New Delhi: The Union Ministry of Health and Family Welfare has questioned a decision by the Uttar Pradesh government to allow pregnant women access to ultrasonography (USG) at private diagnostic centres at higher rates than those prescribed by the Centre, ThePrint has learnt.
The UP government had been providing at least one free USG service to pregnant women in the state since FY 2017-18 in accordance with the Centre’s Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), which is aimed at providing antenatal care to all pregnant women at public hospitals as part of the Janani Shishu Suraksha Karyakram (JSSK).
The PMSMA, launched in 2016, requires states to provide USG to pregnant women at district hospitals or community health centres (CHCs), but also permits opting for public-private partnership (PPP) models.
The USG during antenatal care is a test that significantly uses sound waves to create the image of the foetus, placenta and uterus, and helps doctors in monitoring the baby’s and the mother’s health and well-being.
In cases where government hospitals lack manpower, facilities can explore the possibility of private providers coming to public health facilities for conducting USG, according to the operational guidelines for the scheme. The cost for the scheme is part of the National Health Mission’s free diagnostic initiative, shared by the Centre and states on a 60:40 basis.
In 2023, the UP government had decided to offer e-Rupee vouchers worth Rs 300 per USG to beneficiaries to avail the service in private diagnostic centres. Earlier this year, the rate was revised to Rs 425 per service, a move that has not gone down well with the health ministry.
Subsequently, in August this year, it sent a letter to the state, which sees the highest number of births in the country annually according to government statistics, asking it to provide USG services at public health institutions only, senior government officials told ThePrint.
“The ministry asked the state to ensure USG machines in about 820 CHCs and also recruit and train ultrasonographists to provide the required service to pregnant women,” a senior official said.
In its reply to the Centre this month, the UP government, however, has reiterated its stand to continue providing USG services to pregnant women through private centres at the revised rate, saying that the move has allowed greater penetration of the service in the state.
ThePrint has accessed a copy of the reply sent by Partha Sarthi Sen Sharma, principal secretary (health) to Union Health Secretary Punya Salila Srivastava.
The reply also underlined that the Centre’s insistence on procurement of USG machines for CHCs and training of personnel “negates the possible use of technology and private sector participation”.
“The availability of government ultrasonographists in all rural CHCs would be near impossible in the short run,” reads the reply by Sharma.
ThePrint reached out to Sharma for a comment on the matter via call and text message, but did not get a response. This report will be updated, if and when a response is received. An email to Srivastava also remains unanswered as of now.
Earlier this month, the UP government had announced that over 6 lakh pregnant women have benefitted from its free ultrasound service at private centres across the state since February 2023.
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USG critical in pregnancy
Experts say that USG during pregnancy is essential as it can help detect any abnormalities that can hurt the growth and development of the baby.
“The complications or issues may include the abnormal position of the baby, multiple pregnancies, low amniotic fluid in the body and problems with the placenta. These complications may consist of special care for the betterment of their health,” said Dr Manju Gupta, senior consultant-obstetrician & gynaecologist at Motherhood Hospitals in Noida.
Dr Sumana Banerjee, senior consultant and unit head-obstetrics & gynaecology at Aakash Healthcare in Delhi, highlighted that USG in early pregnancy to the second trimester helps in identifying abnormal foetuses.
In later stages of pregnancy, it helps in identifying intrauterine growth retardation and Doppler abnormalities (blood flow in abdominal area) in the foetuses, which aids in delivering the child safely according to the ultrasound parameters.
“In the absence of USG facilities in rural areas, it becomes difficult to detect abnormal foetuses, and such foetuses are born with lifelong morbidity or chances of mortality. Therefore, the lack of USG in the first two trimesters in rural areas increases the financial and mental strain on parents of such abnormal children,” Banerjee said.
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