Maternal Health Programmes for NEET PG PSM: ANC Schedule, Partograph, AMTSL, JSY, JSSK, PMSMA, Calcium, MDSR

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🎯 Exam priority: High-yield (Tier 1). Maternal health questions test the ANC visit windows, partograph lines, AMTSL, JSY amounts and eligibility, JSSK entitlements, the PMSMA date and the definition of a maternal death. Everything here is from MoHFW guideline documents.

CBME mapping: CM 10.

Antenatal Care

At least four antenatal visits (more if needed):

• At the sub-centre: pregnancy test, haemoglobin, urine sugar and protein, rapid malaria test. At the PHC/CHC/FRU: blood group with Rh, VDRL/RPR, HIV, blood sugar and more.

• Anaemia in pregnancy: Hb below 11 g/dl; severe below 7 g/dl. (IFA and deworming schedules are in the nutrition article — Anaemia Mukt Bharat.)

• Calcium: 1 g a day as two tablets (with two different meals — never both at once), from 14 weeks of pregnancy to 6 months after delivery.

• PMSMA: fixed-day, assured ANC for women in the 2nd/3rd trimester on the 9th of every month by obstetricians/medical officers, with private doctors volunteering. High-risk women get a red sticker on the MCP card; others a green one.

Labour: Partograph and AMTSL

• Active labour starts at 4 cm cervical dilatation; the first plot goes on the alert line.

• The action line is 4 hours to the right of the alert line. Crossing the alert line means refer to an FRU; crossing the action line means intervention is needed.

• The second stage takes about 2 hours in a primigravida and about half an hour in a multigravida.

• AMTSL (to prevent PPH): (1) a uterotonic — oxytocin 10 IU IM in a facility, or misoprostol 600 µg orally for a home delivery; (2) controlled cord traction; (3) uterine massage.

• Oxytocin is stored at 4–8 °C and must not be frozen.

• Newborn: normal respiratory rate is 30–60 a minute; outside this range, refer.

Janani Suraksha Yojana and JSSK

JSY pays cash for institutional delivery. Low Performing States (LPS): UP, Uttarakhand, Bihar, Jharkhand, MP, Chhattisgarh, Assam, Rajasthan, Odisha and J&K; the rest are High Performing States (HPS).

• In LPS, all pregnant women delivering in government or accredited private institutions are eligible; in HPS, BPL women aged 19+ and all SC/ST women.

• Home delivery (BPL, 19+): ₹500 per delivery, up to 2 live births. Each beneficiary has a JSY card with the MCH card.

• Amounts as in the national JSY guidelines (ASHA package for HPS from April 2009).

JSSK (launched 1 June 2011): free and cashless delivery including caesarean section, drugs, diagnostics, diet, blood, no user charges, and free transport home → facility, between facilities and back home after a 48-hour stay. Sick newborns were covered up to 30 days, since expanded to sick infants.

Post-natal Care and Maternal Death Surveillance

• The post-natal period lasts 6 weeks (42 days); up to 30% of maternal deaths happen in it. High-risk mothers are picked up during HBNC home visits and sent to a facility or PMSMA session.

• Maternal death: death while pregnant or within 42 days of the end of pregnancy, from any cause related to or aggravated by the pregnancy or its management — not accidental or incidental causes.

• MMR = maternal deaths per 1,00,000 live births.

• MDSR: the ASHA is the primary informant and reports the death of any woman aged 15–49 within 24 hours; a facility sends the notification within 24 hours and the investigation form within 48 hours, and files a NIL report in months without deaths.

Traps the Examiner Sets

• First ANC visit is within 12 weeks; the 3rd visit (28–34 weeks) is the one with the MO.

• Action line = alert line + 4 hours.

• Home-delivery uterotonic = misoprostol 600 µg, not oxytocin.

• Calcium starts at 14 weeks, not the first trimester.

• PMSMA = 9th of every month, 2nd/3rd trimester only.

• JSY LPS rural mother gets ₹1400; JSSK is entitlements (no cash).

• Maternal death window is 42 days and excludes accidental causes; MMR denominator is live births.

Rapid-Revision Cards

• ANC visits

  ≤ 12 wk · 14–26 wk · 28–34 wk (with MO) · 36 wk–term.

• ANC tests at SC

  Pregnancy test, Hb, urine sugar + protein, malaria RDT.

• ANC tests at PHC/CHC/FRU

  Blood group + Rh, VDRL/RPR, HIV, blood sugar.

• Anaemia in pregnancy

  Hb < 11 g/dl; severe < 7 g/dl.

• Calcium in pregnancy

  1 g/day as 2 tablets, 14 weeks → 6 months postpartum.

• Partograph

  Active labour ≥ 4 cm; alert line → refer; action line (+4 h) → intervene.

• AMTSL

  Oxytocin 10 IU IM (facility) or misoprostol 600 µg oral (home) + CCT + uterine massage.

• Oxytocin storage

  4–8 °C, never frozen.

• JSY rural

  LPS ₹1400 + ASHA ₹600; HPS ₹700 + ASHA ₹200.

• JSY urban

  LPS ₹1000 + ₹200; HPS ₹600 + ₹200.

• JSY eligibility

  LPS: all institutional deliveries; HPS: BPL 19+ and all SC/ST.

• JSY home delivery

  ₹500, BPL 19+, up to 2 live births.

