There has been a decline of 22% in maternal mortality ratio, from 167 per 100,000 live births in 2013 to 130 in 2016; is the improvement satisfactory?
Of course, it is a great achievement for a country like India. What is more impressive is the rate of decline, which makes us believe that India will meet the target it has set for 2030 (bringing it under 100 per 100,000 live births) under the sustainable development goals.
What do you think worked for India?
Saving a woman’s life depends on the family, community and healthcare facility; and India has managed to make steady progress in these three areas.
The significant decline in maternal deaths is proof that people’s mind-set is beginning to change; more pregnant women are now visiting a hospital and most families are now not okay about a woman delivering at home.
The quality of care has improved and in remote areas we have adequately trained auxiliary nurse midwives and mid-wives, which is a big factor.
Also, providing transportation facility to the hospital and back is a big plus.
Do you think reduction in early marriages and adolescent pregnancies has played a role?
It’s true that pregnancy during adolescence is riskier but the largest number of pregnant women in India is still between the age group of 22 and 45. We have to focus on adolescences and beyond. We must understand that a pregnant woman can develop complications any time, and in most cases we cannot predict it so there has to be a sustained effort.
What are the challenges ahead?
I have a lot of confidence in India’s data collection system; it’s a huge cohort to be able to follow and India has managed quite well. Last mile is always a challenge; while nearly 80% women now deliver in a hospital, there still is about 20% left. There are good examples of states like Kerala, Maharashtra and Tamil Nadu and we must see what they did right and follow their practices.