Context: India hit targeted maternal mortality rate of 100 deaths per lakh live births

Source: The Hindu

The National Health Policy’s goal of 100 maternal deaths for every lakh live birth has been met by India. Additionally, the country’s MMR decreased by 83% between 1990 and 2020, which was significantly greater than the global MMR fall. Between 1990 and 2020, India’s infant mortality rate decreased by 69%, whilst the global IMR decreased by 55%. The Under-5 Mortality Rate has also decreased by 75%, compared to a global drop rate of 58%.

Chief medical officers’ abilities must be strengthened and improved, and training and capacity-building activities are essential to maximizing their use and laying the groundwork for the healthcare system to achieve the desired outcomes at the local level. ASHA employees must be empowered and given incentives for doing daily tasks.

Model Question:

“Reducing Maternal Mortality Rate (MMR), Infant Mortality Rate (IMR), and Under-5 Mortality Rate (U5MR) is crucial for achieving India’s health and development goals.” Discuss the current status, causes, government initiatives, and the way forward to improve these indicators.

Model Answer

Maternal Mortality Rate (MMR), Infant Mortality Rate (IMR), and Under-5 Mortality Rate (U5MR) are key indicators of a country’s healthcare system and socio-economic development. Reducing these rates is essential for achieving Sustainable Development Goals (SDG 3.1 and 3.2) and improving overall public health in India.

Current Status of MMR, IMR, and U5MR in India

Indicator         Definition              Current Status (as per SRS 2019-21)  SDG Target (2030)

MMR  Maternal deaths per 100,000 live births                     97                  Less than 70

IMR     Infant deaths (under 1 year) per 1,000 live births      27                        12

U5MR Child deaths (under 5 years) per 1,000 live births     32                         25

India has made significant progress in reducing mortality rates, but regional disparities remain, especially in states like Uttar Pradesh, Bihar, and Madhya Pradesh.

Causes of High MMR, IMR, and U5MR in India

1. Healthcare Gaps: Inadequate access to quality maternal and child healthcare, especially in rural areas. Shortage of trained medical personnel, including doctors and midwives.
2. Malnutrition and Anemia: Malnutrition in pregnant women leads to complications during childbirth. Anemia affects nearly 50% of Indian women, increasing the risk of maternal deaths.
3. Lack of Institutional Deliveries: Home births without skilled birth attendants increase maternal and neonatal deaths.
4. Neonatal and Childhood Diseases: Pneumonia, diarrhea, and sepsis are major causes of infant and under-5 deaths. Low birth weight and premature births increase infant mortality risk.
5. Socio-economic Factors: Early marriages and adolescent pregnancies increase maternal risks. Poverty and lack of sanitation impact child and maternal health.

Government Initiatives to Reduce MMR, IMR, and U5MR

1. Maternal Health Programs: Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) – Free antenatal care for pregnant women. Janani Suraksha Yojana (JSY) – Promotes institutional deliveries by providing financial incentives. LaQshya Initiative – Improves quality of maternity care in labor rooms and operation theatres.
2. Child Health and Nutrition Programs: Rashtriya Bal Swasthya Karyakram (RBSK) – Screening for birth defects and childhood diseases. Intensified Mission Indradhanush (IMI) – Improves vaccination coverage to prevent child mortality. Poshan Abhiyaan – Targets malnutrition and anemia among mothers and children.
3. Healthcare Infrastructure and Policy Initiatives: Ayushman Bharat – Health and Wellness Centers (HWCs) – Strengthening primary healthcare services. Surakshit Matritva Aashwasan (SUMAN) – Ensures zero maternal and newborn deaths due to preventable causes. Kilkari and Mobile Academy – Mobile-based programs for maternal and child health awareness.

Way Forward

1. Strengthening Primary Healthcare: Increase healthcare infrastructure and skilled workforce in rural areas. Improve antenatal and postnatal care services.
2. Addressing Malnutrition and Anemia: Strengthen supplementary nutrition programs for pregnant women and children. Expand Iron and Folic Acid supplementation under Anemia Mukt Bharat.
3. Enhancing Institutional Deliveries and Skilled Birth Attendance: Ensure 100% institutional deliveries, especially in high-risk states. Train more ASHA workers, midwives, and medical staff.
4. Community Awareness and Behavioral Change: Conduct mass awareness campaigns on maternal and child healthcare. Address socio-cultural factors like early marriages and adolescent pregnancies.
5. Leveraging Technology and Data Analytics: Use AI and digital health records to track high-risk pregnancies. Strengthen telemedicine services for remote areas.

India has made commendable progress in reducing MMR, IMR, and U5MR, but challenges remain in achieving SDG targets by 2030. A multi-sectoral approach, integrating healthcare, nutrition, sanitation, and education, is essential for ensuring better maternal and child health outcomes. With continued policy focus and community participation, India can further reduce mortality rates and improve the overall health of mothers and children.