Saving Mothers, Strengthening Futures - India's Success in Reducing Maternal Mortality

Context:

This document, released by the Press Information Bureau, Government of India, on March 21, 2025, under the Ministry of Health and Family Welfare, highlights India's progress in reducing maternal mortality. It emphasizes the decline in Maternal Mortality Ratio (MMR) from 130 (2014-16) to 97 (2018-20) per 100,000 live births, attributing this to government initiatives, improved healthcare access, and infrastructure strengthening. The document details key schemes under the National Health Mission (NHM), state innovations, and statistical trends, aligning with the Sustainable Development Goal (SDG) target of MMR below 70 by 2030.

Crisp Notes:

Introduction

• Maternal Mortality Definition: Death of a woman during pregnancy or within 42 days of termination, due to pregnancy-related causes (excluding accidents).
• Maternal Mortality Ratio (MMR): Number of maternal deaths per 100,000 live births; a key healthcare quality indicator.
• India’s Progress: MMR reduced from 130 (2014-16) to 97 (2018-20); achieved National Health Policy (NHP) 2017 target of <100.
• Global Milestone: WHO certified India for eliminating maternal and neonatal tetanus (May 15, 2015).

Trends in Maternal Mortality

• MMR Decline: From 130 (2014-16) to 97 (2018-20) per 100,000 live births.
• SDG Achievers: 8 states (Kerala, Maharashtra, Telangana, Andhra Pradesh, Tamil Nadu, Jharkhand, Gujarat, Karnataka) below 70.
• NFHS-5 (2019-21) Highlights:
• • First trimester ANC visits: 59% (NFHS-4) to 70% (NFHS-5).
  • Four+ ANC visits: 51% to 59%.
  • Institutional births: 79% to 89% (100% in Kerala, Goa, Lakshadweep, Puducherry, Tamil Nadu; >90% in 18 States/UTs).
  • Rural vs. Urban: 87% rural, 94% urban institutional deliveries.
• Age Distribution (2018-20):
• • Peak maternal deaths: 20-24 (32%) and 25-29 (30%) age groups.

Government Initiatives to Reduce MMR

1. National Health Mission (NHM)
2. • Strategy: Reproductive, Maternal, Newborn, Child, Adolescent Health, and Nutrition (RMNCAH+N).
   • Support: Funds States/UTs via Annual Programme Implementation Plans (PIPs) to reduce MMR and neonatal mortality.
2. Janani Suraksha Yojana (JSY)
3. • Launch: 2005.
   • Objective: Reduce maternal and neonatal mortality by promoting institutional deliveries, targeting SC/ST/BPL women.
   • Focus: Cash incentives for institutional births.
3. Pradhan Mantri Matru Vandana Yojana (PMMVY)
4. • Type: Maternity benefit program under Ministry of Women and Child Development.
   • Benefit: ₹5,000 for first living child (post-January 1, 2017), subject to conditions.
   • PMMVY 2.0 (April 1, 2022): Additional incentive for second child if a girl, promoting gender equity.
4. Janani Shishu Suraksha Karyakaram (JSSK)
5. • Launch: 2011.
   • Objective: Eliminate out-of-pocket expenses for pregnant women and sick infants.
   • Benefits: Free delivery (including C-section), transport, diagnostics, medicines, diet, and blood in public facilities.
5. Surakshit Matritva Aashwasan (SUMAN)
6. • Launch: 2019.
   • Objective: Ensure free, dignified, quality healthcare with zero tolerance for service denial.
   • Focus: End preventable maternal and newborn deaths in public facilities.
6. Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)
7. • Launch: 2016.
   • Objective: Free, quality ANC on the 9th of every month.
   • Extended PMSMA (e-PMSMA): Tracks high-risk pregnancies (HRP) with financial incentives for 3 extra visits + ASHA support.
   • Impact: Over 5.9 crore women examined by March 21, 2025.
7. LaQshya
8. • Launch: 2017.
   • Objective: Improve quality of care in labour rooms and maternity operation theatres.
   • Focus: Respectful, high-quality care during delivery and postpartum.
8. Capacity Building
9. • Training: MBBS doctors in Anesthesia (LSAS) and Obstetric Care (EmOC) for rural areas.
9. Maternal Death Surveillance Review (MDSR)
10. • Purpose: Identify causes, take corrective actions, and improve obstetric care at facility/community levels.
10. Village Health, Sanitation and Nutrition Day (VHSND)
11. • Purpose: Outreach for maternal/child care and nutrition.
11. IEC/BCC Activities
12. • Focus: Early ANC registration, institutional delivery, nutrition awareness via MCP Card and Safe Motherhood Booklet.
12. Reproductive and Child Health (RCH) Portal
13. • Purpose: Web-based tracking of pregnant women/newborns for complete services.
13. Anaemia Mukt Bharat (AMB)
14. • Part of: POSHAN Abhiyan.
    • Objective: Tackle anaemia in pregnant women and adolescents through testing, treatment, and communication strategies.

Infrastructure Strengthening

• Comprehensive Abortion Care (CAC): Enhanced via training, drugs, and IEC.
• Delivery Points: Upgraded with infrastructure, equipment, and manpower for RMNCAH+N services.
• First Referral Units (FRUs): Functionalized with manpower, blood storage, and referral linkages.
• Maternal and Child Health (MCH) Wings: Established at high-caseload facilities.
• Obstetric ICU/HDU: Operationalized at tertiary care facilities for complicated pregnancies.

Success Stories and Innovations

• Madhya Pradesh - Dastak Abhiyan: Community campaign for early detection and intervention of maternal risks.
• Tamil Nadu - Emergency Obstetric Care Model: Robust referral system for timely emergency care.

Conclusion

• Achievements: MMR reduced to 97 (2018-20), meeting NHP 2017 target; 8 states below SDG target of 70.
• Future Goal: Achieve SDG target of MMR <70 by 2030 through stronger healthcare systems and expanded maternal health access.