New Delhi: India had the highest number of maternal deaths, accounting for almost a fifth of the global total in 2013, according to the latest UN report.

In 2013, maternal deaths in India stood at 50,000, or 17% of such deaths across the world, the report said. Global maternal mortality has, however, dropped 45% in 2013 compared with 1990.

“In India, even though we strive for institutional deliveries and have successfully managed to increase them, the facilities within the institutions are not adequate enough to give women post-natal care for 48 hours as is required," said Sona Sharma, joint director of advocacy and communications at Population Fund of India, a civil society group that looks at population issues and reproductive health care. “Secondly, the focus on family planning is not adequate. Studies have suggested that there is a strong link between family planning and reduction in maternal mortality, hence the government should increase its focus on this aspect," she added.

The global maternal mortality ratio (MMR) dropped to 210 maternal deaths per 100,000 live births from 380 maternal deaths in 1990. Maternal mortality has declined to 190 in 2013 from 530 in 1990 in South Asia.

A separate study by British medical journal Lancet on Tuesday said more than one in four maternal deaths in the world are caused by medical conditions such as diabetes, HIV, malaria and obesity, highlighting the changing conditions that cause maternal deaths.

“The new data show a changing profile in the conditions that cause maternal deaths; reflecting the increasing burden of non-communicable diseases in women throughout the world. Ending preventable maternal deaths will require both continued efforts to reduce complications directly related to pregnancy, and more of a focus on noncommunicable diseases and their effect in pregnancy," Marleen Temmerman, director of reproductive health and research at World Health Organization and co-author of the study, said in a statement.

While Sub-Saharan Africa was the poorest performer, the highest risk of maternal death is in Chad where one in 15 pregnant women die.

“Relatively simple and well-known interventions, like midwifery services and gender-based violence prevention and response, can make a huge difference if scaled up and coupled with investments in innovations, especially in the area of contraceptives." said Kate Gilmore, deputy executive director, United Nations Population Fund (UNFPA).

Despite the progress in reducing maternal deaths, the UN report noted that progress was not fast enough and that lack of complete government health records is one of the primary culprits. Adding that only one-third of all deaths worldwide are recorded, the United Nations Commission on Information and Accountability for Women’s and Children’s Health has said that by 2015, all countries are required to have taken significant steps to establish a system for registration of births, deaths and causes of death.

The report also highlighted that most countries will fail to meet the Millennium Development Goals (MDGs) target of a 75% reduction in MMR from 1990 to 2015. The report pointed out that less than 40% of countries have a complete civil registration system with a good attribution of cause of death, which is necessary for the accurate measurement of maternal mortality.

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