Kerala’s Maternal Mortality Ratio
Kerala’s maternal mortality ratio (MMR) has recently risen from 18 to 30 per 100,000 live births, according to the Sample Registration System (SRS) bulletin for 2021-2023. This increase follows the impact of COVID-19 related maternal deaths and reflects demographic changes in the State. Kerala and Andhra Pradesh now share the lowest MMR among state of Indias despite this rise.
Recent Trends in Maternal Mortality Ratio
Kerala’s MMR was steady around 30-32 per 100,000 live births from 2014 to 2019. The sudden spike to 51 in 2021-22 was due to 220 maternal deaths linked to the COVID-19 pandemic. The latest data shows a decline in live births, affecting MMR calculations. While maternal deaths remain fairly stable, fewer live births increase the ratio.
Declining Live Births and Its Impact
Kerala’s annual live births dropped from 5 to 5.5 lakh in previous years to under 4 lakh recently. In 2023, live births numbered 3,93,231 and are expected to fall to around 3.54 lakh by 2024-25. The MMR is calculated by dividing maternal deaths by live births and multiplying by 100,000. A declining denominator with steady maternal deaths naturally raises the ratio.
Data Sources and Variance in Figures
The SRS uses sample studies to estimate MMR, while Kerala’s Health Department maintains a detailed line list of maternal deaths. The latter is considered more accurate but is less cited in official reports. The difference between the two data sets explains some variance in MMR figures.
Definition and Classification of Maternal Mortality
MMR measures maternal deaths per 100,000 live births in a given period. Maternal deaths include deaths related to pregnancy or its management within 42 days of pregnancy termination, excluding accidental causes. The International Classification of Diseases (ICD) codes O00-O96, O98, O99 and A34 define maternal deaths. ICD-11, effective from 2022, updated terminology without altering statistics.
Live Birth and Related Terms
A live birth is when a baby shows signs of life after birth, regardless of pregnancy duration. For maternal mortality reporting, deaths within 42 days post-pregnancy are counted. Deaths occurring after 42 days but within one year are termed late maternal deaths. ICD-11 combines early and late maternal deaths under comprehensive maternal death.
Policy Implications and Challenges
Kerala’s focus on safe motherhood has reduced MMR over decades. However, the last-mile reduction in maternal deaths is challenging due to changing social and demographic factors. Declining birth rates affect MMR calculations, requiring nuanced interpretation of data for policy decisions.
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