Lok Sabha Question No. 3205 (UNSTARRED), answered on 2019-12-06
Subject: Global Maternal Deaths
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Hema Malini, Chandeshwar Prasad

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE

## DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 3205 TO BE ANSWERED ON 6 TH DECEMBER, 2019

## GLOBAL MATERNAL DEAT HS

## 3205. SHRIMATI HEMA MALINI: SHRI CHANDRESHWAR PRASAD:

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

- (a) whether India has seen a significant redu tion 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 - wisereduction of MMR during the last five years;
- (d) whether India has the world's largest number of anaemic women, even thoughreducing 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, p 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 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,  indicato methodol ogies.

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, hemoglobinopath 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 tabl same  is  continued  during  the  post - natal  (lactating)  period  (till  180  days).  Pregn nt women, who are found to be clinically anaemic, are line listed given additiona tablets for taking two tablets daily and followed up for comprehensive managemen higher facilities.
- To tackle the problem of anaemia due to malaria particularly i n pregnant women and children,  Long  Lasting  Insecticide  Nets  (LLINs)  and  Insecticide  Treated  Bed  N (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.

(Source: RGI-SRS MMR Bulletin)

## ANNEXURE

## Maternal Mortality Ratio: India and State wise

|        |                | MMR-2011-13- SRS   | MMR-2014- 16-SRS   | MMR-2015- 17 SRS   |
|--------|----------------|--------------------|--------------------|--------------------|
| Sl. No | India/States   |                    |                    |                    |
|        | India          | 167                | 130                | 122                |
| 1      | Assam          | 300                | 237                | 229                |
| 2      | Bihar          |                    | 165                | 165                |
| 3      | Jharkhand      | 208                | 165                | 76                 |
| 4      | Madhya Pradesh |                    | 173                | 188                |
| 5      | Chhattisgarh   | 221                | 173                | 141                |
| 6      | Odisha         | 222                | 180                | 168                |
| 7      | Rajasthan      | 244                | 199                | 186                |
| 8      | Uttar Pradesh  |                    | 201                | 216                |
| 9      | Uttrakhand     | 285                | 201                | 89                 |
| 10     | Andhra Pradesh |                    | 74                 | 74                 |
| 11     | Telangana      | 92                 | 81                 | 76                 |
| 12     | Karnataka      | 133                | 108                | 97                 |
| 13     | Kerala         | 61                 | 46                 | 42                 |
| 14     | Tamil Nadu     | 79                 | 66                 | 63                 |
| 15     | Gujarat        | 112                | 91                 | 87                 |
| 16     | Haryana        | 127                | 101                | 98                 |
| 17     | Maharashtra    | 68                 | 61                 | 55                 |
| 18     | Punjab         | 141                | 122                | 122                |
| 19     | West Bengal    | 113                | 101                | 94                 |