• The Maternal Mortality Ratio (MMR) of India has declined by 10 points, the Union health ministry said, noting that the country is on the verge of achieving its SDG target of 70 per lakh live births by 2030.

• The Maternal Mortality Ratio is the number of maternal deaths during a given time period per 1 lakh live births during the same time period. 

• Quoting a special bulletin on Maternal Mortality Ratio (MMR) released by the Registrar General of India, the ministry said the country has been witnessing a progressive reduction in MMR from 130/lakh in 2014-2016, 122/lakh in 2015-17, 113/lakh in 2016-18, and 103 per lakh live births in 2017-19.

• With this persistent decline, India is on the verge of achieving National Health Policy (NHP) target of 100/lakh live births by 2020 and on track to achieve the sustainable development goal (SDG) target of 70 per lakh live births by 2030.

• The number of states which have achieved the SDG target has now risen from five to seven — Kerala (30), Maharashtra (38), Telangana (56), Tamil Nadu (58), Andhra Pradesh (58), Jharkhand (61) and Gujarat (70). 

• There are now nine states that have achieved the target of MMR set by NHP which include the above seven states as well as Karnataka (83) and Haryana (96).

• Five states — Uttarakhand (101), West Bengal (109), Punjab (114), Bihar (130), Odisha (136) and Rajasthan (141) — have MMR in between 100-150, while for four states like Chhattisgarh (160), Madhya Pradesh (163), Uttar Pradesh (167) and Assam (205) have MMR above 150.

• Encouraging achievement has been reported by Uttar Pradesh, which has shown the maximum decline of 30 points followed by Rajasthan (23 points), Bihar (19 points), Punjab (15 points) and Odisha (14 points). 

• West Bengal, Haryana, Uttarakhand and Chhattisgarh have shown an increase in MMR and hence, will need to reappraise their strategy and intensify their efforts to accelerate the MMR decline to achieve the SDG target. 

Govt interventions for improving Maternal Mortality Rate (MMR):

• Janani Suraksha Yojana (JSY), a demand promotion and conditional cash transfer scheme was launched in April 2005 with the objective of reducing Maternal and Infant Mortality by promoting institutional delivery among pregnant women.

• The Pradhan Mantri Matru Vandana Yojana (Maternity Benefit Programme) is a direct benefit transfer (DBT) scheme under which cash benefits are provided to pregnant women in their bank account directly to meet enhanced nutritional needs and partially compensate for wage loss. Under PMMVY, a cash incentive of Rs 5,000 is provided in three instalments directly to the bank/post office account of pregnant women and lactating mothers for the first child in the family.

• Labour Room Quality Improvement Initiative (LaQshya), launched in 2017 aims to improve the quality of care in labour room and maternity operation theatres to ensure that pregnant women receive respectful and quality care during delivery and immediate post-partum period.

• Anaemia Mukt Bharat (AMB) strategy as a part of POSHAN Abhiyan aims to strengthen the existing mechanisms and foster newer strategies to tackle anaemia which include testing & treatment of anaemia in school going adolescents & pregnant women, addressing non nutritional causes of anaemia and a comprehensive communication strategy. The strategy is estimated to reach out to 450 million beneficiaries including 30 million pregnant women.

• Surakshit Matritva Aashwasan (SUMAN) aims to provide assured, dignified, respectful and quality healthcare at no cost and zero tolerance for denial of services for every woman and newborn visiting the public health facility to end all preventable maternal and newborn deaths.

• Janani Shishu Suraksha Karyakram (JSSK) aims to eliminate out-of-pocket expenses for pregnant women and sick infants by entitling them to free delivery including caesarean section, free transport, diagnostics, medicines, other consumables, diet and blood in public health institutions.

• Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) provides pregnant women fixed day, free of cost assured and quality antenatal care on the ninth day of every month.

• Comprehensive Abortion Care services are strengthened through trainings of health care providers, supply of drugs, equipment, Information Education and Communication (IEC) etc.

• Midwifery programme is launched to create a cadre for nurse practitioners in midwifery who are skilled in accordance to International Confederation of Midwives (ICM) competencies and capable of providing compassionate women-centred, reproductive, maternal and new-born health care services.

• Over 25,000 ‘Delivery Points’ across the country are strengthened in terms of infrastructure, equipment, and trained manpower for provision of comprehensive RMNCAH+N services.

• Functionalisation of First Referral Units (FRUs) by ensuring manpower, blood storage units, referral linkages etc. 

• Setting up of Maternal and Child Health (MCH) Wings at high caseload facilities to improve the quality of care provided to mothers and children.

• Operationalisation of Obstetric ICU/HDU at high case load tertiary care facilities across the country to handle complicated pregnancies.

• Capacity building is undertaken for MBBS doctors in Anesthesia (LSAS) and Obstetric Care including C-section (EmOC) skills to overcome the shortage of specialists in these disciplines, particularly in rural areas.

• Maternal Death Surveillance Review (MDSR) is implemented both at facilities and at the community level. The purpose is to take corrective action at appropriate levels and improve the quality of obstetric care.

• Monthly Village Health, Sanitation and Nutrition Day (VHSND) is an outreach activity for provision of maternal and child care including nutrition.

• Regular IEC/BCC activities are conducted for early registration of antenatal care (ANC), regular ANC, institutional delivery, nutrition, and care during pregnancy etc.

• Mother Child Protection (MCP) Cards and Safe Motherhood Booklets are distributed to pregnant women for educating them on diet, rest, danger signs of pregnancy, benefit schemes and institutional deliveries.

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