• JSSK

  1 June 2011; free delivery/CS, drugs, diagnostics, diet, blood, transport (drop back after 48 h).

• PMSMA

  9th of every month; 2nd/3rd trimester; red sticker = high risk.

• Maternal death

  During pregnancy or ≤ 42 days after; not accidental/incidental.

• MDSR reporting

  ASHA primary informant; 24 h notification; facility form 4 within 48 h; NIL reports.

Sources

Sources

Facts in this article were checked against these documents.

• Guidelines for Antenatal Care and Skilled Attendance at Birth by ANMs/LHVs/SNs — Maternal Health Division, MoHFW, 2010 (link)

• Janani Suraksha Yojana: Features & Frequently Asked Questions and Answers (guidelines) — MoHFW, 2006 (link)

• Janani Shishu Suraksha Karyakaram (JSSK) — National Health Mission, n.d. (link)

• Pradhan Mantri Surakshit Matritva Abhiyan: Operational Framework — MoHFW, 2016 (link)

• National Guidelines for Calcium Supplementation During Pregnancy and Lactation — MoHFW, 2014 (link)

• Guidance Note on Optimizing Post-Natal Care — MoHFW, n.d. (link)

• Guidelines for Maternal Death Surveillance & Response — MoHFW, n.d. (link)

Test Yourself: Practice Questions

Eighteen questions in NEET PG style.

Practice Questions (NEET PG pattern)

Original questions written in the style of the exam: +4 for a correct answer, −1 for a wrong one. Every answer was checked against the sources listed above. NEET PG papers are not published by NBEMS, so these are not past-paper questions.

Q1. Under MoHFW guidelines, the first antenatal visit should be

• (a) after quickening

• (b) at 16 weeks

• (c) between 14 and 26 weeks

• (d) within 12 weeks

Q2. The antenatal visit recommended with the PHC medical officer is between

• (a) 36 weeks and term

• (b) 14 and 26 weeks

• (c) 8 and 12 weeks

• (d) 28 and 34 weeks

Q3. Which antenatal test is done at the sub-centre?

• (a) VDRL/RPR

• (b) Blood grouping with Rh

• (c) Haemoglobin estimation

• (d) HIV testing

Q4. On a partograph, the action line lies to the right of the alert line by

• (a) 6 hours

• (b) 4 hours

• (c) 2 hours

• (d) 1 hour

Q5. Active phase of labour begins at a cervical dilatation of

• (a) 2 cm

• (b) 8 cm

• (c) 6 cm

• (d) 4 cm

Q6. For a home delivery, the uterotonic recommended for AMTSL by the MoHFW guidelines is

• (a) misoprostol 600 µg orally

• (b) ergometrine 0.2 mg IV

• (c) oxytocin 10 IU IV push

• (d) carboprost 250 µg IM

Q7. Which is NOT a component of AMTSL?

• (a) Controlled cord traction

• (b) Early fundal pressure

• (c) Uterotonic drug

• (d) Uterine massage

Q8. National guidelines recommend calcium supplementation of

• (a) 500 mg/day from conception

• (b) 1 g/day in two divided doses from 14 weeks of pregnancy to 6 months postpartum

• (c) 2 g/day as a single dose

• (d) 1.5 g/day only in the third trimester

Q9. Under Janani Suraksha Yojana, a mother in a rural area of a Low Performing State receives

• (a) ₹600

• (b) ₹1400

• (c) ₹700

• (d) ₹1000

Q10. In High Performing States, JSY cash for institutional delivery is available to

• (a) BPL women aged 19 and above and all SC/ST women

• (b) only women delivering at home

• (c) only primigravidas

• (d) all pregnant women

Q11. JSY assistance for home delivery to BPL women is

• (a) ₹500 for every birth

• (b) not available

• (c) ₹1400 per delivery

• (d) ₹500 per delivery, up to 2 live births

Q12. Janani Shishu Suraksha Karyakram (JSSK) was launched on

• (a) 12 April 2005

• (b) 9 June 2016

• (c) 1 June 2011

• (d) 15 August 2018

Q13. Which is a JSSK entitlement for pregnant women?

• (a) Free sterilisation incentive

• (b) Cash of ₹1400

• (c) Free drop back home after a 48-hour stay

• (d) Free formula milk

Q14. Pradhan Mantri Surakshit Matritva Abhiyan provides fixed-day antenatal care on

• (a) the 1st of every month

• (b) the 15th of every month

• (c) every Wednesday

• (d) the 9th of every month

Q15. Under PMSMA, a high-risk pregnant woman's MCP card is marked with a

• (a) red sticker

• (b) blue stamp

• (c) green sticker

• (d) yellow sticker

Q16. A maternal death includes death within how many days of the end of pregnancy?

• (a) 42 days

• (b) 7 days

• (c) 28 days

• (d) 1 year

Q17. Under MDSR, the primary informant for deaths of women aged 15–49 in a village is the

• (a) Gram pradhan

• (b) ASHA

• (c) Medical officer

• (d) ANM

Q18. The denominator of the maternal mortality ratio is

• (a) 1,00,000 women aged 15–49

• (b) 1,00,000 population

• (c) 1,00,000 live births

• (d) 1000 live births

Active Recall

From memory: give the four ANC visit windows and where each test is done; explain the partograph lines and the three steps of AMTSL; state the calcium schedule; give JSY amounts and eligibility, JSSK entitlements and the PMSMA arrangement; and define a maternal death, MMR and the MDSR reporting chain.