Context

• India has improved its maternal mortality ratio (MMR) 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.

What is maternal mortality?

• As per World Health Organization, Maternal death is 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.

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Maternal mortality ratio (MMR)

• Main indicator: Maternal mortality ratio is a Kay indicator maternal mortality ratio.
• Definition: The maternal mortality ratio (MMR) is defined as the number of maternal deaths during a given time period per 100,000 live births during the same time period.
• Shows risk of maternal death: It depicts the risk of maternal death relative to the number of live births and essentially captures the risk of death in a single pregnancy or a single live birth.
• SDG target: Target 3.1 of Sustainable Development Goals (SDG) set by the United Nations aims at reducing the global maternal mortality ratio to less than 70 per 100,000 live births.

Maternal mortality Ratio (MMR) in India: An overview of recent figures

• North eastern states show improvement: In 2014-2016, the north-eastern 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.
• Southern states always better than national average: 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.
• Kerala the best performer: Kerala continues to remain the best performer, with a low MMR of 19 per one lakh live births.
• On regional level Assam improved but continues to have high MMR: On the regional level, Assam continues to have the highest MMR (195) but has improved its own performance over the years.
• Better performing states: Among the better-performing states with an MMR lower than 100, barring Kerala, are Maharashtra (33), Telangana (43), Andhra Pradesh (45) and Gujarat (57).
• Other states with high MMR: Madhya Pradesh (173), Uttar Pradesh (167), Chhattisgarh (137), Odisha (119), Bihar (118), Rajasthan (113), Haryana (110), Punjab (105) and West Bengal (105).
• Sates with high MMR mostly belongs to socioeconomically poor regions: Most of these states belong to the Empowered Action Group (EAG) a classification of socioeconomically poor regions on whom the country’s development depends.

The Statistics including Maternal Mortality Rate and lifetime risk

• Maternal mortality rate: It is the maternal deaths of women in the ages 15-49 per lakh of women in that age group.
• As defined by Registrar General of India: The Registrar General of India defines 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.”

Maternal Mortality Ratio (MMR) v/s Maternal Mortality Rate

• Maternal Mortality Ratio (MMR): This is derived as the proportion of maternal deaths per 1,00,000 live births, reported under the Sample Registration System (SRS).
• Maternal Mortality Rate: This is calculated as maternal deaths of women in the ages 15-49 per lakh of women in that age group, reported under SRS.

Maternal mortality rate in India

• India’s maternal mortality rate is six.
• 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.

Conclusion

• 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.

Mains question

Q. What is Maternal mortality. What is the difference between Maternal mortality ratio (MMR) and Maternal mortality rate. Evaluate India’s progress in reducing MMR.

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