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Aim : The Aim of this study were to assess Knowledge and Practice regarding regarding implementation of Mother Child Tracking System (MCTS) among the ANMs working at rural areas in the State of Maharashtra. Research Methodology The Community based Quantitative Descriptive cross-sectional survey research study conducted in selected rural areas in the State of Maharashtra . A total 150 ANMs working in PHCs and SCs selected by Simple Random Sampling. Data were collected by using Split Half method for structure questioner & Rater Inter-Rater method for observational check list .which have 28 structure questions and 66 statement of observational check list. Data were analyzed by descriptive and inferential statistics MAJOR FINDINGS OF THE STUDY The assessment of overall knowledge level about implementation of Mother Child Tracking System (MCTS) among ANMs depicted that majority 112 (74.7%) ANMs had excellent knowledge and 31 (20.7%) ANMs had good knowledge. Remaining 7 (4.7%) ANMs had average knowledge. None of the ANMs were in Poor knowledge range. This shows that most of ANMs had adequate knowledge regarding implementation of Mother Child Tracking System (MCTS) Practice level about implementation of Mother Child Tracking System (MCTS) among ANMs depicted that All of ANMs 150 (100%) were practicing 167 excellently regarding implementation of Mother Child Tracking System (MCTS). None of ANMs were practicing well, averagely or poorly. The finding indicated that, mean Knowledge score 3.10 (77.5%) was seen regarding MCTS Software-Child Health Services. Followed by which 1.54 (77%) regarding Data Collection - Monthly recording. Mean Knowledge score 3 (75%) was found regarding MCTS SoftwareMaternal Health Services, 4.24 (70.7%)(75%) was found regarding MCTS Software- Maternal Health Services, 4.24 (70.7% )found regarding Concept of MCTS, 1.99 (66.4%) regarding Data Collection -Monthly reporting, 3.89 (64.8%) found regarding MCTS work plan and 1.88 (62.3%) was seen regarding MCTS Software the Pearson's table (r) table value was 0.159 at 0.05 level of significance with no of pairs being 150. The calculated 'r' value was 0.021, which was less than the (r) table value 0.159. The P value 0.803 (p>0.803) which was more than 0.05 level of significance indicated that, there was no correlation between Knowledge and Practices regarding MCTS among ANM in selected rural area of Maharashtra. CONCLUSION This study concluded that Descriptive Cross Sectional survey design was used to assess the Knowledge and Practices regarding implementation of Mother Child Tracking System (MCTS) among the ANMs due to the Importance of health informatics in health care delivery system and also a part of nursing practice. The regular used of MCTS software and availability of digital technology , separate facility for data entry e.g. Room with computer system improve practices related to MCTS and MCH the With the help of descriptive cross sectional design researcher can explore more information regarding Mother Child Tracking System (MCTS) and Maternal and Child Health provided by ANMs INTRODUCTION A moment of unimaginable joy is what a mother feels when a newborn is placed on her arms- a joy every mother should have the right to experience. But for many pregnant women in India this memory will never come to be, the moment of birth is often frightening. The major complications that account for nearly two-thirds of all maternal deaths are severe bleeding (mostly bleeding after childbirth), infections (usually after childbirth), high blood pressure during pregnancy (pre-eclampsia and eclampsia), complications from delivery and unsafe abortions.1 The Government of India has been focusing on initiatives to improve maternal health indicators Much progress has been made in ending preventable maternal deaths in the past two decades: Globally the number of women and girls who die each year due to issues related to pregnancy and childbirth has dropped considerably, from 451,000 in 2000 to 295,000 in 2017, a 38 per cent decrease in 1985 WHO reported that 63-80% of maternal deaths due to direct obstetric causes and 88-98% of all maternal deaths could probably have been prevented with proper handling. to research reproductive behavior; and to assure every woman the right to safe motherhood the initiatives taken under the RCH program will be continued during the tenth Plan. Every effort will be made to ensure that the skill up gradation training which is critical for improving the content and quality of antenatal care is taken up and completed so that all the healthcare providers at primary secondary and tertiary care follow the protocol for screening all pregnant women for identification of those with problems. 2 ANM is the critical person in the screening of pregnant women; she will be given necessary skill upgradation training needed equipment and antenatal cards records to her findings. In order to ensure that the findings at antenatal screening are recorded accurately and reference back and forth becomes a standard practice it is essential to ensure that findings are recorded in a standard format in an antenatal card which is retained by the woman who takes it with her where ever gets referred to. During the Ninth Plan an antenatal card was designed and tested in some states. It is essential that these cards with suitable modification are printed and made available to all states for use. In India, coordination between levels in the health care delivery system and fragmentation of care account for the poor quality of maternal health care. Mass illiteracy is another cause. Effective strategies for reducing the MMR are to place a high priority on maternal and child health (MCH) services and integrate vertical programs (e g family planning) related to MCH. Mother & Child Tracking System (MCTS) is web based reporting software for name based tracking of health services to pregnant mothers and children and their follow up through health providers. It is being implemented by Ministry of Health & Family Welfare (MOHFW), New Delhi. As per the guidelines by Government of India, it has been rolled out in the state since January 2011. It has been declared as Mission Mode Project (MMP) by Central Govt. under National e-Governance Plan (NeGP). It has been declared as Mission Mode Project (MMP) by Central Govt. under National e-Governance Plan (NeGP). To strengthen effective monitoring of mortality indicators IMR and MMR through tracking of health Services to pregnant women & children is the main objective of project. Tracking & monitoring of health services delivered to severe anemic & high risk mothers as well as low birth weight babies, monitoring of health services of beneficiaries in view of fully protected mothers and fully protected child, generation of monthly action plans in the form of work plans at health facility and health worker level as per the beneficiaries allotted are the other objectives of this project. Pregnant woman registration & live birth registration is done by all Government health institutes under rural & urban area. All sub Centre's, primary health Centre's, rural /sub district hospitals, General hospitals, Woman Hospitals, District Hospitals, Government Medical College Hospitals as well as urban health posts, Maternity homes & hospitals under municipal corporation etc. Institutes are implementing MCTS in respective areas After registration of beneficiary (Pregnant Woman or Child) in MCTS 18 digit unique ID is generated by computer system and it will be sent to mobile number registered for that beneficiary in the form of information SMS. Any Government Health facility in the state can retrieve the records of beneficiary by using such MCTS ID in the system for updating of health services. With the use of MCTS Software, facility is provided to update the information of beneficiary anywhere in the nation having access to the MCTS. Due services of pregnant woman and children for current as well as for next month are generated in the form of Work plans for health facility and health workers. Services in the field are being provided as per the work plan and services are recorded in the software to update the information of beneficiary. MCTS is a centralized web based application developed in co-ordination with NIC. MCTS was started on Dec-2009 and since then has come long way MCTS application is introduced for improving delivery of health care services to pregnant women and children up to five years of age through name based tracking of each beneficiary and monitoring service delivery. In July 2011 MCTS has been declared as the Mission Mode Project under NeGP (National e-Governance Plan) ANM will work closely with the Anganwadi worker and will conduct maternal and child health clinics in Anganwadi on specified days in each village according to the advance tour Program. She will be the gatekeeper whose referrals will be at PHC/ CHC. In states where there are major gaps in ANMs there is need to strengthen the existing ANM schools so that lack trained ANMs does not come in the way of improving coverage. In order to cater to the increasing private sector involvement in deliveries some of the states have proposed investing in training of community midwives.