Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)
PMSMA, launched on 9 June 2016, is a flagship maternal health initiative under the National Health Mission. It guarantees free, fixed-day, comprehensive antenatal check-up by a Medical Officer on the 9th of every month to every pregnant woman in India — regardless of parity, place of delivery, or socioeconomic status. The scheme has contributed to India's MMR decline from 167 (2011-13) to 97 (2018-20) per lakh live births.
PMSMA was launched by the Ministry of Health and Family Welfare on 9 June 2016. The '9' is symbolic — the 9th of every month, 9 months of pregnancy, 9 components of care. The scheme guarantees a free comprehensive ANC check-up by a Medical Officer (not just an ANM) at all public health facilities on the 9th of every month. Private sector doctors volunteer through the Indian Medical Association (IMA) to supplement government doctors.
The scheme targets all pregnant women, with special focus on those in the 2nd and 3rd trimesters when most pregnancy complications occur. PMSMA built on the earlier Vandematrama Scheme (now phased out) and complemented JSY/JSSK by adding a structured, fixed-day high-quality ANC platform.
- Blood pressure measurement (and screening for preeclampsia)
- Weight, height, BMI
- Abdominal examination — fundal height, lie, presentation, FHS
- Hb estimation (and complete blood count if anaemia suspected)
- Blood grouping and Rh typing
- Urine examination — albumin and sugar
- Blood sugar — random and, if indicated, OGTT for gestational diabetes
- Screening for syphilis (VDRL), HIV, Hepatitis B
- Ultrasound — at least one during pregnancy, ideally in 1st trimester for dating
- Tetanus-diphtheria (Td) vaccination as per NIS schedule
- Iron-folic acid supplementation (100 mg elemental iron + 500 mcg folic acid, daily)
- Albendazole (400 mg) once in 2nd trimester
- Counselling on nutrition, breast-feeding, family planning, institutional delivery, danger signs
- Identification of high-risk pregnancy and referral to higher centre
Every pregnant woman attending PMSMA receives a sticker on her MCP (Mother and Child Protection) card indicating her risk category:
- Red sticker: High-risk pregnancy — requires specialised management at FRU/District Hospital. Examples: severe anaemia (Hb < 7 g%), preeclampsia/eclampsia, previous LSCS, antepartum haemorrhage, multiple pregnancy, malpresentation, gestational diabetes, hypothyroidism, heart disease, chronic hypertension, young/old primigravida (< 19 or > 35 years).
- Blue sticker: Moderate-risk — needs close follow-up at PHC/CHC level. Examples: mild-moderate anaemia (Hb 7-11 g%), pregnancy-induced hypertension without proteinuria, previous 2 abortions, gestational diabetes on diet control, age 19-20 or 30-35 years.
- Green sticker: Low-risk — routine ANC. Normal pregnancy without complications.
Sticker coding is a powerful public health tool — every frontline worker from ASHA to specialist can immediately identify risk level. Red sticker cases are tracked through the RCH portal and ensure facility-based delivery at a higher centre.
PMSMA is implemented on the 9th of every month at all Sub-District Hospitals, CHCs, PHCs, Urban PHCs, and District Hospitals. The Medical Officer is required to perform the comprehensive ANC, with private practitioners volunteering through IMA's 'Pradhan Mantri Surakshit Matritva Abhiyan — Pledge for PMSMA' campaign. ASHAs mobilise pregnant women from their catchment area. The scheme is monitored through the RCH portal (Repductive and Child Health portal, also called RCH-MCTS) which tracks every pregnant woman by name. Special PMSMA-Plus sessions are conducted for high-risk pregnancies on additional days if needed.
India's MMR has declined dramatically in the PMSMA era — from 167 (2011-13) to 130 (2014-16), 113 (2015-17), 103 (2017-19), and 97 (2018-20) per lakh live births. While not all of this decline is attributable to PMSMA alone, the scheme is credited with: (1) earlier detection of high-risk pregnancies, (2) improved referral pathway from PHC to FRU, (3) increased institutional delivery rate, (4) better postpartum haemorrhage and eclampsia management through early detection. Reference: pmsma.nhp.gov.in and SRS MMR bulletins.
PMSMA is a textbook example of how a simple operational innovation — fixed-day, free, doctor-led ANC — can drive measurable maternal mortality reduction at national scale. For UPSC CMS aspirants, the red sticker criteria and the 9 components of PMSMA are high-yield PSM interview questions.