Maternal health in rural India faces numerous challenges, including limited access to quality healthcare services, especially diagnostic tools like ultrasounds. Pregnant women in remote areas often struggle to receive proper monitoring, leading to undiagnosed complications and increased risks for both mother and child. Recognising these issues, the district collector of Ganjam, IAS Dibya Jyoti Parida (2016 batch, Odisha Cadre), initiated the ‘Nirikhyana’ scheme in 2022 with a transformative solution of providing free ultrasounds for pregnant women across the Ganjam district of Odisha.
The Nirikhyana Scheme addresses the critical gap in maternal healthcare by ensuring that every pregnant woman has access to multiple ultrasounds throughout her pregnancy. The scheme provides two to three ultrasounds per woman during her pregnancy, ensuring that complications are detected early, leading to timely medical intervention and significantly reducing the risks of maternal and infant mortality.
Before the implementation of the Nirikhyana Scheme, there were only two government ultrasound centres in the district, and private centres were often out of reach for economically disadvantaged families. “While the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) provided a free ultrasound for pregnant women each month, it was insufficient to ensure consistent monitoring throughout pregnancy,” Mr. Parida shared with Indian Masterminds.
KEY COMPONENTS OF THE SCHEME
The Nirikhyana Scheme has brought several key improvements to maternal health services in Ganjam, especially through the following initiatives:
Expansion of Ultrasound Facilities
Since the scheme’s launch, the number of ultrasound centres has grown to 19 government centres and 23 private centers. This expansion, funded by the District Mineral Fund (DMF) and Corporate Social Responsibility (CSR), has made ultrasound services more widely available in rural areas, significantly improving access to vital diagnostic tools.
Public-Private Partnership (PPP) Model
The Nirikhyana Scheme leverages a public-private (PPP) model to integrate private ultrasound centres into the public health system. “Private centres are reimbursed ₹300 per ultrasound performed through funds provided by the National Health Mission (NHM) under the Diagnostic Fund. This model has allowed private ultrasound centres to contribute to the public healthcare effort by providing free ultrasounds, ensuring that more women benefit from the scheme,” IAS Dheenah Dastageer (2021 batch, Odisha Cadre), Sub Collector and Sub Divisional Magistrate of Berhampur, Ganjam, shared with Indian Masterminds.
Nirikhyana Mobile App: Streamlining Services
One of the most innovative aspects of the Nirikhyana Scheme is its use of technology. The Nirikhyana mobile app has been designed to simplify the process of managing ultrasound services for pregnant women, health workers, and doctors. The app offers several features:
- For pregnant women: The app helps women locate nearby ultrasound centres and schedule appointments, making it easier for them to access services.
- For health workers: The app enables health workers to track ultrasound appointments for women under their care, ensuring that no one misses out on this critical service.
- For Doctors: Medical professionals can use the app to monitor ultrasound results and keep track of any high-risk pregnancies that require urgent attention.
In addition, the app sends real-time notifications about high-risk pregnancies, prompting healthcare providers to take action quickly. “The app’s dashboard also tracks the status of registered pregnancies, helping administrators monitor the scheme’s progress and ensure it reaches all women in need,” Ms. Dastageer added.
IMPACT ON MATERNAL AND INFANT HEALTH
The Nirikhyana Scheme has made a significant impact on maternal and infant health outcomes in Ganjam. By providing consistent and timely ultrasounds, the scheme has played a crucial role in detecting high-risk pregnancies early, enabling timely medical intervention. This has led to a reduction in both the maternal mortality rate (MMR) and infant mortality rate (IMR) in the region.
Ms. Dastageer stated, “Our aim is to make sure that every woman in Ganjam district receives regular monitoring during her pregnancy. There is a common misconception that ultrasounds are only accessible to wealthy individuals, but they are, in fact, a gold standard for women’s healthcare. We have made dedicated efforts to dispel this myth.”
OVERCOMING CHALLENGES AND SCALING THE SCHEME
The implementation of Nirikhyana was not without its challenges. Initially, private ultrasound centres were hesitant to join the scheme, primarily due to concerns about financial compensation. However, the introduction of the PPP model, which reimburses private centres ₹300 per ultrasound, addressed these concerns and ensured the active participation of private providers.
Another challenge was the management of large volumes of data. “Given the high number of pregnant women being monitored, ensuring accurate tracking and recording of ultrasound results posed a significant task,” Mr. Parida informed. The Nirikhyana mobile app, which centralises all data, has played a crucial role in overcoming this challenge.
Ms. Dastageer further added that the app’s user-friendly design, which caters to the technological needs of rural communities, was developed with feedback from users, ensuring that it was intuitive and accessible to all.
EXPANDING NIRIKHYANA’S REACH
The success of Nirikhyana in Ganjam has paved the way for its expansion. Plans are underway to extend the scheme to other districts in Odisha and beyond, aiming to bring ultrasound services to even the most remote areas. Future iterations of the scheme may also include expanding the range of diagnostic tests available, further improving the overall maternal health monitoring system.
While concluding, Mr. Parida said, “The initiative is about more than just providing ultrasounds; it’s about bringing maternal health to the forefront. The focus is on preventing maternal and infant mortality, and we believe this scheme is a crucial step in the right direction.”
The Nirikhyana Scheme stands as a model for how innovative governance, strategic partnerships, and technology can come together to address critical gaps in healthcare. Its efforts in providing free ultrasounds are improving maternal and child health in rural Odisha, and its expansion holds the potential to transform maternal healthcare across India.
