Maternal Health Indicators
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Direct answer
Ninety-seven maternal deaths per 100,000 live births (SRS 2018-20) is India's maternal mortality ratio, with the newest bulletin reporting a further fall to 93 for 2019-21, against the sustainable development goal target of below 70 by 2030; Assam records the highest and Kerala the lowest state values. A maternal death is one occurring during pregnancy or within 42 days of its termination from pregnancy-related causes, and the leading Indian causes remain haemorrhage, hypertensive disorders and sepsis, with anaemia (52.2 per cent of pregnant women per NFHS-5) as the great underlying amplifier. The companion child indicators — IMR 28, NMR 20 and under-five mortality 32 per 1000 live births (SRS 2020, with newer bulletins showing IMR near 26) — are tracked by the same programme architecture: JSY, JSSK, PMSMA, PMMVY, SUMAN and LaQshya.
What you must remember
- MMR: 97 per 100,000 live births (2018-20), 93 in the 2019-21 bulletin; SDG target below 70 by 2030; Kerala lowest, Assam highest.
- Child mortality set (SRS 2020): IMR 28, NMR 20, U5MR 32 per 1000 live births — neonatal deaths form roughly three-quarters of infant deaths, which is why the NMR is the hardest to move.
- Definitions: maternal death = up to 42 days post-termination; late maternal death = 42 days to one year; perinatal mortality combines late fetal deaths and first-week deaths per 1000 total births.
- Causes: haemorrhage (leading direct cause), hypertensive disorders, sepsis, unsafe abortion; anaemia is the leading indirect cause.
- Three delays model (Thaddeus and Maine): delay in deciding to seek care, delay in reaching care, delay in receiving care — every scheme attacks one of these.
- Scheme map: JSY (2005, cash for institutional delivery — 1400 rupees rural in low-performing states), JSSK (2011, free delivery, drugs, diagnostics, diet, transport and caesarean), PMSMA (2016, assured specialist antenatal care on the ninth of every month), PMMVY (2017, 5000 rupees in instalments for the first live birth), SUMAN (2019, zero tolerance for preventable maternal deaths), LaQshya (2017, labour room quality).
- Antenatal schedule: WHO 2016 recommends eight contacts (first within twelve weeks); Indian programme gives iron-folic acid (100 mg elemental iron daily) and tetanus protection.
Working a maternal death review
A 24-year-old second gravida in her third trimester reaches a community health centre at 2 a.m. with bleeding per vaginam, no antenatal card, haemoglobin unknown. She dies despite transfusion — a death review under maternal death surveillance and response reconstructs the pathway. No PMSMA visit (no haemoglobin check, anaemia undetected), no birth-preparedness plan (delay one), no 102 ambulance call because the family waited for a private vehicle (delay two), and the first referral facility lacked blood on site (delay three). Every Indian maternal indicator improves only when this chain is cut at its weakest link: ANM-level risk screening, the mother and child protection card, waiting funds, referral transport, and blood storage at first referral units. Maternal near-miss analysis — women who survived severe complications — complements death reviews because near-misses are more numerous and reveal the same system fractures without waiting for a corpse.
How FMGE frames it
Matching indicator to value is the reliable question: MMR 97, IMR 28, NMR 20, U5MR 32 — and the denominators are asked as deliberately as the numerators (maternal deaths per 100,000 live births; infant deaths per 1000 live births). The second pattern is scheme-to-entitlement matching: JSY equals cash incentive, JSSK equals free entitlements without cash, PMSMA equals the ninth of the month, PMMVY equals 5000 rupees for the first birth. The third trap is the time window — 42 days defines a maternal death; choose 365 days and you have chosen a late maternal death. Finally, remember the NMR-to-IMR relationship: as IMR falls, the proportion of infant deaths occurring in the neonatal period rises, which is exactly why programme money has migrated to labour rooms and newborn care corners.
Frequently asked questions
What is India's current maternal mortality ratio and the SDG target?
The SRS special bulletin gives 97 per 100,000 live births for 2018-20 (93 for 2019-21), against the SDG target of fewer than 70 by 2030.
What is the difference between maternal death and pregnancy-related death?
A maternal death is from any cause related to or aggravated by pregnancy within 42 days of termination; pregnancy-related death includes all deaths in that window regardless of cause.
Which scheme provides free drugs, diagnostics and transport for delivery?
JSSK (Janani Shishu Suraksha Karyakram, 2011), which entitles every pregnant woman to free and cashless delivery, caesarean and transport, with zero-expense care for the sick newborn.
On which day is assured specialist antenatal care provided under PMSMA?
The ninth of every month, free of cost, by private or public specialists, under the Pradhan Mantri Surakshit Matritva Abhiyan of 2016.
Why is the neonatal mortality rate the hardest indicator to reduce?
Because neonatal deaths depend on intrapartum care quality, prematurity management and immediate newborn care rather than on vaccines or nutrition alone.