India improves maternal mortality ratio, but poorer states yet to make progress

This is a considerable improvement from the 130 deaths per lakh in 2014-2016

By Taran Deol
Published: Wednesday 30 November 2022
Kerala, at 0.9, is the only state to achieve a maternal mortality rate of less than one. Photo: iStock.

India has improved its maternal mortality ratio (MMR) — number of deaths per 100,000 live births — to 97 deaths per lakh in 2018-2020 from 103 deaths per lakh in 2017-2019. This is a considerable improvement from the 130 deaths per lakh in 2014-2016, the latest data released by the office of the Registrar General of India showed.

On the regional level, Assam continues to have the highest MMR (195) but has improved its own performance over the years.

In 2014-2016, the northeastern state’s MMR was at a dangerously high 237 deaths per one lakh live births. This has improved significantly over the years to 229 in 2015-2017, 215 in 2016-2018 and 205 in 2017-2019, showed the data released November 28, 2022.

Also read: Maternal mortality in India: What do the recent figures tell us

In the same vein, Kerala continues to remain the best performer, with a low MMR of 19 per one lakh live births.

The southern state was always performing better than the national average and has almost consistently brought down even that figure — from 46 in 2014-2016, 42 in 2015-2017, 43 in 2016-2018 and 30 in 2017-2019.

Sharing the bulletin on Twitter, Union health minister Mansukh Mandaviya remarked: “Significant decline in the Maternal Mortality Ratio from 130 in 2014-16 to 97 per lakh live births in 2018-2020.”

The various healthcare initiatives of Prime Minister Narendra Modi’s government to ensure quality maternal and reproductive care have helped tremendously in bringing down MMR, Mandaviya added.

Other states with high MMR include Madhya Pradesh (173), Uttar Pradesh (167), Chhattisgarh (137), Odisha (119), Bihar (118), Rajasthan (113), Haryana (110), Punjab (105) and West Bengal (105).

Most of these states belong to the Empowered Action Group (EAG) — a classification of socioeconomically poor regions — on whom the country’s development depends.

Also read: Over 15 years of incentivised institutional delivery: Has it ensured safe births?

Among the better-performing states with an MMR lower than 100, barring Kerala, are Maharashtra (33), Telangana (43), Andhra Pradesh (45) and Gujarat (57).

The bulletin also includes statistics on maternal mortality rate and lifetime risk. Maternal mortality rate is the maternal deaths of women in the ages 15-49 per lakh of women in that age group. 

Here, the Registrar General of India defines the latter as “the probability that at least one woman of reproductive age (15-49 years) will die due to childbirth or puerperium (postpartum period), assuming that chance of death is uniformly distributed across the entire reproductive span.”

India’s maternal mortality rate is six, while poor-performing states include Madhya Pradesh (15.3), Uttar Pradesh (14.3), Assam (12.1), Bihar (11) and Chhattisgarh (9.9).

Kerala is the only state to achieve a maternal mortality rate of less than one, at 0.9. Other states in the leading category include Maharashtra (1.8), Telangana (2.3), Andhra Pradesh (2.4) and Tamil Nadu (2.7). 

The lifetime risk figures also show a similar trend, with Madhya Pradesh leading the way at 0.53 per cent, followed by Uttar Pradesh (0.50 per cent), Assam (0.42 per cent), Bihar (0.39 per cent) and Chhattisgarh (0.35 per cent).

At the national level, the lifetime risk of maternal mortality stands at 0.21 per cent.

India’s performance on the maternal mortality front has been improving consistently as the country achieves its national target of reducing MMR to below 100.

But it still lags behind the UN-mandated Sustainable Development Goals target of an MMR equivalent to 70 deaths per 100,000 live births. The country has eight years to meet this benchmark by 2030. Other indicators assessing maternal health indicate large room for improvement.

Anaemia levels among women between the ages of 19 and 49 have increased to 57 per cent in 2019-2021 from 53.1 per cent in 2015-2016. Only 58.1 per cent mothers had at least four antenatal care checkups and 26 per cent of mothers consumed iron folic acid for 180 days or more during pregnancy.

Institutional births across the country have increased to 88.6 per cent in 2019-2021 from 78.9 per cent in 2014-2016.

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