Syllabus: GS2/Health
Context
- The Union Health Ministry recently said that the rate of institutional deliveries in the country has increased to 89%, which led to a significant reduction in the Maternal Mortality Rate (MMR).
What is Maternal Mortality?
- 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.
- Maternal Mortality Ratio (MMR) is the number of maternal deaths per 1,00,000 live births.
- Maternal Mortality Rate: This is calculated as maternal deaths to women in the ages 15-49 per lakh of women in that age group, reported under Sample Registration System (SRS).
- The Sustainable Development Goal (SDG) 3.1 targets reducing the global maternal mortality ratio to less than 70 per 1,00,000 live births by 2030.
Progress Made by India
- In India the MMR declined from 130 per 100,000 live births in 2014-16 to 97 per 100,000 live births in 2018-20.
- Institutional births have increased significantly from 79% (2015-16) to 89% (2019-21) at the national level.
- Institutional delivery is 100% in Kerala, Goa, Lakshadweep, Puducherry and Tamil Nadu and more than 90% in eighteen other States/UTs.
- Even in rural areas, approximately 87% of births are delivered in institutions, while 94% are delivered in urban areas.
Challenges Still Faced By India
- High Out-of-Pocket Expenses (OOPE): Despite policy efforts, families often bear the cost of diagnostics, medicines, and private services during emergencies.
- Sociocultural Barriers: Gender dynamics, low education levels, restricted decision-making power among women, and stigma around maternal care all delay early care-seeking.
- Rise in High-Risk Pregnancies: Trends such as delayed childbirth, obesity, hypertension, diabetes, and short inter-pregnancy intervals contribute to riskier pregnancies.
- Weak Infrastructure in Remote Areas: Rural, tribal, and hilly regions lack emergency obstetric care, reliable transport, and blood storage facilities.
Government Initiatives to Reduce MMR
- Janani Suraksha Yojana (JSY): Launched in 2005 with the objective of reducing maternal and neonatal mortality, JSY promotes institutional delivery among pregnant women especially with weak socio-economic status.
- Pradhan Mantri Matru Vandana Yojana (PMMVY), is a maternity benefit program run by the Ministry of Women and Child Development, Government of India.
- The maternity benefit, of Rs. 5000/-, is available to a woman for the first living child of the family subject to fulfilment of conditionalities.
- Further under ‘Mission Shakti’, the scheme (PMMVY 2.0) provides additional cash incentive for the second child, if that is a girl child.
- Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA): Launched in 2016, PMSMA provides pregnant women a fixed day, free of cost assured and quality Antenatal Care on the 9th day of every month.
- LaQshya: Launched in 2017, LaQshya aims to improve the quality of care in labour room and maternity operation theatres to ensure the quality care during delivery and immediate post-partum.
- Capacity building is taken-up 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.
- Reproductive and child health (RCH) portal is a name-based web-enabled tracking of pregnant women and new-born to ensure provision of regular and complete services to them including antenatal care, institutional delivery and post-natal care.
| Innovations in Maternal Healthcare – Madhya Pradesh’s ‘Dastak Abhiyan’: A community-driven campaign that focuses on early detection of maternal health risks and ensures timely medical intervention. – Tamil Nadu’s Emergency Obstetric Care Model: A robust referral system that ensures pregnant women receive timely emergency care, reducing maternal complications. |
Way Ahead
- India has made significant progress in reducing maternal mortality, successfully achieving the National Health Policy (NHP) target of an MMR below 100 by 2020.
- However, continued efforts are required to reach the SDG target of MMR by 2030.
- Strengthening healthcare infrastructure, expanding maternal health programs, and addressing socioeconomic barriers will be critical in further reducing maternal mortality in the country.
Source: TH
