South scores, India has long way to go

The country’s success in reducing its Maternal Mortality Rate (MMR), as recorded by data released last week, is good news on the health front. According to the special bulletin issued by the Registrar General of India, the MMR dropped from 130 per lakh live births in 2014-16 to 97 per lakh live births in 2018-20. The MMR is the number of mothers who die from complications during pregnancy for every one lakh live births.

This is the first time that the MMR has dropped below 100. Eight states have achieved the target set by the UN under the Sustainable Development Goals (SDG) for 2030, which aims to reduce the global MMR to below 70 per one lakh live births. The states are Kerala, Karnataka, Tamil Nadu, Andhra Pradesh, Maharashtra, Jharkhand and Gujarat. That is a major achievement.

The survey has, however, highlighted the wide disparities in performance among the states. While MMR is the lowest in Kerala at 19 deaths per lakh live births, it is the highest in Assam at 195. Madhya Pradesh and Uttar Pradesh have MMR above 160. Under the National Rural Health Mission, states have been categorised into three groups based on performance. All states other than those from the South, which are in one group, need special attention. Within states, performance has varied across districts and regions, and this should also be taken into consideration when plans are implemented to improve the situation.

The progressive reduction in MMR over the years may be attributed to the various healthcare initiatives that aim to promote reproductive health and to improve the welfare of women and children, such as the Janani Suraksha Yojana, the Janani Shishu Suraksha Karyakram (JSSK), and the Pradhan Mantri Surakshit Matritva Abhiyan (PMSM). Improvement in literacy and education rates and improved awareness about healthcare needs and facilities and social welfare measures have also helped. Maternal mortality is preventable if adequate care is taken from the time of pregnancy to delivery and the post-natal period.

But in the country’s more backward states, medical and human infrastructure for this is still inadequate and the general awareness among people is low. While the gains made are creditable, it is important to ensure that there is no slide back. Some studies have found that the maternal and child health services were considerably affected during the Covid period. It is necessary to put in place strategies to ensure that going forward, public health outcomes are not seriously impacted by that setback.