The progress related to control of maternal mortality ratio (MMR) seems to have plateaued in Madhya Pradesh and Chhattisgarh with the two states recording combined dip of just nine points in the ratio just a year after they recorded a whopping 39-point dip in the MMR.
The MMR is the number of women who succumb to complications related to pregnancy or childbearing in a given year per one lakh live births in that year. It showcases the quality of maternal health and safe childbirth services available in state as well as the health status of women of state.
The special bulletin on MMR for the period 2011-13, released by the Registrar General of India (RGI) on Monday, shows that the combined MMR in MP/Chhattisgarh has gone down to 221 from 230 in 2010-12. This is lower than the 11 point dip at national level for the same comparative period (167 from 178).
The best performer in country is Kerala with MMR of merely 61, quite lower than the national average. In 2010-12, MP and Chhattisgarh had shown a massive dip of 39 points compared to the period of 2007-09 (230 from 269). In this period the national average of MMR dip was 34 points.
The RGI has released the latest MMR figures for three different categories of states – the empowered action group (EAG) states and Assam, the southern states and the other states of India.
Being part of the EAG states, Madhya Pradesh and Chhattisgarh are considered among the worst performers in context of most health and development indices including maternal health. But the solace is that the two states together are second best performers amongst the lot behind Bihar and Jharkhand combined (MMR – 208). The other states in EAG include Orissa, Rajasthan, Uttar Pradesh and Uttarakhand.
The worst performer state is Assam with MMR of 300 (for 2011-13), but it has made a big achievement by recording 28 point dip compared to 2010-12, when it had MMR of 328. Activist Sachin Jain, who is advisor to the Supreme Court appointed commissioners in Right to Food case, said that the lack of comprehensive approach towards women and child health was a big problem.
There was no convergence between the health and the women and child development department in this regard. "The good result of last year was probably fruits of short term approach, but the impact did not last long," he said.
Javed Anis, secretary of MP Lok Sangharsh Sajha Manch said that target-oriented approach would not help and working with the community for behavioural changes and improving health services were imperative.
Trevor Clark, chief of UNICEF MP office said that drop in maternal mortality was a positive sign as more mothers are being saved. "But need is to accelerate the decline by improving the quality of care at facility level, early identification of high risk mothers, and infection control and management."
Principal Secretary of health department, Pravir Krishn, responding to the trend, said that it has to be understood that MMR for 2010-12 was 230 and for 2011-13 it is 221, which means that maternal deaths of 2011 and 2012 are common for both estimates while deaths for 2010 are replaced by that in 2013. Also the figures are combined for MP and Chhattisgarh.
"We continue with the downward slide. The only problem is that we have a huge backlog which needs continuous efforts that are afoot in each village now. Mamta Tech is the way forward to launch the quantum jump we need to propel it to the next phase. Change is round the corner," Krishn said.