Mortality Numbers Lower @ whatisindia.com Thursday, November 02, 2006 18:38:34 IST

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The Federal Government claimed Maternal Mortality Rate (MMR) declined to 301 per one hundred thousand and said that six states continued to be worrisome but announced various incentives to encourage women to go for institutional delivery. Health Secretary P.K. Hota releasing the findings of a survey conducted by the Registrar General of India announced that the MMR “declined to 301 in 2001-03 as against 398 in 1997-98 and 327 in 1999-01.”

Uttar Pradesh (517), Assam (490), Rajasthan (445), Madhya Pradesh (379), Bihar (371), and Orissa (358) were identified as states where there continues to be an alarmingly high number of maternity deaths during childbirth ranging from 368 to 517. The best performing states were Kerala, Tamil Nadu, Maharashtra , Haryana, and Gujarat . Hota says that the new Federal incentives to encourage pregnant women to use hospital services “will be given Rs 2,000 each” and also upping its incentive program for men and women to opt for sterilization.

However, the figure cited by the Health Ministry is a sleight of hand. By stating the Meta numbers, they conceal that one in five women die at giving birth. However, the retire Hota highlighted that even though the Meta numbers showed progress, “there is no substitute to women's education, increasing age of marriage and institutional delivery.” While it is not surprising to see Uttar Pradesh, Bihar , and Orissa on the worst performer list is not surprising, it is shocking that Rajasthan and Madhya Pradesh have such high numbers. Communist bastion West Bengal claiming to be erudite is another shocking revelation.

Awareness on better nutrition for the mother, higher age of marriage of girls, and availability of better medical facilities in the past decade are good developments that are directly attributable for the lowering of these numbers. However, as pointed out recently by the Director of the World Food Program in India, lack of nutrition and the lack of awareness are prime reasons for high levels of child mortality—which fell from 70 per 100 thousand to 58 from 1997 to 2004. However, the Meta figures are again misleading as Bihar alone accounts for over 500 avoidable dead children a day.

Except for Assam , there is correlation between high population and high mortality and except Kerala there is a correlation between high economic growth and low mortality. Kerala fortunately has the advantage of higher levels of literacy and that is helping that state achieve lower MMR even though its economy is in shambles. Further, the better performing states apparently have higher incentives that encourage institutional deliveries and better medical facilities. Lack of medical facilities and lack of awareness are causing 2/5 of the women in poorly performing states to give birth at home.

The survey found hemorrhage as the chief cause of deaths and mothers delivering the second child soon after the first were identified as a high-risk population. An earlier survey suggested that Dalits opted for in-home deliveries while Christians and Muslims preferred institutional deliveries.