Maternal Mortality Ratio in India

Context:

Recently, the Registrar General of India’s Sample Registration System (SRS) released the latest special bulletin on Maternal Mortality in India (2017-19).

What is the Maternal Mortality Ratio (MMR)?

• Maternal Mortality ratio is often used interchangeably with the maternal mortality rate.
• However, the World Health Organisation has distinguished between these two indicators of maternal deaths.
• Maternal Mortality Ratio (MMR) is the number of maternal deaths per 1,00,000 live births. It is a measure of the risk of death once a woman has become pregnant.
• Maternal Mortality Rate is the number of maternal deaths (direct and indirect) in a given period per 1,00,000 women of reproductive age during the same period.

Where does India Stand on MMR?

• The MMR of India has declined by 10 points. It has declined from 113 in 2016-18 to 103 in 2017-19 (8.8 % decline).
• The country had been witnessing a progressive reduction in the MMR from 130 in 2014-2016, 122 in 2015-17, 113 in 2016-18, and to 103 in 2017-19.
  • India was on the verge of achieving the National Health Policy (NHP) target of 100/lakh live births by 2020 and certainly on track to achieve the United Nations Sustainable Development Goals target of 70/ lakh live births by 2030.
• Many developed countries have successfully brought down MMR to single digits. Italy, Norway, Poland and Belarus have the lowest MMR of two, while it is seven in both Germany and the UK, 10 in Canada and 19 in the US.
• Most of India’s neighbours — Nepal (186), Bangladesh (173) and Pakistan (140) — have a higher MMR. However, China and Sri Lanka are way ahead with MMRs of 18.3 and 36 respectively.

What are the State Specific Findings?

• The number of States that have achieved the SDG target has now risen from five to seven — Kerala (30), Maharashtra (38), Telangana (56), Tamil Nadu (58), Andhra Pradesh (58), Jharkhand (61), and Gujarat (70).
  • Kerala has recorded the lowest MMR which puts Kerala way ahead of the national MMR of 103.
  • Kerala’s Maternal MMR has dropped by 12 points. The last SRS bulletin (2015-17) had put the State’s MMR at 42 (later adjusting it to 43).
• There are now nine States that have achieved the MMR target set by the NHP, which include the above seven and Karnataka (83) and Haryana (96).
• Uttarakhand (101), West Bengal (109), Punjab (114), Bihar (130), Odisha (136) and Rajasthan (141) — have the MMR in between 100-150, while Chhattisgarh (160), Madhya Pradesh (163), Uttar Pradesh (167) and Assam (205) have the MMR above 150.

Various determinants of maternal health in India

Initiatives by Indian Government:

Improved quality and coverage of health services through government initiatives have led to the fall in the maternal mortality rate. Some of the government initiatives are as follows:

LaQshya:

• The Union Ministry of Health and Family Welfare launched the Labour room Quality Improvement Initiative (LaQshya).
• It aims to improve the quality of care in the labour room and maternity operation theatres in public health facilities.
• This is to reduce the preventable maternal and newborn deaths, morbidity and stillbirths.
• A comprehensive strategy has been adopted that includes infrastructure up-gradation, ensuring the availability of vital equipment, improved and adequate human resources and improving skills of healthcare workers.
• The quality of the labour rooms and maternity operation theatres will be assessed through the National Quality Assurance Standards (NQAS).

POSHAN Abhiyaan (National Nutrition Mission)

• It was launched on March 8, 2018, to improve nutritional outcomes among pregnant women, lactating mothers and children by reducing the level of stunting, underweight, anaemia and low birth weight by 2022.
• It aims to ensure service delivery and interventions through technology, behavioural change through convergence. It lays down specific targets that are to be achieved based on different parameters READ MORE…

Janani Suraksha Yojana (JSY):

• It is a safe motherhood intervention under the National Health Mission (NHM).
• Launched on 12^th April 2005, it is a 100% centrally sponsored scheme that is being implemented across all states and Union Territories with special focus on low performing states.
• It integrates cash assistance with delivery and post-delivery care to reduce the maternal and neonatal mortality rate and promote institutional delivery of the pregnant women, especially with weak socio-economic status. READ MORE…

Pradhan Mantri Surakhit Matritva Abhiyan (PMSMA):

• It was launched in 2016 by the Health Ministry to provide free comprehensive and quality antenatal checkups for pregnant women across the country.
• It aims to make safe pregnancy a social movement across the country.
• Since its launch is successful in conducting more than 25 lakh check-ups in high-priority districts identified by the Health Ministry.

Pradhan Mantri Matru Vandana Yojana (PMMVY):

• It is a centrally sponsored maternity benefit scheme that is being implemented since January 2017.
• It is being implemented by the Ministry of Women and Child Development.
• It provides a cash benefit to the pregnant women in their bank account directly to address their nutritional needs and compensate for their wage loss.
• All pregnant women and lactating mothers, except those who are in regular employment with the Central government or the state governments or PSUs or those receiving similar benefits under any other laws are eligible for this scheme. READ MORE…

Surakhit Matritva Aashwasan Initiative (SUMAN)

• Launched in 2019, it aims to provide free quality healthcare to all pregnant women, mothers up to 6 months after delivery and all sick newborns who are visiting a public health facility.
• It aims for zero preventable maternal and newborn deaths.

Way Forward:

• Ensure equal access to Nutrition, Health, and education.
• Need to adopt a Life Cycle approach to empowerment of girls and women.
• Recognise Women’s Reproductive Rights, Focus on Young mothers and adolescent unmarried girls.
• Enforcement of Child marriage prevention programs, Emphasis on safe delivery in institutional set ups.
• Adolescent girls’ programmes should focus on protecting girls from early and unwanted childbearing.
• Encourage young women to delay marriage age by promoting education and skill development.
• Encourage young couples to practice family planning and delay their first child.
• Train Social workers in hospitals, and Community health workers under the national health mission.
• Improve mental health services for women, address stigma, discrimination and violence against HIV‐positive women and female sex workers.
• Address health problems of women in the informal sector, Improve water and sanitation Situation for women.
• Universal availability of maternity benefits and Childcare facilities to all women workers across the organized and unorganized Sectors.
• Flexible designs for the Schemes, depending on local needs and region‐Specific issues.
• Adopt Need‐based Schemes, Pro‐active Publicity of Schemes, Creation of Simple, local language materials to explain.

Source: The Hindu

You can find many articles on DEVELOPMENT PROCESS (part of GS II) in our website. Go through these articles share with your friends and post your views in comment section.