Question : Global Maternal Deaths

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) whether India has seen a significant reduction in maternal mortality in recent years but it still accounts for a large share of the global maternal deaths as most women in rural parts of the country still lack access to quality maternity care;

(b) if so, the details thereof;

(c) the details of State/UT-wise reduction of MMR during the last five years;

(d) whether India has the world’s largest number of anaemic women, even though reducing its prevalence is a priority for the Government; and

(e) if so, the details thereof?

ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND
FAMILY WELFARE
(SHRI ASHWINI KUMAR CHOUBEY)
(a) to (c): Registrar General of India provides estimates on fertility and mortality using the Sample Registration System (SRS).

As per the report of Sample Registration System (SRS) 2015-17 released by Registrar General of India (RGI), Maternal Mortality Ratio (MMR) of India reduced from 167, per 100,000 live births in SRS 2011-13 to 130 in SRS 2014-16 which has further reduced to 122 per 100,000 live births is 2015-17.


Maternal Mortality Estimation Inter – Agency Group (MMEIG) provides global estimates of MMR.


As per the report of MMEIG 2017, the global MMR is estimated as 211 maternal deaths per 100,000 live births & India estimates 145 maternal deaths per 100,000 live births. India accounts12% of the global maternal deaths.



The difference in two figures is due to different time period & methodologies. However, the average annual rate of reduction (ARR) in global MMR during the 2000–2017 period was 2.9% while India’s MMR has declined by 8% in SRS 2014-16 as compared to previous survey in 2011-13 and furthermore declined by 6.15% in 2015-17 as compared to previous survey 2014-16, which is higher than the global decline.

The detailed State/UT wise MMR is placed at Annexure.

(d) & (e): As per WHO report on worldwide prevalence of anaemia 1993-2005, in India the proportion of non-pregnant women of reproductive age (15-49.9 years) who are anaemic (Hb<12gm/dl) is 52%.

As per NFHS-IV (2015-16), all women age (15-49 years) who are anaemic is 53.1%.

The difference in two figures is due to different time period, indicators & methodologies.

Under the RMNCAH+N in National Health Mission, MoHFW is carrying out following for management of anaemia:

1. Anaemia Mukt Bharat strategy has been launched for prophylactic supplementation and therapeutic treatment of anemia by Iron Folic Acid in children (6-59 months), pre- school children (5-9 years), adolescents girls and boys (10-19 years), pregnant and lactating women and in women of reproductive age group (15-49 years) in programme mode through life cycle approach. The strategy also intends to address non-nutritional causes of anemia in endemic pockets, with special focus on malaria, hemoglobinopathies and fluorosis.
Additionally, strategy proposes:
? Universal screening of pregnant women for anaemia. Every pregnant woman is given 180 tablets of iron and folic acid, after the first trimester, to be taken 1 tablet daily and same is continued during the post-natal (lactating) period (till 180 days). Pregnant women, who are found to be clinically anaemic, are line listed given additional 180 tablets for taking two tablets daily and followed up for comprehensive management at higher facilities.
? To tackle the problem of anaemia due to malaria particularly in pregnant women and children, Long Lasting Insecticide Nets (LLINs) and Insecticide Treated Bed Nets (ITBNs) are being distributed.
2. Monthly Village Health and Nutrition Days (VHND) as an outreach activity at Anganwadi centers for provision of maternal and child care including nutrition in convergence with the ICDS.