Context of the News
India’s Maternal Mortality Ratio (MMR), defined as the number of maternal deaths per 1,00,000 live births, has improved by just one point from 88 in 2021-23 to 87 in 2022-24, according to the latest Sample Registration System (SRS) bulletin released by the Office of the Registrar General and Census Commissioner, Ministry of Home Affairs. The headline is a near-stall in national progress, after two decades of sharp improvement, with India having cut MMR from 212 in 2007-09 to 88 in 2020-22, putting the country on track for the Sustainable Development Goal (SDG 3.1) target of reducing the global MMR to less than 70 by 2030.
Key Highlights
- Indicator: Maternal Mortality Ratio (MMR), deaths of women due to pregnancy-related causes per 1,00,000 live births.
- Source: Sample Registration System (SRS) bulletin.
- Latest value (2022-24): 87.
- Previous value (2021-23): 88.
Two-decade trend:
| Period | MMR (per 1,00,000 live births) |
|---|---|
| 2007-09 | 212 |
| 2020-22 | 88 |
| 2021-23 | 88 |
| 2022-24 | 87 |
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SDG target:
| Indicator | Target |
|---|---|
| SDG 3.1 | Reduce global MMR to less than 70 per 1,00,000 live births by 2030 |
State-level performance:
| Category | States |
|---|---|
| Strong improvers | Odisha, Assam, Chhattisgarh, Punjab, Telangana (cut MMR by 11-29 points) |
| Moderate improvers | Tamil Nadu and West Bengal (cut by 10 points each) |
| High-birth states improving | Bihar, Madhya Pradesh |
| Worsening states | Jharkhand (biggest), Uttar Pradesh, Gujarat |
| State with India’s highest MMR | Uttar Pradesh at 154 (nearly twice the national average) |
Regional and global comparison:
| India vs Country | Status |
|---|---|
| China, Sri Lanka, Bhutan | Well ahead of India |
| Bangladesh, Nepal, Pakistan, Myanmar | Behind India |
| Malaysia, Thailand, Vietnam | Ahead of India |
| Sub-Saharan Africa | Very high MMR, pulls global average up |
About the News (Q&A)
What is the main finding?
India’s MMR has moved only by one point, from 88 to 87, between 2021-23 and 2022-24, suggesting that national progress has slowed sharply after two decades of rapid decline.
How does this compare to earlier years?
India had cut MMR from 212 in 2007-09 to 88 in 2020-22, a major achievement. Compared to this rapid pace, the latest one-point change is a near-stall.
Which states have improved?
(a) Odisha, Assam, Chhattisgarh, Punjab, Telangana (cut MMR by 11-29 points). (b) Tamil Nadu, West Bengal (cut by 10 points each). (c) Bihar, Madhya Pradesh (both high-birth states).
Which states have worsened?
(a) Jharkhand (biggest increase). (b) Uttar Pradesh. (c) Gujarat.
Uttar Pradesh now has India’s highest MMR at 154, nearly twice the national average.
How does India compare globally?
India is behind: China, Sri Lanka, Bhutan, Malaysia, Thailand, Vietnam. India is ahead of: Bangladesh, Nepal, Pakistan, Myanmar. The global average is higher than India because of very high MMR in parts of sub-Saharan Africa.
Background Concepts (Q&A)
What is the “Maternal Mortality Ratio (MMR)”, and How is It Different from Other Maternal Indicators?
The Maternal Mortality Ratio (MMR) is defined by the World Health Organization (WHO) as the number of maternal deaths per 1,00,000 live births in a given period. A maternal death is the death of a woman while pregnant or within 42 days of the end of pregnancy, from any cause related to or aggravated by the pregnancy or its management (but not from accidents or incidental causes). MMR measures the risk of dying from pregnancy or childbirth per pregnancy, and is the most widely used indicator of maternal health. India tracks MMR through the Sample Registration System (SRS), run by the Office of the Registrar General and Census Commissioner.
Two related but different indicators are:
(a) The Maternal Mortality Rate, which measures the number of maternal deaths per 1,00,000 women of reproductive age (15-49 years) in a given period. It reflects both the risk of pregnancy and the frequency of pregnancy in the population.
(b) The Lifetime Risk of Maternal Death, which measures the probability that a 15-year-old female will eventually die from a maternal cause. It combines the per-pregnancy risk (MMR) with the fertility rate (TFR).
MMR is preferred globally because it isolates the risk per pregnancy, making it comparable across countries with different fertility rates. India’s MMR of 87 (2022-24) means about 87 women die for every 1,00,000 live births, a sharp improvement over 2007-09 (212) but still higher than the SDG target of 70.
What are the Main Causes of Maternal Mortality in India, and What is the Policy Response?
