Indore (Madhya Pradesh): In a surprising reversal of expectations, Indore the city known for its premier healthcare infrastructure has recorded the lowest performance in crucial antenatal care (ANC) services under the state’s Maternal Health Programme for the April–June 2025 quarter.
According to official data, only 45% of pregnant women in Indore completed all four mandatory ANC checkups, the lowest among the eight districts in the Indore division. In stark contrast, tribal district Alirajpur not only topped in four ANC check-ups (73%), but also achieved the highest ANC registration rate at 90%—far ahead of the urban hub of Indore, which managed just 48% registration.
This revelation has shocked health authorities and exposed glaring gaps in the maternal care system of Madhya Pradesh’s most urbanised city. Of the 23,133 expected ANC registrations in Indore, only 11,063 were completed, despite the city having the highest annual and proportional targets.
Tribal districts outperform urban Indore
While Indore faltered, tribal and remote districts demonstrated remarkable performance:
Alirajpur: 90% registration | 73% four ANC checkups
Jhabua: 82% registration | 59% four ANC checkups
Barwani: 75% registration | 52% four ANC checkups
Dhar: 56% registration | 57% four ANC checkups
Even districts like Khandwa (60%), Khargone (48%), and Burhanpur (40%) either matched or slightly trailed Indore, despite having fewer resources and more challenging geographies.
A wake-up call amidst alarming MMR
This underperformance in ANC coverage comes at a time when Madhya Pradesh ranks worst in the country for maternal mortality, with 159 maternal deaths per 100,000 live births, according to the SRS Bulletin 2022. The national average stands at 88, with Kerala having the lowest at just 19.
Health experts have long stressed that antenatal checkups are critical for detecting complications like anaemia, high blood pressure, infections, and foetal abnormalities. The World Health Organisation recommends a minimum of four ANC visits to reduce maternal and infant deaths.
A case that raised alarms
A recent case in Indore underscored the risks of inadequate ANC. On July 22, a 22-year-old mother from Dewas delivered rare parapagusdicephalus conjoined twins (two heads, one torso) at MTH Hospital. Despite attending four ANC checkups at a government PHC, the anomaly went undetected until labour, raising concerns about quality and accuracy of ANC diagnostics, especially in rural settings.
Action initiated: CMHOs under scanner
In response to the findings, divisional commissioner Deepak Singh issued show-cause notices to the chief medical and health officers (CMHOs) of all eight districts, including Indore. They have been directed to explain the failure to meet ANC targets and submit immediate corrective action plans.
Dr Madhav Hasani, CMHO Indore, admitted the city is falling short in ANC outreach. “We are identifying gaps, particularly in urban slums and peri-urban areas, where awareness and early registration are low. Corrective steps are now underway,” he said.
