30 Mar 2024 : Daily Answer Writing

Q1) Sustained decline in maternal mortality rate (MMR) requires public investments for a robust maternal and neo-natal care that can equitably address the causes of mortality. Discuss.

(250 Words/15 Marks)


Maternal Mortality Rate (MMR) is the number of maternal deaths during a given time period per 100,000 live births during the same time period.

Even though there has been a significant improvement in MMR in India which now stands at 97/lakh live births, sustained decline may face following impediments:

  1. Lack of quality health services in the last mile may disrupt the health achievements made in MMR over the years.

E.g., institutional deliveries in rural areas of Jharkhand, Chhattisgarh, Bihar etc., states continue to be low.

  1. Nutritional deficiency, unequal access to healthy diets etc., may reverse the gains achieved in capping the MMR.

E.g., high level of anaemia in Pregnant Woman Lactating Mothers (PWLM) in India.

  1. High Out-of-Pocket Expenditure (OOPE)  associated with healthcare services have the effect of pushing families into poverty, which in turn has severe consequences for maternal and neo-natal health.
  2. Lack of trained healthcare professionals (doctors, nurses, paramedics) in PHCs, CHCs, rural areas have restricted the access to quality healthcare for millions. It has also over-burdened the secondary and tertiary institutions.

The importance of public investments for a robust maternal/neo-natal care can be seen from:

  1. Public investment will bridge the gaps in access to maternal/neo-natal care arising from socio-economic disparities and cultural variations.

E.g., expanding the reach of JSY, PMMVY etc., schemes to the last mile.

  1. Public investments will aid in widening the umbrella of social security.

E.g., High OOPE incurred in providing for maternal and neo-natal care can be averted by increasing public investments.

  1. Enhanced public investment will translate to institutional deliveries and robust care for PWLM, reducing MMR and IMR alike.

E.g., as per NFHS-4, 21% of births took place outside professional health facilities.

  1. It will augment the ecosystem for PHCs, CHCs etc., thereby checking morbidities in new-born babies and mothers and also facilitating periodic review of their health.
  2. Training, capacity building, and reasonable compensation for ASHA workers will further improve the indicators of MMR and IMR in the country; public investment will also ensure checking the deficiency of quality health care professionals (doctors, nurses, para-medics), especially in the rural areas.
  3. Enhanced public investment will check the major problem of nutritional deficiency in PWLM, thereby improving maternal as well as neo-natal health.

E.g., lack of key nutrients like iodine, iron, folate, zinc etc.

Maternal and Neo-natal care are the pillars for a healthy and robust demography in the country. In addition to public investments, following steps can be taken to augment the same:

  1. Private-Public partnership in health sector will have the spillover impact of improving health outcomes in PWLM and new born babies.
  2. Within the existing framework, a more elaborate role should be imparted to the local bodies in maintaining the ecosystem for maternal and neo-natal health.
  3. Measures for improving maternal and neo-natal health can be made more effective by adopting a more targeted approach to utilise scarce resources in an efficient manner.

E.g., nutritional mapping of PWLM and accordingly taking corrective steps.

  1. Innovative ways should be employed to augment maternal and neo-natal health.

E.g., including local ingredients in diets; preventive health care like yoga, exercises, meditation etc.; strengthening the role of community in maternal and neo-natal health etc.

Maternal and neo-natal health are the foundation for a healthy society. It is an imperative to take measures beyond increasing public investments to augment maternal and neo-natal health


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