The study, ‘Maternal Mortality for 181 countries, 1980-2008: A systematic analysis of progress toward millennium development Goal 5’ says India is one of the few countries — others being Egypt, Romania, Bangladesh and China — that have recorded “substantial decline” in MMR. In 1980, India reported about 677 maternal deaths (the death of women during pregnancy, childbirth or in the 42 days after delivery) per 1,00,000 live births but in 2008, this was down to 254 deaths. Indian maternal mortality ratio (MMR) fell from 570 per 1,00,000 births in 1990 to 230 in 2008. This is a 59% decline.
Acknowledging this success should not encourage complacency. Regardless of the magnitude of the decline, MMR of 230 is hardly a cause for celebration. While India has lower MMR than Pakistan, Bangladesh and Nepal and considerably lower than over 600 in most sub-Saharan African countries, comparison with MMR of 38 in China and 39 in Sri Lanka gives enough sense of the task ahead.
According to a recent report in Lancet medical journal, more than half all maternal deaths in 2008 were reported from just six countries: India, Nigeria, Pakistan, Afghanistan, Ethiopia and the Democratic Republic of Congo. In India, every year, about 78,000 women die during pregnancy, childbirth or within 48 hours of delivery. And what is perhaps most unfortunate is that 75% of these deaths are preventable.
In order to ensure that India meets the United Nations Millennium Development Goal of bringing down its MMR to 109 by 2015, an integrated and stepwise approach focusing on increased family planning and safe abortion combined with consecutively increased skilled birth attendants, improved care before and after birth, reduced home-birth and increased institutional delivery with improved emergency obstetric care could eventually prevent nearly 80% of maternal deaths.
Apart from the above health care services, there has to be mechanisms to ensure accountability in health system for the substantial deaths occurring during child birth. Mandatory maternal death audits should be enforced and rural health care system should be made more responsive and responsible towards the preventable deaths taking place in the absence of any state accountability.
Sukarya means “good work”. We are a Trust under the Indian Trust Act, in February 2001. The mission of Sukarya is to ensure equitable access to quality health services for all including the poorest sections of the society, especially women, adolescents and children by serving the health needs of the underserved and un-reached communities through provision of comprehensive health care services. Health and Women Empowerment are two main thrust areas.
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