• Maternal Mortality Ratio (MMR) has declined from 130 per lakh live births in 2014-16 to 97 per lakh live births in 2018-20, according to a special bulletin released by the Office of the Registrar General of India.

• According to the data, Assam has the highest Maternal Mortality Ratio (MMR) of 195 while Kerala has the lowest of 19 per lakh live births. 

• The present bulletin provides the level of maternal mortality for the period 2018-2020.

• Assam, which has the highest MMR of 195, is followed by Madhya Pradesh with MMR of 173 per lakh live births and Uttar Pradesh 167.

• Kerala, which has the lowest MMR of 19, is followed by Maharashtra 33 and Telangana 43.

• The Office of the Registrar General of India under the ministry of home affairs, apart from conducting the Population Census and monitoring the implementation of the Registration of Births and Deaths Act in the country, has been giving estimates on fertility and mortality using the Sample Registration System (SRS).

What is Maternal Mortality Ratio (MMR)?

• 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. 

• Maternal mortality in a region is a measure of the reproductive health of women in the area. Many women of reproductive age die due to complications during and following pregnancy and childbirth or abortion.

• According to the World Health Organisation (WHO), maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.

• The target 3.1 of the Sustainable Development Goals set by the United Nations aims at reducing the global maternal mortality ratio to less than 70 per 1,00,000 live births.

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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