Surakshit Matritva Aashwasan (SUMAN)

Introduction

India has long struggled with high maternal and infant mortality rates, especially in rural and underserved areas. To tackle this critical issue, the Government of India launched the Surakshit Matritva Aashwasan (SUMAN) initiative under the Ministry of Health and Family Welfare. The scheme aims to provide assured, dignified, respectful, and quality healthcare at no cost to every woman and newborn.

Launched in October 2019, SUMAN is a rights-based approach to maternal and child healthcare, designed to provide dignified, respectful, and free healthcare services to all pregnant women, postnatal mothers, and newborns.

What is SUMAN?

SUMAN, short for Surakshit Matritva Aashwasan, is a government initiative launched on October 10, 2019. It seeks to reduce maternal and neonatal mortality by ensuring universal access to quality and respectful maternal healthcare services.

Key Idea: No woman should die while giving life.

Objectives of SUMAN

The main goals of SUMAN are:

• Eliminate preventable maternal and newborn deaths
• Ensure zero out-of-pocket expenses for pregnant women and sick newborns
• Provide dignified and respectful care at public health facilities
• Ensure timely access to quality health services
• Promote community engagement and accountability

Broader Alignment:

• National Health Policy, 2017
• Sustainable Development Goals (SDGs) – particularly SDG 3.1 and 3.2
• Ayushman Bharat

Key Components of SUMAN

SUMAN is more than a maternal care scheme—it is a system-wide reform in maternal and child healthcare services:

1. Service Guarantee Charter

• Pregnant women and sick newborns are entitled to 14 assured services, including:
  • 4 quality antenatal check-ups
  • Safe institutional delivery
  • Emergency obstetric care
  • Neonatal resuscitation
  • Postpartum contraception and counseling
  • Immunization

2. Respectful Maternity Care (RMC)

• Promotes privacy, informed consent, and emotional support during childbirth.
• Prevents verbal or physical abuse, discrimination, and neglect of women in labor.

3. Grievance Redress Mechanism

• Toll-free helpline (104/102/108)
• Complaint tracking system
• Monthly community dialogues via Jan Samvad

4. Infrastructure and Quality Assurance

• Linked with LaQshya program to improve labor room quality.
• Enhancements in SNCUs, blood banks, transport, and referral systems.
• Incorporates Kayakalp standards for cleanliness and hygiene.

Key Features of SUMAN

Feature	Details
Free Services	Antenatal check-ups, delivery (normal/C-section), postnatal care, sick newborn care
Zero Expense Guarantee	No charges for any maternal or neonatal health services in public facilities
Grievance Redressal	Toll-free helpline, grievance portal, and community-based platforms
Respectful Care	Emphasis on dignity, privacy, and consent during childbirth
Quality Benchmarking	Adherence to LaQshya standards (Labour Room Quality Improvement Initiative)
Community Monitoring	Use of tools like Maternal Death Surveillance and Response (MDSR)
Transport Facility	Free referral transport for pregnant women and newborns

Who is Eligible?

Category	Eligibility
Pregnant Women	All pregnant women accessing public health institutions
Newborns	All newborns up to 1 year of age
Postnatal Mothers	All mothers within 6 months of delivery
Health Facilities	All public health facilities across India

Services Offered under SUMAN

SUMAN promises the following entitlement-based healthcare services:

For Pregnant Women

• Four antenatal check-ups
• Iron-folic acid supplementation
• Tetanus-diphtheria immunization
• Ultrasound scans during pregnancy
• Institutional delivery with skilled birth attendants
• Safe abortion services (as per law)
• Postnatal check-ups at regular intervals

For Sick Newborns

• Free treatment and care for illnesses
• Access to Special Newborn Care Units (SNCUs)
• Free transport and diagnostics
• Follow-up care and vaccination support

Implementation Mechanism

SUMAN is implemented by the Ministry of Health and Family Welfare (MoHFW) in collaboration with:

• State Health Departments
• National Health Mission (NHM)
• Janani Suraksha Yojana (JSY)
• Pradhan Mantri Matru Vandana Yojana (PMMVY)

SUMAN is integrated with existing health schemes and uses infrastructure, manpower, and data systems like:

• Reproductive and Child Health (RCH) portal
• Mother and Child Tracking System (MCTS)
• LaQshya and Kayakalp programs for quality assurance

Target Beneficiaries

Category	Entitlement
Pregnant Women	Free & respectful maternity services
Postnatal Mothers	Free follow-up care up to 6 weeks
Newborns	Free care for sick infants up to 1 year
Community	Empowered to demand quality care and accountability

Impact of SUMAN So Far

Indicator	Before SUMAN	After SUMAN (As per NHM Reports)
Maternal Mortality Ratio (MMR)	122 (2015-17)	97 (2018-20)
Institutional Deliveries	78%	88%+
Sick Newborn Care Access	Fragmented	Improved access via SNCUs
Awareness and Grievance Redressal	Limited	Increasing through toll-free platforms

Note: While attribution to SUMAN alone is difficult, the program complements overall maternal healthcare efforts.

Challenges in SUMAN Implementation

Despite its ambitious design, SUMAN faces several challenges:

• Shortage of staff in rural health centres
• Inadequate infrastructure in primary and community health centres
• Poor data monitoring and reporting in some states
• Lack of awareness among rural women about their entitlements
• Cultural barriers and social taboos around childbirth in some regions
• Delayed fund disbursements affecting timely care delivery

Way Forward

To enhance the effectiveness of SUMAN:

• Strengthen last-mile delivery through frontline workers (ASHA, ANM)
• Boost community awareness campaigns on maternal health rights
• Ensure availability of skilled healthcare providers
• Regular audits and quality checks in labor rooms
• Introduce digital tracking of maternal services in remote areas

Conclusion

SUMAN reflects India’s commitment to universal health coverage and the right to dignified maternal care. It is a step toward achieving the Sustainable Development Goal (SDG) 3 — ensuring health and well-being for all, especially mothers and newborns.

Ensuring a woman’s safety during pregnancy isn’t just about saving a life—it’s about safeguarding generations to come.