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Maternal mortality ratio in decline

Child and maternal health concept.
Image credit: Pippa Ranger/Department for International Development [Licensed under CC BY 2.0]
The maternal mortality ratio has declined in India in recent years according to recently unveiled Sample Registration System (SRS) data, boding good news for the nation’s mothers. 

According to the figures, since 2013 maternal mortality has declined from 77 deaths per every lakh live births to seventy deaths for every lakh live births in southern states. In other states, the maternal mortality ratio declined from 93 deaths for every 100,000 live births to ninety. Between the 2014-16 and 2015-17 periods, the maternal mortality ratio in the country as a whole declined from 130 deaths for every 100,000 live births to 122 – a change the SRS described as “heartening.” The decline equates to 2,000 fewer maternal deaths each year. 

This decline translates to maternal deaths declining by 6.15 percent between the 2014-16 and 2015-17 periods alone. Since 2013, the decline was even greater at 26.9, falling from 167 to 122 currently. Maternal mortality has more than halved since the 2004-06 period – the first bulletin on the subject to be released by the SRS – when the number of deaths for every lakh live births stood at 254. 

Nonetheless, maternal mortality remains a challenge and the burden of deaths is far from evenly distributed across the states with Assam recording a ratio of 229 versus a ratio of 42 in Kerala. Other states such as Uttar Pradesh, Madhya Pradesh, Rajasthan, Odisha, Bihar, and Chhattisgarh also recorded maternal mortality ratios above the national average, at 216, 188, 186, 168, 165, and 141 respectively. 

These states (sans Assam) belong to the Empowered Action Group (EAG) of Indian states, where socioeconomic indicators including health are worse compared to other parts of the country. However, the SRS report expresses positivity that “the decline has been most significant in [EAG] states.” Uttarakhand, which also belongs to the EAG, effected a significant improvement in maternal mortality as it brought its maternal mortality ratio down to 89 deaths for every one lakh births – ranking eighth best in the country. 

Uttarakhand’s maternal mortality ratio of 86 is encouraging. It has met a National Health Policy target of reducing maternal mortality ratio to fewer than 100,000, together with Andhra Pradesh, Gujarat, Haryana, Jharkhand, Karnataka, Kerala, Maharashtra, Tamil Nadu, Telangana, and West Bengal. “Maternal mortality and child deaths are considered key health indicators for any country and state as they reflect the condition of healthcare in the respective area,” said Uttarakhand director-general of health Dr Amita Upreti. “Our target is to reduce MMR further by 2020.” 

Sustainable Development Goal targets state that a country’s maternal mortality ratio should be fewer than seventy deaths for every 100,000 live births. In multiple states, this target has been met: Kerala (42), Maharashtra (55), and Tamil Nadu (63). Others, including Andhra Pradesh and Telangana (both 76), are “within striking distance” of realising the seventy target according to a Union Health Ministry official. 

Worldwide, 290,000 women died during pregnancy and childbirth in 2017. India’s progress is encouraging news, but there is still much more to do at the national level. The latest figures show that improvement is possible. To do so requires sustained momentum and targeted interventions to reduce the number of India’s mothers who lose their lives in pregnancy and childbirth. 

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