Maternal mortality rate falls

But there is a long way to go

Maternal mortality, which remains high in India, indicating the country's deficit in human development, has nevertheless been steadily going down. The latest official figures, which measure the number of maternal deaths per 100,000 live births for the period 2010-12, indicate that maternal deaths in childbirth have fallen by more than half (55 per cent) over one and a half decades (1997-2012). The rate of decline over three three-year periods (covering 2003-2012) has been 14-17 per cent. But within this overall picture, the numbers offer an insight into the composition of the change. The decline is being achieved in good part by rapid progress by the most backward states. Thus, the difference between the best and the worst is narrowing. The difference between the best and the worst has fallen from 336 deaths in 1997-98 to 152 in 2010-12. Taking states individually, the difference between the worst (the highest in deaths), Assam, and the best (the lowest), Kerala, fell from 309 in 2007-09 to 262 in 2010-12.

Given this backdrop, in order to understand the task ahead, it is important to look at where individual states stand. Their divergence captures the reality that while the worst districts in the laggard states have sometimes performed worse than sub-Saharan Africa, the best-performing states, such as Kerala and Tamil Nadu, have reported numbers close to those of developing countries. According to the latest data, the worst laggard is Assam, followed by Uttar Pradesh/Uttarakhand, Rajasthan and Odisha. Kerala, Maharashtra and Tamil Nadu are in the lead. What makes it interesting is that Maharashtra and West Bengal, though not in the south, really belong to the leading group, whereas Karnataka, a southern state, lags behind the two. A similar varied picture emerges when we look at progress made by different states in different groups. Many of the worst states have run faster than the best. In the nine-year period (2003-12), as many as 10 states - including most of the worst - have improved their mortality count (in other words, reduced it) by nearly a third (around 30 per cent), with the lead being taken by Rajasthan and Uttar Pradesh/Uttarakhand. The absolute laggard is West Bengal (17 per cent), followed by Tamil Nadu, Punjab, Haryana and Odisha (22.4 per cent). Gujarat appears roughly in the middle at 23.7 per cent.

What about international comparisons? According to the 2010 figures from the "World Development Indicators", South Korea has a maternal mortality count of 16, followed by Sri Lanka (35) and China (37). India is way below at 200, lagging behind even Nepal (170). The three regional countries that are behind India are Indonesia (220), Bangladesh (240) and Pakistan (260). India should do at least as well as Nepal - clearly, much remains to be done.