New Delhi: India continues to make remarkable strides in maternal healthcare even as a new global study highlights both significant achievements and remaining challenges in reducing maternal deaths. According to a comprehensive analysis published in The Lancet Obstetrics, Gynaecology, and Women’s Health, India accounted for approximately 24,700 maternal deaths out of the global total of 2.4 lakh in 2023. This positions the country among nations with the highest maternal mortality burden in South Asia and sub-Saharan Africa. Yet, official Indian data and the same study reveal an impressive 86% reduction in the maternal mortality ratio since 1990—nearly double the global average—demonstrating the effectiveness of sustained national efforts.
With less than five years left to achieve the Sustainable Development Goal target of fewer than 70 maternal deaths per 100,000 live births, these findings underscore the need for continued focus while celebrating India’s faster-than-average progress.
Understanding Maternal Mortality: Definition and Global Targets
Maternal mortality refers to the death of a woman while pregnant or within 42 days of the termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to the pregnancy or its management. This definition, provided by the World Health Organization, excludes accidental or incidental causes unrelated to pregnancy.
The key indicator for measuring maternal mortality is the Maternal Mortality Ratio (MMR), which is calculated as the number of maternal deaths during a given time period per 100,000 live births in the same period. The Sustainable Development Goals (SDG) 3.1 aims to reduce the global MMR to less than 70 per 100,000 live births by 2030. Despite three decades of global efforts, many countries, including several with high burdens, continue to fall short of this target.
Lancet Global Burden of Disease 2023 Study: Key Findings on Maternal Deaths
The Global Burden of Disease 2023 research, led by experts from the Institute for Health Metrics and Evaluation at the University of Washington and global collaborators, offers the most up-to-date assessment of maternal mortality trends across 204 countries and territories through 2023.
According to the study, there were an estimated 2.4 lakh maternal deaths worldwide in 2023, translating to a global maternal mortality ratio of 190.5 per 100,000 live births. This marks a decline of more than one-third from the 1990 figure of 321 per 100,000 live births. However, the pace of improvement has slowed in recent years, and progress remains uneven across different regions.
The analysis reveals that 104 out of 204 countries and territories have not yet met the SDG target of fewer than 70 maternal deaths per 100,000 live births. Researchers emphasize the urgent need for renewed action and sustained investment as the 2030 deadline approaches.
In this global context, India recorded about 24,700 maternal deaths in 2023. The study estimates India’s MMR at 116 per 100,000 live births for that year, reflecting a nearly 80% reduction from 508 in 1990. For comparison, Pakistan reported an estimated 10,300 maternal deaths, Ethiopia 11,900, and Nigeria 32,900 in the same period. These figures highlight the concentrated burden in certain parts of South Asia and sub-Saharan Africa.
India’s Impressive Progress: 86% Decline in MMR Since 1990
India’s achievements in maternal health stand out when viewed over the long term. The latest Sample Registration System (SRS) data for 2021–23 places the country’s MMR at 88 per 100,000 live births. The Union Health Ministry has highlighted that India has achieved an 86% reduction in MMR since 1990 according to the United Nations Maternal Mortality Estimation Inter-Agency Group (UN-MMEIG) Report. This rate of decline is nearly double the global average reduction of 48%.
The Lancet study aligns with this trend, noting that India has halved its maternal mortality at twice the global pace since 1990. This progress has been globally recognized and reflects the impact of consistent policy interventions and healthcare system strengthening.
The temporary setbacks caused by the COVID-19 pandemic were also acknowledged in the report. Before widespread vaccination, during 2020 and 2021, COVID-19 contributed to higher maternal mortality in regions with elevated pandemic deaths. Despite this disruption, India’s overall trajectory remains one of substantial and sustained improvement.
Major Causes of Maternal Mortality in India
The Lancet report identifies haemorrhage as the leading medical cause of maternal deaths, followed by infection and hypertensive disorders of pregnancy. These clinical factors account for the largest share of fatalities both globally and in high-burden countries like India.
Beyond medical reasons, several socio-cultural and systemic issues contribute to the problem. Traditional beliefs and social norms, combined with familial pressures, poverty, and lack of education, often delay seeking timely care. Many women face barriers rooted in gender dynamics and community practices that affect access to healthcare.
