India’s Maternal Mortality Ratio (MMR)
Source: SRS Special Bulletin on Maternal Mortality
Summary
India’s Maternal Mortality Ratio (MMR) — maternal deaths per 1,00,000 live births — has improved marginally to 87 in 2022-24, according to the latest Sample Registration System (SRS) bulletin released by the Office of the Registrar General & Census Commissioner (RGI), Ministry of Home Affairs. The headline story is a near-stall in national progress after two decades of sharp decline. Even so, India’s MMR has halved from 167 in 2011-13 to 87 in 2022-24, and the country has surpassed its National Health Policy goal of an MMR of 100 set for 2020, keeping it on track for the SDG 3.1 target of under 70 by 2030.
Key takeaways:
- Latest value: India’s MMR has declined to nearly 87 maternal deaths per one lakh live births per the latest SRS Special Bulletin on Maternal Mortality (2022-24).
- Near-stall: an improvement of just ~1 point from the previous period — slower than the historically steep decline.
- Long arc: UN-MMEIG estimates India’s MMR fell from 560 per lakh in 1990 to nearly 80 in 2023 — an 86% decline, well above the global average reduction of 48%.
- Assam milestone: Assam recorded an MMR of 84, falling below India’s 87 for the first time.
- Persistent disparities: large states like Uttar Pradesh remain far above the national average, while southern states are well below.
- SDG track: on course for SDG 3.1 (<70 by 2030), but the slowing pace is a concern.
Background & Concept
What is MMR? The Maternal Mortality Ratio is the number of maternal deaths per 1,00,000 live births in a given period. A maternal death (per WHO/ICD) is the death of a woman while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management — but not from accidental or incidental causes.
It is a critical barometer of women’s reproductive health and the strength of a health system, capturing antenatal care, institutional delivery, emergency obstetric care, and postnatal support.
MMR vs MM Rate (don’t confuse): MMR = maternal deaths per 1,00,000 live births; the Maternal Mortality Rate = maternal deaths per 1,00,000 women aged 15–49 (the reproductive-age population). MMR is the headline indicator.
Snapshot — Two-Decade Trend
| Period | MMR (per 1,00,000 live births) |
|---|---|
| 2007-09 | 212 |
| 2011-13 | 167 |
| 2014-16 | 130 |
| 2018-20 | 97 |
| 2019-21 | 93 |
| 2021-23 | 88 |
| 2022-24 | 87 |
Targets
| Indicator | Target |
|---|---|
| SDG 3.1 | Reduce global MMR to < 70 per 1,00,000 live births by 2030 |
| National Health Policy (NHP), 2017 | MMR of 100 by 2020 — achieved (India is now below it) |
State-Level Performance (per the bulletin)
| Category | States |
|---|---|
| Strong improvers | Odisha, Assam, Chhattisgarh, Punjab, Telangana (cut MMR by 11–29 points) |
| Moderate improvers | Tamil Nadu and West Bengal (≈10 points each) |
| High-birth states improving | Bihar, Madhya Pradesh |
| Worsening | Jharkhand (biggest rise), Uttar Pradesh, Gujarat |
| Highest MMR | Uttar Pradesh at 154 — nearly twice the national average |
Many of the lagging states fall within the Empowered Action Group (EAG) — Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Odisha, Rajasthan, Uttar Pradesh, Uttarakhand (with Assam often grouped alongside) — high-focus states for health interventions.
Regional & Global Comparison
| India vs | Status |
|---|---|
| China, Sri Lanka, Bhutan | Ahead of India (lower MMR) |
| Malaysia, Thailand, Vietnam | Ahead of India |
| Bangladesh, Nepal, Pakistan, Myanmar | Behind India (higher MMR) |
| Sub-Saharan Africa | Very high MMR — pulls the global average up |
About the Source
Sample Registration System (SRS) — A large-scale demographic survey run by the Office of the Registrar General & Census Commissioner, India (RGI), under the Ministry of Home Affairs. It provides reliable estimates of fertility and mortality indicators (birth rate, death rate, IMR, MMR) at the national and state levels through a dual-record system of continuous enumeration plus periodic survey. It is the primary official source for India’s MMR.
Causes & Key Interventions
Major causes of maternal death: haemorrhage, sepsis/infection, hypertensive disorders (pre-eclampsia/eclampsia), unsafe abortion, and obstructed labour.
Flagship interventions that have driven the decline:
- Janani Suraksha Yojana (JSY) — conditional cash transfer promoting institutional delivery.
- Janani Shishu Suraksha Karyakram (JSSK) — free delivery, drugs, diagnostics, transport, and diet in public facilities.
- Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) — assured free antenatal check-ups on the 9th of every month.
- SUMAN (Surakshit Matritva Aashwasan) — assured, dignified, free maternal and newborn care.
- LaQshya — improving quality of care in labour rooms and maternity OTs.
- ASHA / ANM workforce and the broader RMNCAH+ (Reproductive, Maternal, Newborn, Child, Adolescent Health) strategy.
Keywords & Definitions
▸ Maternal Mortality Ratio (MMR): Maternal deaths per 1,00,000 live births in a given period — India’s headline maternal-health indicator (87 in 2022-24).
