Steps taken for Reducing Maternal Mortality

1. At a Glance

• Maternal Mortality Ratio (MMR) = maternal deaths per 1,00,000 live births; India's latest MMR (SRS 2021-23) = 88 [1][2].
• Reducing MMR is central to SDG-3.1 (target: <70 by 2030) and to India's flagship National Health Mission (NHM) package under Ministry of Health & Family Welfare (MoHFW) [2][5].
• Topic clusters multiple GS-II welfare schemes (JSY, JSSK, PMSMA, SUMAN, LaQshya) — a high-yield Prelims + Mains theme on women & child health [3].

2. Why in the News

• PIB release, 13 March 2026 — MoHFW reported MMR has fallen to 88 per lakh live births (SRS 2021-23) and that 5.93 crore institutional deliveries were conducted in the last three years [1].
• Release consolidated the full step-ladder of MMR-reducing schemes (JSY, JSSK, PMSMA, Extended PMSMA, LaQshya, SUMAN, FRUs, MCH Wings, Birth Homes) [1].

3. Background & Evolution

• 2005: Janani Suraksha Yojana (JSY) launched under NRHM — cash incentive for institutional delivery [2].
• 2011: Janani Shishu Suraksha Karyakram (JSSK) — free delivery, C-section, drugs, diagnostics, transport, blood; zero out-of-pocket expense [2].
• 2016: Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) — free ANC on the 9th of every month by OB-GYN specialists [2].
• 2017: LaQshya (Labour Room Quality Improvement Initiative) — labour-room & maternity-OT quality [2].
• 2019: SUMAN (Surakshit Matritva Aashwasan) — assured, dignified, respectful care; zero denial of services [2].
• MMR trajectory (SRS): 130 (2014-16) → 122 (2015-17) → 113 (2016-18) → 103 (2017-19) → 97 (2018-20) → 88 (2021-23) [2][4][1].

4. Core Static Facts

• Definition (MMR): maternal deaths per 1,00,000 live births during pregnancy/childbirth/42 days postpartum [2].
• Source agency: Sample Registration System (SRS), Office of the Registrar General of India (RGI) — under MHA [1].
• Nodal ministry: MoHFW; umbrella programme = National Health Mission [2].
• SDG-3.1 target: MMR < 70 / lakh live births by 2030 [5].
• National goal under NHP 2017: MMR 100 by 2020 (already met) [5].
• Key schemes: JSY (2005), JSSK (2011), PMSMA (2016), LaQshya (2017), SUMAN (2019), Extended PMSMA (high-risk pregnancy tracking & incentives) [1][2].
• Infrastructure: First Referral Units (FRUs), Maternal & Child Health (MCH) Wings, Birth Waiting Homes / Birth Homes [1].
• Recent output: 5.93 crore institutional deliveries in the last 3 years [1].

5. Multi-Dimensional Analysis

Social

• Direct gender-equity instrument — targets poor, rural, SC/ST women via JSY cash incentives [2].
• SUMAN's "zero denial" pillar tackles respectful maternity care, addressing class/caste-based discrimination at facilities [1].

Administrative

• Centrally Sponsored Scheme implemented via state Health Departments; PIP-based NHM funding [2].
• High-Risk Pregnancy (HRP) tracking via Extended PMSMA + incentivised specialist check-ups creates a referral pyramid: Sub-Centre → PHC → FRU [1].

Economic

• JSSK eliminates out-of-pocket expenditure for maternity care — catastrophic-health-expenditure mitigation [2].
• Cash incentives under JSY shift demand to public institutions, raising institutional delivery share [2].

Health-Systems / Quality

• LaQshya certifies labour rooms on quality standards (intra-partum care, infection control) [2].
• FRUs & MCH Wings address the "Three Delays" model — delay in decision, transport, and quality care [1].

Legal/Governance

• Operates within Article 47 (DPSP — duty to raise nutrition & public health) [constitutional anchor].
• Aligned with SDG-3.1 (UN) and WHO Global Strategy for Women's, Children's and Adolescents' Health [5].

6. Recent Developments (last 12-18 months)

• 13 Mar 2026: PIB release confirms MMR = 88 (SRS 2021-23); 5.93 crore institutional deliveries in 3 years [1].
• Extended PMSMA scaled up for high-risk pregnancy tracking with incentives to specialists [1].
• Birth Homes / Birth Waiting Homes flagged as new infrastructure push for hard-to-reach areas [1].
• Earlier (2025) PIB note: India on steady trajectory toward SDG-3.1 (MMR<70 by 2030) [5].

7. Prelims Hooks

• MMR India (SRS 2021-23) = 88 per lakh live births [1].
• MMR computed by SRS, Registrar General of India (under MHA) — NOT MoHFW [1].
• JSY launched 2005 under NRHM [2].
• JSSK launched 2011 — entitles free C-section, transport, blood, diagnostics [2].
• PMSMA launched 2016 — free ANC on the 9th of every month [2].
• LaQshya launched 2017 — targets labour rooms & maternity OTs [2].
• SUMAN launched 2019 — "zero denial of services" guarantee [2].
• SDG-3.1 target: MMR < 70 by 2030 [5].
• MMR fell from 130 (2014-16) to 88 (2021-23) [4][1].
• Institutional deliveries (last 3 yrs) = 5.93 crore [1].
• FRU = First Referral Unit — equipped for C-section, blood storage, 24×7 emergency obstetric care [1].
• Extended PMSMA focuses on High-Risk Pregnancy (HRP) identification [1].
• States with historically highest MMR: Assam, MP, UP (MMR Bulletin context) [4].
• WHO definition of "maternal death" includes deaths up to 42 days post-termination of pregnancy [2].

8. Mains Relevance

• GS-II: Welfare schemes for vulnerable sections; issues relating to health.
• GS-I: Role of women, social empowerment.
• Plausible stems: 1. "Despite a sharp fall in MMR, India remains short of the SDG-3.1 target. Examine the structural bottlenecks and evaluate the basket of NHM interventions." (GS-II, 15 marks) 2. "Discuss how schemes like JSY, JSSK, PMSMA and SUMAN together address the 'Three Delays' framework in maternal health." (GS-II, 10 marks) 3. "Quality of intrapartum care, not merely institutional delivery, is the next frontier in reducing maternal mortality in India. Comment." (GS-II, 15 marks)

9. Related Topics to Study Next

• National Health Mission (NHM) — umbrella vehicle for these schemes.
• Infant Mortality Rate (IMR) & Under-5 Mortality — co-tracked SDG indicators.
• Anaemia Mukt Bharat & POSHAN Abhiyaan — upstream nutrition determinants of maternal death.
• Ayushman Bharat – PMJAY & HWCs — financing & primary-care backbone.
• Mission Indradhanush — immunisation linkage in the maternal-child continuum.
• SDG-3 (Good Health & Well-being) — international benchmarking framework.
• NFHS-5 indicators — ANC coverage, institutional delivery share, anaemia prevalence.
• Sample Registration System (SRS) — data source literacy for MMR/IMR/TFR.

10. Common Errors / Trap Areas

• MMR vs MMRate: MMR is per 1,00,000 live births; Maternal Mortality Rate is per women of reproductive age — distinct indicators.
• Data source confusion — MMR is published by RGI/SRS (MHA), NOT NFHS or MoHFW.
• Launch-year mix-ups: JSY (2005) ≠ JSSK (2011) ≠ PMSMA (2016) ≠ LaQshya (2017) ≠ SUMAN (2019).
• PMSMA day is 9th of every month, not 1st or 11th.
• SDG target is 70 by 2030, not 100 (which was the older NHP-2017 national goal).