According to the Sample Registration System (SRS) bulletin 2021-23, Kerala that had always had one of the best maternal health records has reported an increase in the maternal mortality ratio (MMR) between 18 and 30 per 100,000 live births. In spite of the growth, Kerala and Andhra Pradesh continue to have the lowest MMR in the Indian states. This shift is explained, in large part, by the influence of COVID-19-related maternal mortality or the demographic changes in the state.
Recent Trends
Kerala Kerala Kerala had a stable level of 30-32 per 100,000 live births of MMR between 2014 and 2019. Nevertheless, in 2021-22, it increased to a high of 51, after 220 deaths related to COVID-19 among mothers. As the pandemic subsided, the ratio has gone down, though demographic shifts, particularly the declining fertility, have a continued effect on the number.
Declining Live Births
One of them is a drastic decline in the number of live births in the state to less than 4 lakh per year, compared to 5-5.5 lakh in previous years. Kerala registered 3,93,231 live births in 2023 and it is estimated that it will decrease to 3.54 lakh in 2024-25. As MMR is calculated as the number of deaths of the mother per 100,000 births, a declining denominator and a constant number of deaths leads to a larger ratio, without deteriorating health outcome.
Data Variance
The SRS estimates are not equivalent with those of the Kerala Health department line listing, which gives more information on maternal death and is said to be more precise. SRS numbers are heavily used in national reports, but at the level of the state, the trends can be seen in a way that can be explained by some fine-tuning, which is why minor differences may appear in the reported MMR.
Definition and Classification.
Maternal mortality is a term that is used to describe deaths that occur as a result of pregnancy or its care during the 42 days of termination, but not as a result of accidents. Codes that are labelled as maternal deaths in the International Classification of Diseases (ICD) include O00-O96, O98, O99, and A34. Below, the terminology in ICD-11 has been revised, although the statistical framework remains the same, including now late maternal deaths (in one year of termination of pregnancy).
Policy Implications
The ability of Kerala to reduce the maternal deaths over decades indicates that it has made strong investments in healthcare. Nevertheless, additional cuts are not so easy, because social and demographic changes affect indicators. Reduced fertility means that MMR should be viewed carefully by the policymakers and should develop strategies aimed at delivering quality obstetric care, emergency response and managing high-risk pregnancies to continue the gains.