Despite significant progress in reducing Maternal Mortality Ratio, India continues to face challenges in achieving SDG targets uniformly across states. Critically examine the gaps and suggest measures the SUMAN Roadmap 2030 can address.

Q. Despite significant progress in reducing Maternal Mortality Ratio, India continues to face challenges in achieving SDG targets uniformly across states. Critically examine the gaps and suggest measures the SUMAN Roadmap 2030 can address. (15 marks, 250-350 words)

India's maternal health record is one of measured success: MMR has fallen 86% between 1990 and 2023 against a global decline of 48% [4], yet the national average of 87 per 1,00,000 live births masks sharp inter-state divergence from the SDG target of 70 [2].

Progress achieved - MMR has declined from 130 (2014–16) to 87 [2]; NMR fell 70% since 1990 against 54% globally, placing India among top performers in child-mortality reduction [4]. - SUMAN (2019) guarantees zero-cost, zero-denial, respectful care for every pregnant woman and sick newborn at public health facilities [3].

Persisting gaps - Uneven federal performance: only eight states — Kerala (20) to Karnataka (63) — have met the SDG MMR target, while high-burden EAG states remain far behind [4]. - Newborn survival lags further: just six states/UTs have achieved NMR ≤12 [4], showing that facility-based quality of care, not access alone, is the binding constraint. - Health is a State subject (Seventh Schedule, List II, Entry 6); differential absorptive capacity, labour-room staffing shortages and weak referral chains dilute uniform outcomes. - Demand-side vulnerabilities — anaemia, adolescent pregnancy, delayed transport — and dignity violations persist despite the zero-denial mandate [3].

Measures the Roadmap addresses - Targeted geography: customised high-risk pregnancy management in 130 high-focus districts across 13 states [1]. - Institutional depth: Centres of Excellence for maternal and newborn healthcare with stronger inter-facility referral linkages [1]. - Accountability: the JANANI Portal for digital monitoring and a centralised SUMAN Call Centre for grievance redressal [1]. - Convergence with PMSMA's assured antenatal care [3] and quality protocols for labour rooms.

India's challenge has thus shifted from expanding access to guaranteeing uniform quality and dignity of care. If the Roadmap's district-level targeting and digital accountability are matched by predictable NHM financing and trained midwifery cadres in lagging states, the goal of zero preventable maternal and newborn deaths [1] is achievable — realising both SDG-3 and the Article 21 promise of health as a right.

(~305 words)

Sources: 1. Union Health Minister Shri Jagat Prakash Nadda Launches 'SUMAN Roadmap 2030' to Strengthen Maternal and Newborn Healthcare, PIB (29 June 2026) — Roadmap design: 130 high-focus districts, Centres of Excellence, JANANI Portal, SUMAN Call Centre, zero preventable deaths goal 2. Union Health Minister Chairs 16th Conference of the Central Council of Health and Family Welfare, PIB (29 June 2026) — current MMR of 87, decline from 130 (2014–16), SDG target of 70 3. Steps taken by Government of India to improve Women's Health, PIB — SUMAN's zero-cost, zero-denial, respectful care mandate; PMSMA assured antenatal care 4. India witnesses a steady downward trend in maternal and child mortality towards achievement of SDG 2030 targets, PIB — 86% MMR decline vs 48% global, 70% NMR decline vs 54% global, states meeting SDG MMR/NMR thresholds