🗞️ Why in News A peer-reviewed study published in a leading medical journal (March 2026) found that India accounted for approximately 24,700 of the 2.4 lakh global maternal deaths in 2023 — making India one of the highest-burden countries globally, despite a 77% reduction in its Maternal Mortality Rate (MMR) since 1990.
Understanding Maternal Mortality
Maternal Mortality refers to the death of a woman during pregnancy, childbirth, or within 42 days of delivery, from causes related to or aggravated by the pregnancy or its management.
Maternal Mortality Rate (MMR): Defined as the number of maternal deaths per 1 lakh (100,000) live births in a given period.
Global Context (2023 Data)
| Indicator | Figure |
|---|---|
| Global maternal deaths (2023) | ~2,40,000 |
| India’s maternal deaths (2023) | ~24,700 |
| India’s MMR (2023) | 116 per 1 lakh live births |
| SDG target (by 2030) | Below 70 per 1 lakh live births |
| India’s MMR (1990) | 508 per 1 lakh live births |
| India’s MMR improvement | ~77% reduction in 33 years |
India’s Progress Trajectory
| Year | Approximate MMR | Major Programme Active |
|---|---|---|
| 1990 | 508 | No dedicated national programme |
| 2000 | ~380 | Reproductive and Child Health (RCH) programme |
| 2005 | ~280 | Janani Suraksha Yojana (JSY) launched |
| 2010 | ~212 | PMSMA introduced |
| 2015 | ~174 | NHM expansion; LaQshya programme conceptualised |
| 2020 | ~130 | Poshan Abhiyan; COVID-19 disruptions |
| 2023 | 116 | Current SDG tracking figure |
The Stalled Progress Problem
Sharpest improvement: 2000–2015. The rapid institutional delivery push, ASHA worker deployment, and JSY incentives produced dramatic reductions. However, progress has slowed significantly post-2015.
Why Progress Slowed
- Reaching the “hard to reach”: Easy institutional gains achieved; remaining deaths concentrated in remote, poorly-connected areas with weak health infrastructure
- Quality of care problem: Institutional delivery rates increased (~89% by NFHS-5, 2020), but institutional quality did not uniformly improve — skilled birth attendants, blood banks, and emergency obstetric care remain unavailable in many public facilities
- COVID-19 disruptions (2020–22): Maternal health services interrupted; delayed ANC check-ups; reduced institutional deliveries in some areas
- Indirect causes rising: Deaths from pre-existing hypertension, anaemia, diabetes, and obesity — conditions requiring longitudinal management, not just delivery-time intervention
Primary Causes of Maternal Deaths in India
- Haemorrhage (excessive bleeding): ~26% of maternal deaths — post-partum haemorrhage (PPH) remains the leading cause; requires blood availability and skilled staff
- Hypertensive disorders (pre-eclampsia/eclampsia): ~14% — requires early ANC detection
- Infections/Sepsis: ~11% — post-delivery infections, especially in poor-quality facilities
- Obstructed labour: ~9% — requires emergency obstetric care (C-section capability)
- Indirect causes (anaemia, malaria, heart disease): ~28% — pre-existing conditions complicating pregnancy
India’s Policy Response — Key Programmes
Janani Suraksha Yojana (JSY) — 2005
- Cash transfer to incentivise institutional delivery — Rs 1,400 (rural), Rs 1,000 (urban) per delivery
- ~1 crore beneficiaries annually
- Dramatically increased institutional delivery rate from 38.7% (2005) to 89% (2020)
Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) — 2016
- Free ANC check-up on the 9th of every month at government health facilities
- Covers all three trimesters
- Services: Blood pressure, blood group, Hb level, HIV test, USG (in select centres)
LaQshya Programme — 2017
- Labour Room Quality Improvement Initiative
- Improves quality of care in labour rooms and Maternity Operation Theatres (OTs) in district hospitals and medical colleges
- Certification of compliant facilities as “LaQshya Certified”
Poshan Abhiyan (National Nutrition Mission) — 2018
- Addresses maternal malnutrition — anaemia, low body weight
- Targets reducing anaemia among women of reproductive age by 3% per year
- India’s anaemia prevalence among women: 57% (NFHS-5, 2019–21) — major contributor to maternal mortality
Surakshit Matritva Aashwasan (SUMAN) — 2019
- Guarantees zero expenditure, dignified, respectful maternity care at public facilities
- Includes: Free delivery (normal and C-section), free diagnostics, free medicines, free diet during delivery
Regional Disparities
India’s MMR statistics mask severe internal disparities:
| State | Approximate MMR (2020) |
|---|---|
| Kerala | ~19 (near global best-practice) |
| Tamil Nadu | ~54 |
| Andhra Pradesh | ~45 |
| Rajasthan | ~163 |
| Madhya Pradesh | ~173 |
| Uttar Pradesh | ~167 |
| Bihar | ~130 |
The SDG challenge: Even if Kerala-level MMR is achieved nationally, the aggregate requires rapid improvement in the “BIMARU” states (Bihar, MP, Rajasthan, UP) which account for a disproportionate share of births and maternal deaths.
