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Maternal Mortality in India: A Review of Trends and Patterns

by William Joe; U S Mishra;B Subha Sri…et al.

IEG Working paper no.353, 2015

High maternal mortality in India, particularly across empowered action group (EAG) states, is a critical policy concern. This paper discusses the trends and patterns in reduction in maternal mortality in India, and focuses on highlighting inter- and intra-state disparities. We find that the trends in the maternal mortality ratio (MMR) for the past two decades (particularly, the rate of decline) do not commensurate well with the observed improvements
in the socioeconomic indicators of the country. Huge inter-state and intra-state disparities in the MMR constitute a major policy concern. For instance, the MMR reported for the EAG/Assam group was 438 in 2001–03 and 257 in 2010–12, almost five times higher than that of Kerala (MMR 66), which has the least MMR of all states. Further, we draw attention towards the confidence interval around the MMR estimates, and argue that the declines are
statistically significant only for large samples obtained after combining the regional sub- samples; for most states, we cannot infer any significant decline. We also examine the relationship between the MMR and economic growth. Our results suggest significant growth elasticity: a 1-per-cent increase in per capita net state domestic product (PCNSDP) is associated with a 0.5-per-cent decline in MMR. This estimate is adjusted for the total fertility rate (TFR) across states, which also finds a positive and significant relationship with MMR. In concluding, we emphasise that integrating developmental and health sector policies would reduce MMR faster.
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