has the highest absolute burden of maternal + child mortality + stunting in the world. 35.5% of under-fives are stunted (NFHS-5, 2019-21); 57% of women 15-49 are anaemic; ~24,000 women die annually in childbirth. The unit covers the NHM + JSY + JSSK + RBSK + RKSK + POSHAN Abhiyaan that built the plumbing — and where it still leaks.

Why this matters for UPSC

A frequently-tested GS-II topic. Prelims: NFHS-5 indicators, POSHAN Abhiyaan targets, ICDS components, RBSK 4Ds, JSY/JSSK provisions (asked 2017, 2019, 2021, 2023, 2024). Mains: appears almost every year — "nutrition challenges" (2019), "POSHAN Abhiyaan evaluation" (2023), "MMR + IMR trajectory" (2022). Interview: high-frequency probes on stunting + anaemia.