Surakshit Matritva Aashwasan (SUMAN) Program

Introduction

The Surakshit Matritva Aashwasan (SUMAN) initiative was launched by the Ministry of Health and Family Welfare (MoHFW), Government of India, in October 2019. It acts as a comprehensive umbrella program aimed at achieving zero preventable maternal and newborn deaths. The initiative integrates several existing maternal and child health programs to provide assured, dignified, and quality healthcare at no cost to the beneficiaries.

Core Vision And Objectives

• To end all preventable maternal and newborn deaths and morbidities.
• To provide a positive birth experience through Respectful Maternity Care (RMC).
• To ensure zero tolerance for denial of services at public health facilities.
• To guarantee 100% free and cashless services for the target demographic.
• To establish a highly responsive grievance redressal mechanism.

Target Beneficiaries

• All pregnant women.
• All mothers up to 6 months post-delivery.
• All sick newborns and infants.

Key Service Entitlements And Guarantees

Zero Expense Services

• Absolute elimination of out-of-pocket expenditure.
• Free essential diagnostics, investigations, and blood transfusion services.
• Free provision of essential drugs and medical consumables.
• Free diet provided to the mother during the facility stay.

Assured And Timely Transport

• Guaranteed free ambulance services (via toll-free numbers like 102/108).
• Covers transport from home to the health facility, inter-facility transfers for complications, and drop-back home after discharge.
• Assurance of ambulance arrival within 1 hour of the distress call in most geographies.

Respectful Maternity Care (RMC)

• Ensuring privacy and confidentiality during labor and delivery.
• Permitting a birth companion of the mother's choice during the active phase of labor.
• Strict zero-tolerance policy towards verbal, physical, or emotional abuse of the mother.
• Providing culturally appropriate care and respecting the mother's autonomy.

Zero Denial Of Services

• Mandatory provision of immediate care for all maternal and neonatal complications.
• If a facility is unequipped to handle a specific complication, it is the facility's responsibility to stabilize and seamlessly transfer the patient to a higher center; refusal of admission is strictly prohibited.

Pediatric And Neonatal Focus Areas

For the pediatric practitioner, SUMAN reinforces and guarantees access to critical neonatal interventions:

• Essential Newborn Care (ENC): Immediate drying, tactile stimulation, and maintenance of the warm chain.
• Neonatal Resuscitation: Assured availability of trained personnel (NSSK certified) and functional newborn care corners (NBCC) at all delivery points.
• Nutrition And KMC: Uninterrupted support for early initiation of exclusive breastfeeding within one hour and implementation of Kangaroo Mother Care for premature and low birth weight infants.
• Sick Newborn Care: Guaranteed free treatment of neonatal sepsis, birth asphyxia, and prematurity complications at Special Newborn Care Units (SNCUs) and First Referral Units (FRUs).
• Immunization: Assured administration of zero-dose vaccines (BCG, OPV, Hepatitis B) prior to discharge.

Integration With Existing Health Schemes

SUMAN consolidates the benefits and operational frameworks of multiple prior initiatives to prevent duplication and ensure seamless service delivery:

• Janani Shishu Suraksha Karyakram (JSSK): Forms the backbone of the "zero out-of-pocket expenditure" mandate.
• Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA): Integrates the mandatory antenatal check-ups on the 9th of every month by a medical officer/specialist.
• LaQshya: Incorporates the Labor Room Quality Improvement Initiative to standardize infrastructure and protocols in maternity operation theatres and labor rooms.
• Janani Suraksha Yojana (JSY): Integrates the conditional cash transfer mechanism for institutional deliveries.

Implementation And Monitoring Framework

• SUMAN Compliant Facilities: Public health facilities are assessed against stringent maternal and newborn health indicators; those meeting the criteria are officially notified as "SUMAN facilities."
• Maternal and Perinatal Death Surveillance and Response (MPDSR): Mandatory institutional reporting and auditing of every maternal and perinatal death to identify systemic bottlenecks.
• Grievance Redressal: Establishment of a centralized mega call center and facility-level helpdesks. Grievances must be addressed with a specified turnaround time to ensure accountability.