India’s SDG Commitment
India is a signatory to the Sustainable Development Goals (SDGs) adopted at the UN General Assembly in September 2015:
- SDG 3 (Good Health and Well-being): Target 3.1 — reduce global MMR to below 70 per 1,00,000 live births by 2030
- At India’s current rate of improvement (~5–8 MMR points per year since 2015), reaching 70 by 2030 would require accelerating the pace of improvement by 2–3x
- India’s National Health Policy 2017 set an internal target of MMR ≤100 by 2020 — not achieved; revised target: MMR ≤70 by 2030 (aligned with SDG)
UPSC Relevance
Prelims: India MMR 2023 = 116; SDG 3.1 target = 70 by 2030; India’s maternal deaths 2023 = ~24,700; JSY (2005); PMSMA; LaQshya; SUMAN (2019); Poshan Abhiyan.
Mains GS-2 (Social Justice/Health): Maternal health as a human rights issue; SDG 3; role of ASHA workers; institutional delivery vs. quality of care; federal health governance — Centre-state cooperation on maternal health.
Interview Angle: “India has raised institutional delivery rates to 89% — yet maternal deaths remain high. What does this tell us about the difference between access and quality in public health systems?”
📌 Facts Corner — Knowledgepedia
India Maternal Mortality — Complete Reference:
- MMR definition: Maternal deaths per 1 lakh live births
- India MMR (1990): 508 → (2023): 116 — 77% reduction
- India maternal deaths (2023): ~24,700
- Global maternal deaths (2023): ~2.4 lakh
- SDG 3.1 target: Below 70 per 1 lakh live births by 2030
- India NHP 2017 target: MMR ≤100 by 2020 (not achieved)
Key Programmes:
- JSY (2005): Cash incentive for institutional delivery; Rs 1,400 rural / Rs 1,000 urban
- PMSMA (2016): Free ANC on 9th of every month
- LaQshya (2017): Labour room quality improvement
- Poshan Abhiyan (2018): National Nutrition Mission targeting anaemia in women
- SUMAN (2019): Zero-expenditure dignified maternity care guarantee
ASHA Workers:
- Total: ~10 lakh ASHAs across India
- Role: Maternal health education, facilitating institutional delivery, JSY paperwork
- Trained by: State health departments under NHM
Other Relevant Facts:
- India’s institutional delivery rate: 38.7% (2005) → 89% (NFHS-5, 2020)
- Anaemia among women of reproductive age: 57% (NFHS-5) — major maternal mortality risk factor
- India’s NFHS-5 (2019–21): National Family Health Survey — key data source
- SDGs adopted: UN General Assembly, September 25, 2015 (replacing MDGs)
- MDG 5: Reduce MMR by 75% between 1990–2015 — India did not achieve this target in time
Sources: MoHFW, NITI Aayog SDG India Index, GKToday