India's Journey Towards Better Maternal and Child Health: A Milestone in Progress

India has achieved significant progress in maternal and child health, as reported in the SRS 2021. Key health indicators such as Maternal Mortality Ratio (MMR), Infant Mortality Rate (IMR), Neonatal Mortality Rate (NMR), and Under-Five Mortality Rate (U5MR) show steady declines. India outpaces global trends, with an 86% drop in MMR since 1990. Initiatives like Ayushman Bharat, enhanced public health infrastructure, skilled healthcare workers, and digital surveillance have driven these gains, positioning India on track to meet its 2030 Sustainable Development Goals (SDG).

India has made remarkable strides in improving maternal and child health outcomes, as highlighted in the Sample Registration System (SRS) Report 2021, published by the Registrar General of India under the Ministry of Health and Family Welfare (MoHFW). The report reveals a steady decline in critical health indicators, including the Maternal Mortality Ratio (MMR), Infant Mortality Rate (IMR), Neonatal Mortality Rate (NMR), and Under-Five Mortality Rate (U5MR). These achievements not only position India ahead of global averages in some areas but also signal its alignment with the Sustainable Development Goals (SDG) for 2030.

Decoding the Key Metrics

Understanding the progress requires familiarity with key health indicators:

• Maternal Mortality Ratio (MMR): Tracks maternal deaths during pregnancy or within 42 days of childbirth per 100,000 live births. It reflects the accessibility and quality of maternal care.

• Infant Mortality Rate (IMR): Measures deaths of infants under one year per 1,000 live births.

• Neonatal Mortality Rate (NMR): Focuses on deaths within the first 28 days of life per 1,000 live births, emphasizing maternal and neonatal care quality.

• Under-Five Mortality Rate (U5MR): Indicates the likelihood of a child dying before the age of five, per 1,000 live births.

• Total Fertility Rate (TFR): Represents the average number of children a woman is expected to have based on current fertility trends.

• Sex Ratio at Birth: Records the number of female births per 1,000 male births, with deviations often pointing to gender bias.

Progress in Numbers: A Positive Shift

The SRS 2021 report underscores substantial progress across the board:

• MMR: Dropped from 130 (2014–16) to 93 (2019–21) per 100,000 live births.

• IMR: Declined from 39 (2014) to 27 (2021) per 1,000 live births.

• NMR: Fell from 26 (2014) to 19 (2021) per 1,000 live births.

• U5MR: Reduced from 45 (2014) to 31 (2021) per 1,000 live births.

• Sex Ratio at Birth: Improved from 899 females per 1,000 males in 2014 to 913 in 2021.

• TFR: Declined from 2.3 (2014) to 2.0 (2021), indicating stabilization.

Outperforming Global Trends

India's progress stands out in comparison to global benchmarks, as reported by international agencies:

• According to the UN Maternal Mortality Estimation Inter-agency Group (2023), India achieved an 86% reduction in MMR from 1990 to 2023, significantly higher than the global decline of 48%.

• The UN Inter-agency Group for Child Mortality Estimation (2024) highlights India’s accomplishments:

  • U5MR: Decreased by 78% in India, compared to a global reduction of 61%.

  • NMR: Dropped by 70% in India, surpassing the 54% global decline.

  • IMR: Fell by 71% in India, outpacing the global decline of 58%.

The Ministry of Health and Family Welfare acknowledges these achievements as placing India among the top-performing nations in reducing child mortality rates globally.

Factors Driving the Progress

The improvements stem from a combination of targeted policies and initiatives:

1. Ayushman Bharat Scheme: Offering health insurance and improving access to quality care.

2. Enhanced Public Health Infrastructure: Establishing maternity waiting homes, maternal and child health units, and sick newborn care units (SNCUs).

3. Skilled Workforce: Deploying trained birth attendants and midwives to enhance delivery outcomes.

4. Evidence-Based Practices: Introducing antenatal corticosteroids and CPAP therapy to improve neonatal survival rates.

5. Digital Surveillance: Leveraging technology to monitor maternal and child health outcomes.

The MoHFW has emphasized that these programs prioritize free, high-quality care for vulnerable populations, ensuring that no one is denied essential services.

A Roadmap for the Future

As India continues to advance in maternal and child health metrics, its achievements exemplify the impact of focused policies and robust implementation. With sustained efforts, India is well-positioned to meet its 2030 SDG targets, setting a benchmark for other nations striving to improve healthcare outcomes.