Maternal Mortality Ratio in India: Current situation, trends, and main reasons

Indian MMR has improved surprisingly well from 384 in 2000 to 80 per 100,000 live births in the year 2023. However, this trend notwithstanding, India continues to be the second largest contributor of global maternal death accounting for 7.2% of global maternal death. Leading causes of maternal deaths are hemorrhage, pregnancy related infections and hypertensive disorders. These constant problems point to the necessity of a focus on particular healthcare interventions such as in areas where high MMRs prevail, and attention on the sources of maternal mortality should be taken seriously.

Summary:

• India’s MMR fell from 384 in the year 2000 to 80 in the year 2023, 86% decline.

• India accounts for 7.2% of the total maternal deaths in the world which is still a major concern of international health.

Key Points:

• Current Status in India: 19,000 maternal deaths were recorded in 2023 to add up 7.2% of world maternal deaths.

• Progress Made: Since 1990, India has lowered its MMR by 86%, which is more than the worldwide average decline.

Data Point

• Leading Causes of Maternal Deaths:

  • Hemorrhage – 47%

  • Pregnancy-related infections – 12%

  • Hypertensive disorders – 7%

• Regional Disparities in MMR:

  • States with MMR <70: Kerala, Maharashtra, Tamil Nadu

  • States with high MMRs:

  • Uttar Pradesh – 167

  • Madhya Pradesh – 173

  • Assam – 195

• Global Trends:

  • 40% global decline in maternal deaths (2000–2023)

  • Sub-Saharan Africa leads in MMR; Moderate levels are found in South Asia & Oceania.

• SDG Goal 3.1

  • Weights into reducing global MMR< (below 70) by year 2030- requires accelerated action

• Access Challenges: NHM and JSY schemes are not creating the institutional deliveries and skilled birth attendants in the rural areas.

• Emerging Threats: Non-communicable diseases such as diabetes and hypertension are becoming increasing causes of indirect maternal deaths.

How India Can Accelerate Progress:

• Strengthening Primary Health Care (PHC): Increase the mandate of Health and Wellness Centers (HWCs) to serve quality maternal care to rural and under served areas.

• Targeting High-Risk States: Increase investment in states such as Uttar Pradesh, Bihar and Madhya Pradesh though mobile health units, telemedicine, and the community health workers (ASHA) to increase the access to skilled care.

• Policy Integration and Social Justice: Ensure in line with maternal health policies with SDGs 5 (Gender Equality) and 10(Reduced Inequalities on Marginalized groups, including adolescent girls and low-income communities.

• Enhancing Data Systems: Enhance maternal death data collection through the Civil Registration System (CRS) and utilise digital forums such as U-WIN for a real-time monitoring of maternal health indicators.

• Expanding Targeted Programs: Initiatives such as Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) should be implemented on a larger scale, to offer such focus care for vulnerable populations.

Conclusion:

 India’s success against maternal deaths deserves our scrutiny but there is little that can be said about the inequalities that continue to exist across the country and about new health challenges that loom in the shape of NCDs. In order to accelerate improvement, India needs to focus on strengthening access to healthcare especially in underserved region and continue expanding impact focused health programs while taking care of social determinants of health. Eradicating maternal mortality level in 2030 in order for the SDG target to be achieved will need multi-dimension approach that will include enhanced healthcare infrastructure, improved data system and specific policy interventions.