India shows improvement in maternal mortality ratio, decline most significant in backward states: Report

Maternal mortality ratio (MMR) provides a measure of the quality of safe deliveries and maternal care. But India's healthcare services have lagged in this respect in comparison to neighbours like China, Sri Lanka and Maldives.

Maternal and child mortality and morbidity are considered key health indicators as they reflect the state of female healthcare. To improve these, the government has made efforts over the years, which has resulted in reducing the maternal mortality by over 69 percent since 1990. Yet, it still has some catching up to do with better-performing Asian countries.

The gap in maternal healthcare between urban and rural areas is often blamed for the overall poor scores and the inequalities are also evident through varying maternal mortality ratios across country.

Which states have shown improvement?

The improvement registered by the country is most significant in the "empowered action group (EAG)" states and Assam, from 246 to 188, in the last three years. EAG states are those where economic and development indicators are a particular concern like Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttarakhand and Uttar Pradesh.

Among the southern states, the decline is from 93 to 77 and in the other states from 115 to 93. The heartening statistics point to steady gains, likely linked to more focused efforts to improve maternal care and rising number of institutional deliveries and more attention to health protocols.

As compared to other states, MMR continues to be substantially high in EAG states despite the drop. Assam still recorded the highest maternal death ratio at 237, though down from 300 in 2011-13. Similarly, UP and Uttarakhand registered an MMR of 201, down from 285 in the last three years.

Kerala has turned in a stellar performance, in what can be seen as evidence of a robust public health system as well as high levels of education and awareness, with the lowest MMR of 46, falling from 61 in 2011-13.

Apart from Kerala, Tamil Nadu and Andhra Pradesh also performed well after recording MMR of 66 and 74, respectively.

Government efforts to bring down MMR

A number of healthcare schemes like the Janani Suraksha Yojna, or the maternity benefit scheme, has brought about a surge in institutional deliveries and financial uptakes in most states. Besides, the Rashtriya Kishor Swasthya Karyakram focuses on adolescent health and improving nutritional status and "Partnerships and Opportunities to Strengthen and Harmonise Actions for Nutrition (Poshan)" aims at community-based management of malnourished children.

The health ministry has introduced as well as expanded coverage of these schemes to address these challenges, with its main focus on remote areas. It has also started some new schemes to provide care to women at different stages of pregnancy and increase institutional deliveries to prevent deaths.

"After the launch of the National Rural Health Mission in 2005, significant improvements have taken place in building the health infrastructure in the country," a senior health ministry official said.