A new report released by the United Nations Maternal Mortality Estimation Inter-Agency Group (MMEIG) has recognized India for its substantial progress in reducing maternal deaths. The report, which provides the most updated and internationally comparable estimates from 2000 to 2023, shows that India’s Maternal Mortality Ratio (MMR) declined from 103 to 80 per 100,000 live births between 2020 and 2023—an impressive 23-point drop in just three years.
This reduction brings India’s total decline in maternal mortality since 1990 to 86%, outpacing the global average of 48%. Despite this progress, India continues to carry a significant share of the global maternal death burden, accounting for 19,000 of the estimated 260,000 maternal deaths globally in 2023—approximately 7.2% of the total.
A Global Picture of Maternal Health
Globally, maternal mortality remains a pressing concern, with over 700 women dying every day from preventable pregnancy and childbirth-related causes. That translates to roughly one woman every two minutes. The Sustainable Development Goal (SDG) 3.1 aims to reduce the global MMR to fewer than 70 per 100,000 live births by 2030.
However, the report shows that current efforts are falling short. As of 2023, the global MMR stood at 197—nearly three times the SDG target. If the current pace continues, projections estimate only a modest reduction to 177 by 2030. To meet the target, a nearly 15% annual rate of reduction is required—an unprecedented challenge, according to the report.
The MMEIG report outlines sharp disparities in maternal survival across regions and income groups. Sub-Saharan Africa remains the most severely affected, accounting for 70% of global maternal deaths and the only region still classified with a “high” MMR at 454 deaths per 100,000 live births. In contrast, Australia and New Zealand recorded the lowest MMR at just 3.
Central and Southern Asia was estimated to have a moderate MMR of 112 in 2023, a 72.9% reduction from 2000, making it the region with the largest percentage improvement globally. India’s numbers place it below the regional average, marking a relative success story.
India’s Standing in the Global Context
India ranks as the second-largest contributor to maternal deaths after Nigeria, which alone accounted for over 75,000 maternal deaths, or 28.7% of the global toll in 2023. For context, India’s maternal mortality burden must be viewed alongside its population of over 1.45 billion, compared to Nigeria’s 232.6 million. Nonetheless, the report calls for intensified efforts to further reduce the number of maternal deaths in India.
India’s strides in maternal health are attributed to sustained policy interventions and government-led programs aimed at expanding access to reproductive and maternal healthcare. Initiatives like the Janani Suraksha Yojana (JSY), LaQshya (Labour Room Quality Improvement Initiative), and the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) have contributed to increased institutional deliveries and early detection of pregnancy complications.
The Ministry of Health and Family Welfare emphasized that India’s approach focuses on a multi-pronged strategy: strengthening the health system, improving skilled birth attendance, enhancing referral systems, and promoting community awareness.
India has also expanded the reach of Accredited Social Health Activists (ASHAs) and auxiliary nurse midwives (ANMs), who play a critical role in rural and underserved regions. However, experts caution that improvements must be equitable across states, with states like Kerala and Tamil Nadu outperforming others such as Uttar Pradesh and Bihar.
India’s performance is commendable, particularly given the country’s vast population and regional disparities in access to healthcare. But with 19,000 maternal deaths still occurring every year, it’s clear that more needs to be done.
Despite the gains, India faces persistent challenges. Quality of care, particularly in rural and conflict-affected areas, remains uneven. According to the report, nearly all maternal deaths are preventable and linked to direct causes like postpartum hemorrhage, unsafe abortions, and hypertensive disorders, or indirect causes such as non-communicable diseases and infections.
The COVID-19 pandemic also posed significant disruptions. A 2021 systematic review cited in the MMEIG report found that maternal deaths increased in countries like India during the pandemic. The spike in deaths was likely driven by reduced access to antenatal services, delays in emergency care, and overwhelmed health systems. While India’s MMR returned to a downward trajectory post-pandemic, the episode underscored the fragility of maternal health services during crises.
Global Resolution for Renewed Focus
In May 2024, the 77th World Health Assembly adopted a resolution to accelerate efforts toward reducing maternal, newborn, and child mortality. The resolution reaffirmed the importance of universal health coverage and the need to expand primary healthcare services—particularly in fragile settings- echoing the principles laid out in the 2018 Astana Declaration.
India’s experience aligns with this global vision. Continued investments in primary healthcare infrastructure, capacity-building for health workers, and public awareness campaigns are essential to sustain momentum. Addressing socio-cultural barriers, gender inequities, and poverty remains equally important.
With only five years left to meet the SDG target of reducing MMR to fewer than 70 deaths per 100,000 live births, India stands at a critical juncture. While recent progress is encouraging, accelerated action is necessary to close the remaining gap.
Looking Forward: Maternal Health as a Social Justice Imperative
The report calls for a shift from narrow biomedical interventions to broader, equity-informed approaches. Social determinants—such as education, income, caste, and gender—play a defining role in maternal health outcomes.
In countries like India, disparities in service access and quality are especially stark among marginalized groups, including scheduled castes, scheduled tribes, and economically weaker sections. Intersectional strategies that address these root inequities must be prioritized in future policy planning.
Experts recommend strengthening data systems to enable real-time tracking, promoting respectful maternity care, and fostering community participation to create an ecosystem where women’s health is prioritized not just during pregnancy, but throughout their life course.
As the world confronts converging crises—from pandemics to climate change—India’s commitment to maternal health can serve as a model for resilience and equity-driven progress. But the road ahead demands urgency, investment, and a whole-of-society approach.