Maternal Mortality Rate in India is on decline, but still more to be done

WHO defines maternal mortality as the death of a woman during pregnancy or in the first 42 days after the birth of the child due to causes directly or indirectly linked with pregnancy. 

The Maternal Mortality Ratio (MMR) of a population is the number of maternal deaths per one hundred thousand number of children born. 

Global believe is that India continues to contribute about a quarter of all global maternal deaths. As per ORGI’s Sample Registration System’s Statistical Reports, the MMR estimates have dropped from 301 maternal deaths per 100,000 live births during 2001-03 to 254 maternal deaths during 2004-06 and further to 212 maternal deaths per 100,000 live births during 2007-09. In the year 2005 National Rural Health Mission was launched.  Reduction of MMR was one of its main objectives.  Although there was about 42 points fall in All-India MMR and the maximum fall was observed in case of EAG States and more so for Assam (90 points), wide disparities still exist across states in India. The MMR ranges from 81 in Kerala to 390 in Assam. The states which are having MMR above the All-India average are EAG states and Assam.  The states which are having MMR still above 300 are Assam (390), Uttar Pradesh/Uttarakhand (359) and Rajasthan (318).  Other EAG states are having MMR more than 250.  The combined MMR for four major Southern states is 127 and the combined MMR for other states including Gujarat (148), Haryana (153), Maharashtra (104), Punjab (172) and West Bengal (145) is 149.  Out of southern states, Karnataka had the highest MMR of 178. 

The Government has already addressing the issue through various State Governments by having All-India programme of Janani Suraksha Yojana (JSY).  It is one of the most important programmes under the overall umbrella of National Rural Health Mission by the Government of India and is aimed at reducing Maternal Mortality Ratio (MMR) and Neo-natal Mortality Rate by promoting institutional deliveries. Under the Scheme, cash incentives are provided to mothers and they are facilitated by Accredited Social Health Activists (ASHAs)/ Sahyogini to deliver their babies in a health facility. There are also provisions for cost reimbursement for transport and incentives to ASHAs/ Sahyogini for encouraging mothers to opt for institutional delivery. The scheme is fully sponsored by the Central Government and is implemented in all States and Union Territories, with special focus on low-performing States like EAG states where the Infant Mortality Rate (IMR) and MMR are the highest in the country. Thus, seeing above much more focus need to be given to the above mentioned EAG States and Assam. It has been observed through Annual Health Survey conducted in 2010-11 that institutional deliveries and safe deliveries at home are increasing in these states.  ANC visits are also increasing.  But still much more needs to be done.  It is only by convincing the eligible women by demonstrating the benefits of having all the recommended three ANCs for all the pregnant women and also of institutional/safe home deliveries and then getting them to resort to such delivery means, the control on MMR for India can not be achieved. For mothers who are being observed for some kind of malnutrition or other complications during their ANCs’ visits, institutional safe deliveries need to be pressed upon more rigorously. For the mothers and/or children who have some kind of illness or complications at the time of delivery, they need to be taken care more and should be kept in the hospital/health institution for more number of days just after the delivery than the normal period of the stay post delivery.

It has been seen globally that MMR has a direct impact on infant mortality. Babies whose mothers die during the first 6 weeks of their lives are far more likely to die in the first two years of life than babies whose mothers survive.