▸ Maternal Death: Death of a woman while pregnant or within 42 days of termination of pregnancy, from pregnancy-related (not accidental) causes.
▸ Maternal Mortality Rate: Maternal deaths per 1,00,000 women aged 15–49 (distinct from the Ratio).
▸ SRS (Sample Registration System): RGI’s demographic survey; the official source for MMR, IMR, and related indicators.
▸ RGI (Registrar General of India): Office of the Registrar General & Census Commissioner, under the Ministry of Home Affairs.
▸ SDG 3.1: UN Sustainable Development Goal target to cut global MMR below 70 per 1,00,000 live births by 2030.
▸ National Health Policy (NHP) 2017: Set an MMR target of 100 by 2020 — since achieved.
▸ EAG (Empowered Action Group) States: High-focus states (Bihar, Jharkhand, MP, Chhattisgarh, Odisha, Rajasthan, UP, Uttarakhand) with weaker health indicators.
▸ UN-MMEIG: UN Maternal Mortality Estimation Inter-Agency Group — produces international MMR estimates.
▸ JSY / JSSK / PMSMA / SUMAN / LaQshya: Key Government of India maternal-health schemes targeting institutional delivery, free care, antenatal check-ups, and quality of care.
Question Section (MCQs)
Q1. The Maternal Mortality Ratio (MMR) is defined as the number of maternal deaths per: (a) 1,000 live births (b) 10,000 live births (c) 1,00,000 live births (d) 1,00,000 women aged 15–49
Q2. India’s Maternal Mortality Ratio data is primarily sourced from: (a) National Family Health Survey (NFHS) (b) Sample Registration System (SRS), Registrar General of India (c) Census of India (d) WHO Global Health Observatory
Q3. As per the latest SRS bulletin (2022-24), India’s MMR stood at approximately: (a) 97 (b) 93 (c) 87 (d) 70
Q4. The SDG 3.1 target related to maternal mortality is to reduce the global MMR to below: (a) 50 (b) 70 (c) 100 (d) 130
Q5. A “maternal death,” as per WHO, refers to the death of a woman while pregnant or within how many days of termination of pregnancy? (a) 28 days (b) 42 days (c) 60 days (d) 90 days
Q6. Consider the following statements:
- The MMR is measured per 1,00,000 live births.
- The Maternal Mortality Rate is measured per 1,00,000 women in the reproductive age group (15–49).
- India has already met the National Health Policy 2017 target of MMR 100. Which are correct? (a) 1 and 2 only (b) 2 and 3 only (c) 1 and 3 only (d) 1, 2 and 3
Q7. Which of the following are Government of India schemes aimed at improving maternal health?
- Janani Suraksha Yojana (JSY)
- Janani Shishu Suraksha Karyakram (JSSK)
- PM Surakshit Matritva Abhiyan (PMSMA)
- SUMAN (a) 1, 2 and 3 only (b) 1, 2 and 4 only (c) 2, 3 and 4 only (d) 1, 2, 3 and 4
Q8. The SRS is conducted by the Office of the Registrar General & Census Commissioner, which functions under the: (a) Ministry of Health and Family Welfare (b) Ministry of Statistics and Programme Implementation (c) Ministry of Home Affairs (d) NITI Aayog
Q9. As per the latest bulletin, the state with India’s highest MMR (nearly twice the national average) is: (a) Bihar (b) Madhya Pradesh (c) Uttar Pradesh (d) Assam
Q10. Which of the following neighbouring/regional countries are generally ahead of India (i.e., have a lower MMR)?
- China 2. Sri Lanka 3. Pakistan 4. Bhutan (a) 1, 2 and 4 only (b) 1, 2 and 3 only (c) 2, 3 and 4 only (d) 1, 3 and 4 only
Answer Key with Explanations
▸ Q1 → (c) 1,00,000 live births. MMR is maternal deaths per 1,00,000 live births. Option (d) describes the Maternal Mortality Rate, not the Ratio.
▸ Q2 → (b) SRS, Registrar General of India. The SRS bulletin is the official source for India’s MMR.
▸ Q3 → (c) 87. The 2022-24 SRS bulletin reports India’s MMR at 87.
▸ Q4 → (b) 70. SDG 3.1 targets a global MMR below 70 per 1,00,000 live births by 2030.
▸ Q5 → (b) 42 days. A maternal death covers the period of pregnancy and up to 42 days after its termination, from pregnancy-related causes.
▸ Q6 → (d) 1, 2 and 3. All three are correct — the Ratio is per live births, the Rate is per women 15–49, and India has surpassed the NHP 2017 target of MMR 100.
▸ Q7 → (d) 1, 2, 3 and 4. JSY, JSSK, PMSMA, and SUMAN are all maternal-health initiatives.
▸ Q8 → (c) Ministry of Home Affairs. The RGI (which runs the SRS) functions under the Ministry of Home Affairs.
▸ Q9 → (c) Uttar Pradesh, reported at 154 — nearly twice the national average.
▸ Q10 → (a) 1, 2 and 4 only. China, Sri Lanka, and Bhutan are ahead of India; Pakistan lags behind India (higher MMR).
