Questions Raised Over Democracy as Core Welfare Concerns Are Allegedly Overlooked: Pawan Khera

At the centre of the criticism is the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), a national programme aimed at ensuring quality healthcare services for pregnant women. While the initiative is designed to reduce maternal and neonatal mortality through regular check-ups and specialist care, the situation on the ground appears starkly different from the programme’s stated objectives.

Anganwadi workers, who form the backbone of community-level maternal care, are reportedly facing an ever-expanding workload. The accumulation of additional responsibilities has taken a visible toll, leaving many workers mentally and physically strained. Their role is critical in identifying beneficiaries and ensuring continuity of care, yet support systems remain limited.

Accredited Social Health Activists (ASHAs), another key pillar of the scheme, are required to remain closely engaged with expectant mothers throughout the entire nine-month period of pregnancy. Despite this sustained commitment, their remuneration remains low, creating financial insecurity and anxiety over meeting basic household needs, including the education and welfare of their own children.

The challenges intensify when ASHA workers accompany pregnant women to hospitals for delivery or medical consultations. In several healthcare facilities, they reportedly lack even basic amenities. The absence of proper waiting areas and clean sanitation facilities not only undermines dignity at the workplace but also affects their ability to continue supporting patients during long hospital stays.

Compounding these issues is a significant shortage of gynaecologists in district hospitals across multiple regions. The lack of specialist doctors means that timely and appropriate maternal care is often unavailable, forcing women to travel long distances or forgo essential treatment altogether. This gap in medical staffing directly impacts the effectiveness of maternal health interventions envisioned under PMSMA.

Taken together, these shortcomings have cast serious doubt on the real-world impact of the Prime Minister’s Safe Motherhood initiative. As opposition leaders like Khera link these systemic failures to broader governance concerns, the situation underscores an urgent need for structural reforms, better resource allocation, and renewed focus on frontline healthcare workers whose efforts remain vital to safeguarding maternal health nationwide.