Demystifying Data: Maternal Healthcare

by BUSHRA ANSARI | 15 March, 2024
Demystifying Data: Maternal Healthcare
Author Bushra Ansari | Published: 15 March, 2024

According to a report released by United Nations agencies, the global Maternal Mortality Ratio (MMR) in 2020 was estimated at 223 maternal deaths per 100,000 live births. In 2020, an estimated 287,000 women globally died from a maternal cause, equivalent to almost 800 maternal deaths every day, or approximately one every two minutes. As per the Government of India, the MMR was 97 maternal deaths per 100,000 live births in 2020. MMR is the number of maternal deaths due to complications in pregnancy or childbirth during a given time period per 100,000 live births during the same time period.

Poor health (anemia, malnutrition, chronic diseases such as hypertension and diabetes) has repercussions not only for women but also for their families. Women in poor health are more likely to give birth to low-weight infants. They also are less likely to be able to provide food and adequate care for their children. Finally, a woman’s health affects the household's economic well-being, as a woman in poor health will be less productive in the labour force.

1. MMR in India has declined over the years from 130 in 2016 to 97 in 2020
MMR in India has declined over the years from 130 in 2016 to 97 in 2020

Data Source- Sample Registration System, Ministry of Home Affairs(SRS, MHA)

India is making steady progress towards achieving Target 3.1 of the United Nations' Sustainable Development Goals (SDGs), which aims to reduce the global MMR to less than 70 per 100,000 live births by 2030.

Health infrastructure and female literacy have emerged as the significant correlates of MMR. Initiatives such as Surakshit Matritva Anushasan (SUMAN) and Labour Room & Quality Improvement Initiative (LaQshya) have played a pivotal role in increasing the number of institutional deliveries from 79 per cent in 2015- 16 to 89 per cent in 2019-20. Around 87 per cent births in rural areas and 94 per cent births in urban areas are institutional deliveries.

2. Maternal mortality landscape in 2020: Kerala records lowest MMR, Assam highest
Maternal mortality landscape in 2020: Kerala records lowest MMR, Assam highest

Data Source- SRS, MHA

Because of the wide variation in cultures, religions, and levels of development across India, it is not surprising that women’s health also varies greatly from state to state.

Assam has India's highest MMR, at 195 per 100,000 live births. Roughly 54% of pregnant women (15-49 years) in Assam are anemic, likely due to poverty, illiteracy, and lack of awareness about iron-folic acid tablets and their benefits. A study at a hospital in eastern Uttar Pradesh found that lack of intensive care unit (ICU) beds, high ICU costs, and inadequate antenatal visits led to high MMR. A brief on maternal and neonatal mortality in Madhya Pradesh listed poor coverage of antenatal care, sub-optimal health facilities, and inadequate number of staff nurses and specialists as high MMR causes. One in five pregnant women in MP deliver at home. NMR (Neonatal Mortality Rate), IMR (Infant Mortality Rate), and U5MR (Under-Five Mortality Rate) are highest among women who delivered at home.

3. 94.6% of total reported deliveries were institutional in year 2021-2022
94.6% of total reported deliveries were institutional in year 2021-2022

Data Source- Health Management Information System, Ministry of Health & Family Welfare

Home births without skilled birth attendants (SBA) can raise risks for both the mother and the baby. Financial constraints, lack of proper transportation facilities, non- accessibility of healthcare institutions and not getting permission from family members were the main reasons cited by the women for delivering at home. It is essential to strengthen public healthcare facilities and effectively use skilled birth attendants and their networks

4. Women with more education are more likely to receive skilled antenatal care (ANC)
Women with more education are more likely to receive skilled antenatal care (ANC)

*Skilled provider includes doctor, auxiliary nurse midwife, nurse, midwife, and lady health visitor
Data Source- National Family Health Survey-5 (2019-2021)

Education plays a significant role in empowering women to make informed decisions during their pregnancy journey and reduces the likelihood of them feeling shame or discomfort when seeking ANC services. Additionally, education enhances women's access to ANC services, equipping them with the knowledge of where to locate these facilities and the financial means to afford them. Through ANC, women can learn from skilled health personnel about healthy behaviors during pregnancy, better understand warning signs during pregnancy and childbirth, and receive social, emotional, and psychological support.

In 2022, the Bikaner district in Rajasthan launched an awareness drive called 'Pukar' to educate pregnant and lactating women, as well as adolescent girls, about maternal and child health. This initiative involved government representatives spreading vital information about institutional deliveries, nutrition during pregnancy, essential tests, and vaccinations to over 2.34 lakh women and 92,300 adolescent girls. As a result, maternal deaths in the district dropped from 70 in 2021 to 32 in 2022. Similarly, the Telangana government's KCR Kits scheme, launched in 2017, has significantly increased institutional deliveries in government hospitals, from 30.5% in 2017 to 56% in 2022. The scheme offers financial support to mothers, provides free prenatal to post-delivery tests and immunization vaccines, and distributes a kit containing items essential for infants and lactating mothers.

It is crucial to scale up efforts to support girls and women across various metrics, such as education, healthcare access, community engagement, and economic participation. Enhancing women's healthcare and encouraging them to take ownership of their health and hygiene through equal access to high-quality care are important strategies. A decentralized approach can be adopted by empowering community-level platforms, such as self-help groups, anganwadi centres, village health committees, and mahila mandals, to raise awareness of women's safety, sexual and reproductive health, and family planning choices.

(Author Bushra Ansari is a Data Analyst at ISDM DataSights, supported by Capgemini)

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