NEW DELHI: The number of women dying from pregnancy-related issues in India has declined from 130 per lakh live births in 2014-16 to 97 per lakh in 2018-20, a special health ministry bulletin released on Tuesday has confirmed. The finding is based on a sample survey of maternal mortality recorded between 2018 and 2020 across the country.
According to the bulletin, Assam had the highest maternal mortality ratio (MMR) - maternal deaths per lakh live births - in 2018-20. The northeastern state recorded an MMR of 195 in 2018-20. Madhya Pradesh was second with an MMR of 173, followed by UP (167). Kerala witnessed the lowest MMR (19), followed by Maharashtra (33) and Telangana (43).
The death of a woman while she is pregnant or within 42 days of termination of pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes, is taken into account while recording maternal mortality as per the guidelines of the World Health Organisation (WHO).
MMR has been on the decline in India for nearly a decade, public health experts have pointed out. "Improvement in healthcare infrastructure, availability of specialised manpower and the increased institutional delivery has played a significant role in it," said an expert.
Union health minister Mansukh Mandaviya tweeted, "...The various healthcare initiatives of PM @NarendraModi Ji's Govt to ensure quality maternal & reproductive care have helped tremendously in bringing down MMR."
Some of the recent interventions made by the government to reduce MMR in India include the
Pradhan Mantri Matru Vandana Yojana
(PMMVY) that came into effect in 2017. It is a direct benefit transfer (DBT) scheme under which cash benefits are provided to pregnant women in their bank accounts to meet enhanced nutritional needs and partially compensate for wage loss. The government also launched the
Labour Room Quality Improvement Initiative
(LaQshya) in 2017 to improve the quality of care in labour room and maternity operation theatres to ensure that pregnant women receive respectful and quality care during delivery and immediate postpartum period. The government is implementing POSHAN Abhiyaan from 2018 with a goal to achieve improvement in nutritional status of children, adolescent girls, pregnant women and lactating mothers.
India is a signatory to the United Nations sustainable development goals (SDGs), which adopted a global MMR target of fewer than 70 deaths per 1,00,000 live births by 2030. Public health specialists say if the declining trend in MMR continues, the country may well be able to achieve the target. "Additional focus is needed to reduce MMR in states like Assam, MP and UP among others," doctors say.
A research published recently in BJOG, an international journal of obstetrics and gynaecology, analysed trends in the MMR in India from 1997 through 2020. The researchers found that the leading causes of maternal death were obstetric haemorrhage (47%; higher in poorer states), pregnancy-related infection (12%) and hypertensive disorders of pregnancy (7%). "India could achieve the UN 2030 MMR goals if the average rate of reduction is maintained. However, without further intervention, the poorer states will not," the study says.