The WHO has commended India's progress in reducing the maternal mortality ratio (MMR).
India's Progress :-
- India has reduced Maternal Mortality Ratio (MMR) by 77 per cent, from 556 per 1,00,000 live births in 1990 to 130 per 1,00,000 live births in 2016.
- Therefore, India is on track towards achieving the Sustainable Development Goal (SDG) target of an MMR below 70 by 2030.
- India has registered a significant decline in Maternal Mortality Ratio, recording a 22 per cent reduction in such deaths since 2013, according to a Sample Registration System bulletin released earlier this week.
What is Maternal Mortality Ratio ?
World Health Organisation (WHO) defines MMR as "the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes."
How is Maternal Mortality Ratio Counted ?
The Maternal Mortality Ratio can be calculated by dividing recorded (or estimated) number of maternal deaths by total recorded (or estimated) number of live births in the same period and multiplying by 100,000.
The data is collected from several sources, including vital registration, health service records, household surveys and census. The collected data can then be distinguished in age and parity, location (urban/rural, major regions/provinces), and socio-economic characteristics.
The first MMR report on maternal mortality in India (1997-2003), describing trends, causes and risk factors, was released in October 2006.
The present bulletin, which provides only the levels of maternal mortality for the period 2014-16, is being brought out as a sequel to the previous bulletin (2011-13).
Maternal Mortality Ratio in India :-
The bulletin was released under Sample Registration System (SRS). To understand the maternal mortality situation in the country better and to map the changes that have taken place, especially at the regional level, the government has categorised states into three groups - Empowered Action Group (EAG), southern states and "other" states.
- EAG states comprise Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Odisha, Rajasthan, Uttar Pradesh and Uttarakhand, and Assam have shown a decline in the number of deaths from 246 to 188.
- The southern states are Andhra Pradesh, Telangana, Karnataka, Kerala and Tamil Nadu and the "other" states categories cover the remaining states and Union territories.
- Overall, the best states include Kerala with 46 MMR, Maharashtra with 61 and Tamil Nadu 66, while the states which have performed worst are Assam with 237, UP/Uttrakhand with 201 and Rajasthan with 199.
What is Sample Registration System ?
Sample Registration System is the largest demographic survey in the country done by the Registrar General of India. The survey is mandated to provide annual estimates of fertility as well as mortality indicators at the state and national level.
Global MMR :-
The global MMR in the year 1990 was 385, while it improved drastically by dropping 44 per cent, with 216 in 2015. Most of the global MMR deaths are caused in Sub-Saharan Africa and South Asia.
WHO Regional Director for South-East Asia, Poonam Khetrapal Singh views on India :-
- The proportion of institutional deliveries in public facilities has almost tripled, from 18 per cent in 2005 to 52 per cent in 2016 (including private facilities, institutional deliveries now stand at 79 per cent).
- State-subsidised demand-side financing like the Janani Shishu Suraksha Karyakram (JSSK)—which allows all pregnant women delivering in public health institutions free transport and no-expense delivery, including cesarean section—has largely closed the urban-rural divide traditionally seen in institutional births.
- Women in India are more literate than ever, with 68 per cent now able to read and write. They are also entering marriage at an older age, with just 27 per cent now wedded before the age of 18. These factors alone have enabled Indian women to better control their reproductive lives and make decisions that reflect their own interests and wants.
- Indian government has put in substantive efforts to facilitate positive engagement between public and private health care providers. Campaigns such as the Pradhan Mantri Surakshit Matritva Abhiyan have been introduced with great impact, allowing women access to antenatal check-ups, obstetric gynaecologists and to track high-risk pregnancies, exactly what is needed to make further gains and achieve the SDG's targets.
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