Drop of Maternal Deaths in India

Office of Registrar General of India (ORGI) estimates reveal fewer women are dying from pregnancy-related causes, but 212 still die per one hundred thousand of live births and much more needs to be done to achieve the set target of National Rural Health Mission which is 100 such deaths per one hundred thousand of live births by the year 2012.
The number of women dying due to complications during pregnancy and childbirth has decreased by 47% from an estimated 398 per one hundred thousand of live child births in 1997-98 to 212 in 2007-09 in case of All India, according to a new Sample Registration Report, 2007-09 released by the ORGI.
The progress is notable, but the annual rate of decline is over three per cent less than what is needed to achieve the target of National Rural Health Mission (NRHM) i.e. by reducing the maternal mortality ratio by 75% between 1997-98 and 2012. This requires an annual decline of 8.8%. The 47% decline since 1997-98 translates into an average annual decline of just over 5.6%.
The data that covers the period from 1997-98 to 2007-09 also highlights the following.
• Only one out of 15 states was having MMR of less than 100 per one hundred thousand live births and that was Gujarat, but now it has deteriorated and MMR is 148 in 2007-09. The other State which deteriorated in this respect over the period is Haryana.
• Only the states of Kerala (81) and Tamil Nadu (97) have MMR of less than 100 in 2007-09.
• The States of Andhra Pradesh, Gujarat, Haryana, Karnataka, Maharastra, Punjab, and West Bengal may also achieve the NRHM target of 100 in respect of MMR.
• The other remaining States are EAG States. The decline in MMR observed over the period for these States are Bihar (6.3%), Madhya Pradesh (4.4%), Uttar Pradesh ( 4.6%), Assam (3.4%) and Orissa (2.6%). As GOI is putting lot many efforts in these States, these States may also come to the level at least in the year 2015 (the terminal year for assessing Millennium Development Goal).

The reduction in maternal death rates in India is encouraging news. States where women are facing a high risk of death during pregnancy or childbirth are taking measures that are proving effective; they are training more midwives, and strengthening hospitals and health centers to assist pregnant women. No woman should die due to inadequate access to family planning and to pregnancy and delivery care that is one of the objectives of NRHM. In order to achieve our goal of improving maternal health and to save women's lives we need to do more to reach those who are most at risk. That means reaching women in rural areas and poorer households, women from ethnic minorities and indigenous groups, and women living with HIV and in conflict zones.
Every birth should be safe and every pregnancy wanted. The lack of maternal health care violates women's rights to life, health, equality, and non-discrimination, but we urgently need to address the shortage of health workers and step up funding for reproductive health services wherever needed most.
Pregnant women still die from four major causes: severe bleeding after childbirth, infections, hypertensive disorders, and unsafe abortion. Maternal deaths are both caused by poverty mainly in India. Given the weak state of health systems in many states, we must work closely with state governments and other partners to strengthen these health systems so that women gain significantly better access to quality family planning and other reproductive health services, skilled health workers at their births, emergency obstetric care, and postnatal care for mothers and newborns. Under NRHM, GOI has increasingly coordinated their assistance to states. Even donor partners namely, WHO, UNICEF, UNFPA and the World Bank are focusing on the states with the greatest burden and help the governments to develop and align their national health plans in order to accelerate progress in maternal and newborn health.
We still need to do more to strengthen national data collection systems. It is vital to support the development of complete and accurate civil registration systems that include births, deaths and causes of death. Every maternal death needs to be counted. Many a times it is the data which may not truly reflect the ground realities.