COVID: INCREASE IN MATERNAL DEATHS AND STILLBIRTHS

Context:

The failure of the health system to cope with COVID-19 pandemic resulted in an increase in maternal deaths and stillbirths, according to a study published in The Lancet Global Health Journal.

Relevance:

GS-II: Social Justice (Issues Related to Women and Children, Health related issues)

Dimensions of the Article:

1. What is Maternal Mortality Ratio?
2. Recent decrease in MMR and its reasons
3. Highlights of the Lancet report
4. Way Forwards suggested

What is Maternal Mortality Ratio?

• Maternal Mortality Ratio (MMR) is the annual number of maternal deaths per 100,000 live births.
• Maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy.
• It is a key performance indicator for efforts to improve the health and safety of mothers before, during, and after childbirth.

Recent decrease in MMR and its reasons

• The Maternal Mortality Ratio (MMR) in India has declined to 113 in 2016­ – 18 from 122 in 2015 – ­17 and 130 in 2014-­2016, according to the special bulletin on Maternal Mortality in India 2016­ – 18, released by the Office of the Registrar General’s Sample Registration System (SRS).
• The MMR of various States according to the bulletin includes  Assam (215), Bihar (149), Madhya Pradesh (173), Chhattisgarh (159), Odisha (150), Rajasthan (164), Uttar Pradesh (197) and Uttarakhand (99).
• The southern States registered a lower MMR Andhra Pradesh (65), Telangana (63), Karnataka (92), Kerala (43) and Tamil Nadu (60).

Reasons for Declining MMR:

• Focus on quality and coverage of health services through public health initiatives have contributed majorly to the decline. Some of these initiatives are:

1. LaQshya,
2. Poshan Abhiyan,
3. Janani Suraksha Yojana,
4. Pradhan Mantri Surakshit Matritva Abhiyan
5. Pradhan Mantri Matru Vandana Yojana,

• The implementation of the Aspirational District Programme and inter-sectoral action has helped to reach the most marginalized and vulnerable population.
• Recently launched Surakshit Matritva Aashwasan Initiative (SUMAN) especially focuses on zero preventable maternal and newborn deaths.
• The continuous progress in reducing the MMR will help the country to achieve the SDG 3 target of MMR below 70 by 2030.

Highlights of the Lancet report

• Overall, there was a 28% increase in the odds of stillbirth, and the risk of mothers dying during pregnancy or childbirth increased by about one-third.
• There was also a rise in maternal depression.
• COVID-19 impact on pregnancy outcomes was disproportionately high on poorer countries.

Way Forwards suggested

• Policy makers and healthcare leaders must urgently investigate robust strategies for preserving safe and respectful maternity care, even during the ongoing global emergency.
• Immediate action is required to avoid rolling back decades of investment in reducing mother and infant mortality in low-resource settings.
• The authors recommend that personnel for maternity services not be redeployed for other critical and medical care during the pandemic and in response to future health system shocks.
• Further, wider societal changes could have also led to deterioration in maternal health including intimate-partner violence, loss of employment and additional care-responsibilities because of closure of schools.

-Source: The Hindu