India’s MMR comparison to Nigeria unfair, says Health Ministry

India's progress in reducing maternal mortality compared to Nigeria, highlighted in UN report, faces challenges due to population differences.

Comparing India’s Maternal Mortality Ratio (MMR) to Nigeria is unfair, the Union Health Ministry said on Wednesday, while reacting to the recently released United Nations Maternal Mortality Estimation Inter-Agency Group (MMEIG) report titled ‘Trends in maternal mortality 2000-2023’, which has indicated that India has made significant strides in reducing MMR but it registered 19,000 maternal deaths in 2023 contributing almost 7.2% to global mortality.

The biggest contributor was Nigeria (28.7%), followed by India and the Democratic Republic of Congo (7.2%), and then, Pakistan (4.1%). “The comparison is not entirely fair when considering the total populations of the two countries (Nigeria: 23.26 crore, India: 145 crore),’’ said the Ministry, in its statement.

India has made significant strides in reducing MMR going from 103 per lakh live births to 80 per lakh live births. The MMR of India has now declined by 86% compared to the global reduction of 48% over the past 33 years from 1990 to 2023. Also, the number of estimated maternal deaths in India has also reduced from 24,000 to 19,000, states the report. However, India is still contributing 7.2% (19,000) of total maternal deaths worldwide, ranking second after Nigeria, which has 75,000 maternal deaths, it adds.

The MMEIG comprises World Health Organisation (WHO), the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA), the World Bank Group and the United Nations Department of Economic and Social Affairs and Population Division (UNDESA/Population Division). In collaboration with technical experts, they developed global, regional and country-level maternal mortality estimates for the period 2000 to 2023.

Maternal mortality rate is defined by the WHO as 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 other causes. “It’s a crucial metric to track the progress of maternal health and identify areas for improvement in healthcare systems,” it notes.

The report adds that every day in 2023, over 700 women died from preventable causes related to pregnancy and childbirth - meaning that approximately one woman is dying every two minutes. Sustainable Development Goal (SDG) target 3.1 is to reduce maternal mortality to less than 70 maternal deaths per 100,000 live births by 2030.

However, the pace of improvement has slowed significantly and the report states that the humanitarian funding cuts adversely impact essential healthcare in many parts of the world. It warns that these cuts have led to facility closures and loss of health workers, while also disrupting supply chains for life-saving supplies and medicines such as treatments for haemorrhage, pre-eclampsia and malaria — all leading causes of maternal deaths.