The Maternal Mortality Ratio (MMR) of India has declined to 212 per 1,00,000 live births in 2007-09 from 254 in 2004-06, thus recording a fall of 42 points or 17 percent. As per the latest results of Sample Registration Survey (SRS) 2007-2009, the Empowered Action Group of States and Assam have registered a significant decline of 67 points in MMR when compared to the figure of 2004-2006. The highest decline in MMR has been observed in Assam (90 points) followed by Uttar Pradesh/Uttarakhand (81 points), Rajasthan (70 points), Madhya Pradesh/Chhattisgarh (66 points), Bihar/Jharkhand (51 points) and Orissa (45 points).The States of Haryana and Punjab have done remarkably well to reduce the MMR and reverse the increase observed during the period 2001-2003 to 2004-2006. Kerala continues to show outstanding performance recording 81 per 1,00,000 live births. While Tamil Nadu recorded 97 per 1,00,000 live births, Maharashtra is a close third with 104 per 1,00,000 live births.
Improving maternal health by reducing the Maternal Mortality Ratio by three quarters between 1990 and 2015 is one of the Millennium Development Goals (Goal 5) of the United Nations. The target for India is to achieve the Maternal Mortality Ratio of 109 by 2015.
Earlier this year, the SRS data on Infant Mortality Rates for 2009 had also indicated 3 points decline when compared to the figures of 2008 – being pegged at 50 per one thousand live births compared to the figure of 53 for the period 2008. The neo-natal mortality rate (deaths in less than 29 days) in 2009 is registered at 34 per one thousand live births, accounting for 67% of total infant mortality deaths. Besides, the early neo-natal mortality (less than 7 days) has been estimated at 27 per 1000 live births indicating that 54% of total infant deaths are occurring before 7 days of birth.
The Ministry of Health & Family Welfare has initiated several programmes to reduce the Infant Mortality Rate and Maternal Mortality Ratio. Two such schemes have been launched recently which are expected to further bring down MMR and IMR significantly during the coming period.
Janani Shishu Surksha Karyakaram (JSSK) is a new approach to health care, placing for the first time utmost emphasis on entitlements and elimination of out of pocket expenses for both pregnant women and sick neo-nates. The initiative entitles all pregnant women, delivering in public health institutions, to absolutely free and no expense delivery including caesarean section. A pregnant woman would be entitled to free transport from home to the government health facility, between the facilities, in case she is referred on account of complications and also drop back home after delivery. The entitlements include free drugs and consumables, free diagnostics, free blood wherever required and free diet during the woman’s stay in the facility. Entitlements have also been put in place for all sick newborns accessing public health institutions for health care till 30 days after birth. This new initiative is estimated to benefit more than one crore pregnant women and newborns every year in both urban and rural areas.
Another new initiative of home-based newborn care scheme is being launched to improve community newborn care practices and to improve early detection of neo-natal illness. Additional initiatives would be given to ASHAs for home visits at regular intervals for the care of the newborns.