Maternal mortality spikes, state's post-natal care to blame

KOCHI: Maternal Mortality Ratio (MMR) in Kerala has increased by 16% in 2012-13 compared to the previous year, a disturbing reversal after the state witnessed a 30% decline in MMR compared to 2010-11. The dead young mothers are not from Attapadi, or similar criminally forsaken tribal hamlets, thus precluding the convenient excuse that it is an aberration.
According to data published by Health Information Cell of Directorate of Health Services (DHS), MMR increased from 133 per 100,000 live births in 2011-12 to 154 per 100,000 live births in 2012-13. It was 190 per 100,000 live births in 2010-11.
The reasons for the rise in MMR in Kerala could range from more reported cases and inadequate ante-natal care to cut in public funding for family welfare programmes. Kerala is still ahead of the national average of MMR ? 212 per 100,000 live births ? though the latest stats give the lie to the official claim of the state's average being just 66. Certainly, the target of 103 deaths per 100,000 live births to be achieved by 2015 as mandated under the United Nations' Millennium Development Goals (MDGs) appears remote.
"The main reason for maternal mortality in Kerala is pregnancy induced hypertension, postpartum haemorrhage and cardiac arrest due to improper post-operative care", said Dr Jayandhi Raghavan, associate gynaecologist, KMCT Medical College, Kozhikode.
In 2012-13, MMR was highest in Kozhikode district with 28 deaths per 100,000 live births, followed by Thrissur with 25 deaths and Malappuram with 23 deaths. In 2011-12, the highest number of maternal deaths was recorded in Kollam district with 22 deaths, followed by 16 deaths in Malappuram, while in Thrissur the MMR was 10 and Kozhikode 13.
"In the past, the private hospitals didn't report maternal deaths. But now they have started reporting and this has led to increase in MMR. However, Kerala still has the lowest MMR in India. As per the Sample Registration System (SRS) our MMR is 66 per 100,000 live births while the national average is 212," said Dr N Sreedhar, additional DHS (Public Health).
Incidentally, increase in MMR has happened at a time when the state government has reduced expenditure on family welfare programmes. While the government spend only 85% (Rs 291 cr was allotted) of the total allotted amount in 2012-13, it had spent almost 196% of the total allotted amount (Rs 169 cr was allotted) in 2011-12. However, Dr Sreedhar played it down, stating, "In 2011-12, government focused more on infrastructure development and that's why the expenditure rose".