(a) whether India tops in the pregnancy related deaths per year as per the WHO report;
(b) if so, the reasons therefor;
(c) the figures in this regard for the last three years, State-wise; and
(d) the steps taken by the Government to reduce such deaths?
THE MINISTER OF CHEMICALS & FERTILIZERS
(SHRI SURESH P. PRABHU)
(a)to(d): A statement is laid on the table of the Lok Sabha.
Statement referred to in reply to Lok Sabha Starred
Question No. 702 for 16.05.2000
a) Although pregnancy related mortality in India is high,
it is not the highest in the world. The World Health Report
1999 published by WHO gives estimations of Maternal
Mortality Ratio (MMR) in respect of various countries for
the year 1990. According to this Report, MMR in India in
1990 was 570 per 100,000 live births. Among our neigbouring
countries MMR in Bangladesh for the same period was 850, in
Nepal 1500 and Bhutan it was 1600.
The National Family Health Survey 1992-93 estimated the
then Maternal Mortality Ratio for India at 437 per 100,000
live births. The latest report of Registrar General of India
1997 places MMR at 408 per 100,000 live births.
b) The main causes for such pregnancy related deaths are :
Direct causes: haemorrhage, infection, abortion,
eclampsia and obstructed labour;
Indirect causes : anaemia, viral hepatitis,
tuberculosis and Malaria;
Socio-economic causes: early age of marriage; adolescent
pregnancies; low status of women; low level of female;
education; lack of access to health services; gender
bias and economic dependency.
(c) The figures of MMR for the last three years are not
available on an annual basis. The Statewise data for 15
major States as per the Registrar General of India Report
1997 is annexed.
(d) Maternal health care is an integral part of the Family
Welfare Programme. Certain vertical interventions like
National Nutritional Anaemia Control Programme and Tetanus
Immunisation Programme for pregnant mothers have been going
on under the Family Welfare Progrmme. In 1992, the
nationwide Child Survival and Safe Motherhood (CSSM) [1992-
97] was launched with World Bank support for integrating
various vertical interventions in the area of maternal and
child health. . The Reproductive and Child Health Programme
which was launched in 1997 for five years, continues by way
of strengthening of the CSSM activities along with certain
new programmes. The major RCH programmes are :
1. Essential obstetric care.
2. Emergency obstetric care.
3. Provision of contractual or part-time appointment of
Anaesthesists, Gynaecologists, Safe Motherhood
consultants and technical staff like Laboratory
Technician, Public Health, Nurses, etc.
4. Provision of drugs and equipment for Maternal Health at
sub-centres, primary health centres, community health
centres / first referral units.
5. A scheme for 24 hour delivery services at selected
primary health centres and community health centres.
6. Additional ANMs for backward districts.
7 Referral transport for pregnant women for eight backward
States.
8. Facilities and training for medical termination of
pregnancies for safe abortions.
9. Prevention, management and control of Reproductive Tract
Infections (RTI)/ Sexually Transmitted Infections (STI).
10.Intensification of Information, Education and
Communication (IEC) Programmes for Maternal and Child
Health through the mass media as also decentralised local
specific activities at the grassroot level.
11.Involvement of NGOs in awareness generation and service
delivery where government services are not adequate.
12. Training of medical / paramedical and other service
providers.
13. Training of Dais.
The need for bringing down MMR considerably and improving
maternal health in general has been strongly stressed in the
National Population Policy which has recently been approved
by the Government. This Policy recommends a holistic
strategy for bringing about total inter-sectoral
coordination at the grassroot level and also for involving
the NGOs, civil society, Panchayati Raj Institutions and
women`s groups in bringing down MMR and Infant Mortality
Ratio
ANNEXURE
Maternal Mortality Ratio (per 100,000 live births) India and
bigger States, 1997
Places MMR
India 408 Andhra Pradesh 154 Assam 401 Bihar 451 Gujarat 29 Haryana 105 Karnataka 195 Kerala 195 Madhya Pradesh 498 Maharashtra 135 Orissa 361 Punjab 196 Rajasthan 677 Tamil Nadu 76 Uttar Pradesh 707 West Bengal 264
Source: SRS, RG India