Bihar has registered a 12-point drop, from 130 to 118 per lakh live births in maternal mortality ratio (MMR), which in common parlance is the number of women dying from pregnancy-related issues, between 2017-19 and 2018-20, respectively, according to a special health ministry bulletin as part of the Sample Registration System (SRS) 2018-20, released on Tuesday, said state health officials.
The state’s MMR, also an indicator of the reproductive health of women in the area, was, however, higher than the national average of 97 per lakh live births, said the official, quoting from the report.
Assam was the worst with MMR of 195 per lakh live births, followed by Madhya Pradesh 173, Uttar Pradesh 167, Chhattisgarh 137, Odisha 119, Bihar (118) and Rajasthan (113). Jharkhand (56) and Uttarakhand (103) were the two states better than Bihar among the nine empowered action group (EAG) states on the MMR parameter, the report said.
The states in the EAG are worse off in MMR.
Madhya Pradesh, Uttarakhand and Haryana were the only three states, which showed a negative growth rate. The MMR in case of Haryana rose by 14 points from 96 per lakh live births in 2017-19 to 110 in 2018-20, Madhya Pradesh by 10 points from 163 per lakh live births in 2017-19 to 173 in 2018-20; and 2 points in case of Uttarakhand from 101 to 103 during the same period.
Despite the improvement, Bihar’s state ranking slid from 14 in 2017-19 to 15 in 2018-20 on the MMR national index.
Among the major interventions Bihar had taken to improve its MMR score were on-job training of labour room staff, posting of specialist doctors at level 3 hospitals or the first referral units (FRUs), functionalising FRUs, vigorously pursuing the anaemia mukta Bharat initiative and quality improvement initiatives such as LaQshya, which is quality improvement initiative in labour room and maternity operation theatre, aimed at improving quality of care for mothers and newborn; strengthening supply chain management by ensuring availability of drugs in the essential drugs list, as also improving ambulance service through public-private partnership, said the official quoted above.
The CARE India has been working closely with the state government to improve the skill of nurses and auxiliary nursing midwives (ANMs), and is implementing a nurse mentoring program called AMANAT, which aims to build the capacity of nurses and ANMs to manage childbirth complications and provide basic emergency obstetric and newborn care and other reproductive health services including family planning, he added.
The Sustainable Development Goals (SDG), set by the United Nations aims at reducing the global maternal mortality ratio, which is the proportion of maternal deaths per 100,000 live births, to less than 70 per one lakh live births by 2030, said the official quoted above.
Maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes, according to the World Health Organisation.