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MMR improves

Overall maternal deaths down, but disparities a concern

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India has delivered an overall improvement in the maternal mortality ratio (MMR) to 97 deaths per one lakh live births in 2018-20 from 130 per lakh in 2014-2016, as per the Health Ministry. At this rate, the country seems to be on course to achieve the UN Sustainable Development Goal’s global target of sub-70 MMR by 2030. MMR is the number of mothers who die from complications during pregnancy for every one lakh live births. The progressive reduction in the MMR over the past years points to the success of the government’s healthcare initiatives related to maternity.

However, the state-wise performance reveals disparities. While Kerala tops with an MMR of 19, Assam, MP and UP are among those with a ‘very high’ MMR of more than 130; Punjab figures in the ‘high’ MMR category (101-130); and Haryana in the ‘low’ group (71-100). Also, access to institutional care is driven by economic and social factors, along with the rural-urban divide. Given that the direct causes of maternal mortality are largely preventable and treatable, these inequities reflect gaps in the health system’s responsiveness to the situation. It speaks of inadequacies in the implementation of schemes like the Pradhan Mantri Surakshit Matritva Abhiyan that aim to strengthen antenatal care by providing assured, quality services free of cost to pregnant women. Or, in the scheme of distributing iron and folic acid supplements to anaemic women that was rolled out with the goal of improving their health and, ultimately, reduce maternal deaths.

More effort is required to ensure the detection of high-risk pregnancies, especially among women and adolescents from SC, ST, poor and rural households as they also suffer from lack of resources and information. Timely intervention and follow-up need to be pushed to reduce complications that account for nearly 66% of maternal deaths during or after childbirth, such as severe bleeding, infections, high blood pressure caused by unsafe deliveries and abortions. All births should be assisted by health professionals as it can make the difference between life and death for both the mother and the baby.

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