India accounts for 15% of world’s maternal deaths: Report2 min read . Updated: 18 Sep 2016, 09:47 PM IST
Though India's maternal mortality ratio (MMR) is reducing at an average of 4.5% annually, it has to bring down MMR at the annual rate of 5.5%
New Delhi: One-third of the total deaths during pregnancy and childbirth in 2015 happened in India and Nigeria even as the total number of global maternal deaths has almost halved since 1990, a Lancet report revealed.
Worldwide, the annual number of maternal deaths per 100,000 live births fell by 44% between 1990 and 2015, from approximately 385 to 216. The sub-Saharan African region accounted for an estimated 66% (201,000) of global maternal deaths, followed by southern Asia at 22% (66,000 deaths).
Basically, only 5% of the world’s countries accounted for over half of maternal deaths. Nigeria with 58,000 deaths accounted for 19% and India at 45,000 deaths, accounted for 15% of the total deaths, according to the report—a series of six papers by an international team of researchers.
One of India’s millennium development goals (MDG) was to reduce its Maternal Mortality Ratio by three quarters. India did not reach this goal and its MMR stands at 174 and haemorrhages and infections still continue to be the leading causes.
According to the MDG mandate, India needs to reduce its MMR to 103. Though India’s MMR is reducing at an average of 4.5% annually, it has to bring down the MMR at the annual rate of 5.5% to meet the Millennium Development Goal.
While births in the presence of skilled birth attendants rose from 57% to 74% between 1990 and 2013, the report warns that many women in poor and rural settings do not have access to such care, while the increase in coverage does not necessarily mean such care is of high quality.
A key strategy for reducing maternal mortality is to ensure that every birth occurred with the assistance of a doctor, nurse, or midwife. The major challenge faced by India is lack of accurate information about births and deaths, particularly when women give birth at home.
The government is working towards addressing the issue of maternal deaths and to accelerate the pace of reduction of MMR across all states under its flagship health programme National Health Mission.
This includes promotion of institutional deliveries through Janani Suraksha Yojana, operationalization of sub-centres, primary health centres, community health centres and district hospitals for providing round the clock basic and comprehensive obstetric care.
The report also said that globally,caesarean section rates are rising in nearly every country and region,with 40.5% of all births being by caesarean section in Latin America and the Caribbean, and increases in some low-income countries in sub-Saharan Africa.
The past decade has seen India cross the WHO threshold (not to exceed 10-15%) for caesareans at an overall level, and leave it way behind in the case of births at private hospitals across several states and districts.
According to a 2016 Mint article, the share of caesarean deliveries in institutional births in India—a surgery that costs two to five times a normal delivery—has doubled in the past decade.
Even in public hospitals, 19 states or Union territories (UTs) have crossed the 15% threshold. But their incidence is much higher in private hospitals: the rate of caesareans in private hospitals is nearly thrice that in public hospital.