In India, the main causes of maternal mortality include: (a) Postpartum haemorrhage (severe bleeding after delivery), the single largest cause globally and in India; (b) Hypertensive disorders, including pre-eclampsia and eclampsia; (c) Sepsis and infections after delivery; (d) Obstructed labour and complications during birth; (e) Unsafe abortion; and (f) Indirect causes like anaemia, malnutrition, malaria, and tuberculosis, which weaken pregnant women and increase the risk of dying during pregnancy or childbirth.
India’s policy response is built around strengthening the entire continuum of maternal care, through programmes like:
(a) Janani Suraksha Yojana (JSY), a conditional cash transfer to encourage institutional deliveries, especially in EAG states. (b) Janani Shishu Suraksha Karyakram (JSSK), which provides free delivery, free Caesarean section, free drugs, diagnostics, blood, and transport for pregnant women in public facilities. (c) Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA and e-PMSMA), which provides free, comprehensive antenatal care on the 9th of every month, with special attention to high-risk pregnancies. (d) Surakshit Matritva Aashwasan (SUMAN), which guarantees zero-tolerance for denial of services to pregnant women in public health facilities. (e) LaQshya, which focuses on improving the quality of care in labour rooms and maternity operation theatres. (f) Anaemia Mukt Bharat and POSHAN Abhiyaan/POSHAN 2.0, which address anaemia and nutrition in adolescent girls, pregnant women, and lactating mothers. (g) Pradhan Mantri Matru Vandana Yojana (PMMVY 2.0), a maternity benefit scheme.
Together, these programmes have helped drive India’s MMR from 212 to 87 in about 15 years, but the last mile, especially in Uttar Pradesh, Jharkhand, and Gujarat, will require stronger system-level reforms.
Practice MCQs
Q1. With reference to India’s latest Maternal Mortality Ratio (MMR) figures, consider the following statements:
- India’s MMR has marginally improved from 88 in 2021-23 to 87 in 2022-24 as per the latest SRS bulletin.
- India had cut MMR from 212 in 2007-09 to 88 in 2020-22.
- The Sustainable Development Goal (SDG) target is to reduce the global MMR to less than 70 per 1,00,000 live births by 2030.
- Uttar Pradesh now has the highest MMR among Indian states at 154, nearly twice the national average.
How many of the above statements are correct? (a) Only one (b) Only two (c) Only three (d) All four (e) None
Q2. Consider the following statements about state-level MMR trends in India:
- Odisha, Assam, Chhattisgarh, Punjab, and Telangana have cut their MMR by 11 to 29 points.
- Tamil Nadu and West Bengal have reduced their MMR by 10 points each.
- Jharkhand, Uttar Pradesh, and Gujarat have seen their MMR worsen in the latest cycle.
- Bihar and Madhya Pradesh, despite being high-birth states, have also reduced their MMR.
Which of the above are correct? (a) 1, 2 and 3 only (b) 1, 3 and 4 only (c) 2 and 4 only (d) 1 and 4 only (e) All four
Q3. With reference to MMR-related concepts, consider the following statements:
- Maternal Mortality Ratio (MMR) is defined as the number of maternal deaths per 1,00,000 live births in a given period.
- A maternal death is the death of a woman while pregnant or within 42 days of the end of pregnancy from any cause related to or aggravated by the pregnancy.
- The Maternal Mortality Rate is calculated per 1,00,000 women of reproductive age (15-49 years), not per 1,00,000 live births.
- The Lifetime Risk of Maternal Death combines per-pregnancy risk with fertility rates.
Which of the above are correct? (a) 1, 2 and 3 only (b) 1, 3 and 4 only (c) 2 and 4 only (d) 1 and 4 only (e) All four
Q4. Consider the following statements about India’s maternal health programmes:
- Janani Suraksha Yojana (JSY) is a conditional cash transfer scheme to encourage institutional deliveries.
- Janani Shishu Suraksha Karyakram (JSSK) provides free delivery, free C-section, free drugs, diagnostics, blood, and transport in public facilities.
- Surakshit Matritva Aashwasan (SUMAN) guarantees zero tolerance for denial of services to pregnant women in public health facilities.
- LaQshya is a Reserve Bank of India programme to improve banking services for pregnant women.
Which of the above are correct? (a) 1, 2 and 3 only (b) 1, 3 and 4 only (c) 2 and 4 only (d) 1 and 4 only (e) All four (Statement 4 is wrong; LaQshya is a Ministry of Health and Family Welfare initiative to improve quality of care in labour rooms and maternity OTs, NOT an RBI banking programme.)
Answer Key
- (d), All four statements are correct.
- (e), All four statements are correct.
- (e), All four statements are correct.
- (a), Statements 1, 2, 3 are correct; Statement 4 is wrong because LaQshya is a Ministry of Health programme, not an RBI banking scheme.
