NEW DELHI: India has brought down its maternal mortality ratio (MMR) to less than a quarter of the levels about two decades ago, outperforming almost all of its erstwhile peers, including neighbours like Bangladesh, Pakistan and Bhutan. The progress has been steady, an analysis of data from 2007-09 to 2018-20 shows.
At the turn of the century, India had a maternal mortality ratio of 400. Since the sample survey in 2007-09 when India recorded an MMR of 212, it fell by 16% to 178 over a three-year period by 2010-12 and by 27% to 130 by 2014-16. Between the SRS surveys in 2014-16 and 2018-20, MMR fell by 25% to 97, thus showing a steady trend of declining maternal mortality.
However, the rate of decline in states such as West Bengal, Haryana, Madhya Pradesh and Punjab was lower than the national rate. Also, different Indian states are at vastly different levels of MMR straddling the spectrum from least developed countries to the developed world.
India’s MMR (the number of maternal deaths during a given period of time per 100,000 live births) at 97 in 2018-20 is at the level of Nicaragua, alow middle income country, among the least developed countries in Central America. However, the current MMR of 167 in a state like Uttar Pradesh is more or less at par with that of war-torn Yemen in 2017 according to Unicef data.
Assam’s MMR is at the level of Gabon and Odisha’s is close to Namibia. Kerala, with an MMR of 19, is at the level of the US, according to official data, having achieved a reduction from 46 in 2014-16. Maharashtra matches Mexico while Telangana has Vietnam for company.
India’s MMR is less thanhalf of the world’s. Global MMR in 2017 was 221. With India accounting for one fifth of the world’s annual child births, improvement on this parameter in India impactsthe global value. With the steady improvement, India is on target to achieve the sustainable development goal (SDG) of 70 by 2030.
One major factor contributing to the dramatic decline has been that while in 2005-06 only 40% of births happened in a medical institution, over the next decade this proportion had been raised to 79%and then to 89% by 2019-21.
Later marriages and female education have contributed too. Almost half (over 47%) of women in the 20-24 age group were married by the age of 18 in 2005-06. This fell to 18% by 2015-16 and further to 15%, according to the recent National Family Health Survey (NFHS) of 2019-21. Only about 55% of women were literate in 2005-06, compared to 81% in 2015-16 and 83% by 2019-21.
While much has been achieved, Sri Lanka’s MMR of 36 and that of states such as Kerala, Maharashtra, Telangana and Andhra Pradesh show that other states in India too can improve, and rapidly. Kerala, for instance, had an MMR of 195, about twice the national level now, less than two decades back.