Status of Maternal mortality in India

Context: Recently, a Sample Registration System (SRS) special bulletin on maternal mortality in India (2017-19), was released.

Key Highlights of the bulletin

• Maternal Mortality Ratio of India has reduced from 130 in SRS 2014-16 to 103 in SRS 2017-19.
• Kerala recorded the lowest Maternal Mortality Ratio (MMR).
• Assam, Madhya Pradesh along with Uttar Pradesh have the highest 14.7% maternal mortality rate.
• Uttar Pradesh, Bihar and Rajasthan have seen the biggest drop in maternal mortality 
• MMR is not homogeneous across states as it varied between 117-209 in different places in Madhya Pradesh at 95%.

What is maternal death?

• Maternal death is a death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy.
• The cause of death may be related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.

Cause of maternal death

• Direct obstetric deaths- are causes of death due to complications of pregnancy, birth or termination.
• Indirect obstetric deaths- are caused by pregnancy interfering or worsening an existing condition, like a heart problem.
• Inequalities in access to quality health services and the gap between rich and poor.

What is maternal mortality ratio?

• Maternal Mortality Ratio (MMR) is defined as the number of maternal deaths during a given time per 100,000 live births during the same time.

Steps taken by the government to reduce MMR
Reproductive, Maternal, New-born, Child and Adolescent Health (RMNCH+A) (2013)

• Aim: to address the major causes of mortality and morbidity among women and children.

SUMAlV- Surakshit Matritva Aashwasan

• Aim: to provide assured, dignified, respectful and Quality healthcare at no cost and zero tolerance for denial of services for every woman and newborn visiting the public health facility

Rashtriya Poshan Abhiyaan (2018)

• Aim: improve nutritional outcomes for children, pregnant women and lactating mothers.

Janani Shishu Suraksha Karyakaram (JSSK)

• Aim: entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery including Caesarean section.

Accredited Social Health Activists (ASHAs)

• Aim: to generate demand and facilitate accessing of health care services by the community.

Key Suggestions

• Addressing inequalities in access to and quality of reproductive, maternal, and new born health care services;
• Ensuring universal health coverage for comprehensive reproductive, maternal, and new born health care;
• Addressing all causes of maternal mortality, reproductive and maternal morbidities, and related disabilities;
• Strengthening health systems to collect high quality data in order to respond to the needs and priorities of women and girls; and
• Ensuring accountability in order to improve quality of care and equity.