Access-related challenges further exacerbate risks. Delays in care frequently occur due to inappropriate referrals, poor emergency preparedness at health facilities, and gaps in the overall referral system. These factors turn potentially manageable complications into life-threatening emergencies.
Government Initiatives and Policy Measures Reducing Maternal Deaths
India has implemented a robust framework of policies and programs to address maternal mortality. The National Health Policy 2017 set a target of reducing MMR to less than 100 per 100,000 live births by 2020, which the country successfully achieved.
The National Health Mission plays a central role through its Reproductive, Maternal, Newborn, Child, Adolescent Health, and Nutrition (RMNCAH+N) strategy. This integrated approach includes several key initiatives:
- Janani Suraksha Yojana (JSY), which promotes institutional deliveries by providing financial incentives to encourage safe childbirth in health facilities.
- Pradhan Mantri Matru Vandana Yojana (PMMVY), which offers maternity benefits in the form of cash support to help women meet nutritional and health needs during pregnancy and post-delivery.
These national programs are complemented by innovative state-level best practices. Tamil Nadu has developed a strong system of Emergency Obstetric Care to ensure timely management of complications. Madhya Pradesh’s community-driven Dastak Abhiyan focuses on door-to-door outreach for early identification and awareness of high-risk pregnancies.
Together, these measures emphasize skilled birth attendance, timely referrals, quality antenatal care, and post-partum follow-up—all critical elements highlighted by the Lancet study for further reducing maternal deaths.
Challenges and the Road Ahead Toward SDG Targets
Despite impressive gains, the absolute figure of 24,700 maternal deaths in 2023 underscores the scale of the challenge remaining in India. The Lancet analysis stresses that stronger health systems, better monitoring, and continued investment are essential to accelerate progress and meet the SDG 3.1 target.
Experts point to the need for addressing the interconnected medical, social, and access-related barriers. Expanding quality antenatal and post-natal services, upgrading emergency obstetric facilities, and integrating maternal health more deeply into primary care networks will be vital. Leveraging technology for real-time data and community-level interventions can help sustain momentum.
The global picture painted by the study serves as both a caution and an inspiration. While maternal deaths have declined significantly since 1990, the slowdown in recent progress and the fact that over half the world’s countries remain off-track highlight the importance of collective and determined action.
Conclusion: Balancing Achievements with Renewed Commitment
India’s maternal health journey reflects a powerful story of determination and results. From achieving the National Health Policy target ahead of schedule to recording an 86% decline in MMR—far exceeding the global average—the country has demonstrated what focused policy and community engagement can accomplish.
The Lancet report’s estimate of 24,700 maternal deaths in 2023 serves as a reminder that the work is not yet complete. As the 2030 deadline for SDG 3.1 approaches, sustained efforts through programs like Janani Suraksha Yojana, Pradhan Mantri Matru Vandana Yojana, and state-level innovations will be crucial.
By building on proven strategies and learning from temporary disruptions such as those during the COVID-19 period, India is well-positioned to push its maternal mortality ratio below 70. This continued progress will not only save mothers’ lives but also serve as a global model for reducing maternal mortality in high-burden settings.
Frequently Asked Questions (FAQs)
1. How many maternal deaths did India record in 2023 according to the Lancet report?
India recorded approximately 24,700 maternal deaths in 2023, out of the global total of 2.4 lakh maternal deaths, according to the Global Burden of Disease 2023 study published in The Lancet.
2. What is India’s current Maternal Mortality Ratio (MMR) and how much has it declined since 1990?
According to the latest Sample Registration System data (2021–23), India’s MMR stands at 88 per 100,000 live births. The country has achieved an 86% reduction in MMR since 1990, nearly double the global average decline of 48%.
3. What are the main causes of high maternal mortality in India?
The leading medical causes are haemorrhage, followed by infection and hypertensive disorders of pregnancy. Socio-cultural factors such as traditional beliefs, poverty, lack of education, and delays in accessing emergency care also contribute significantly.
4. Which government schemes are helping reduce maternal mortality in India?
Key initiatives include Janani Suraksha Yojana (JSY) for promoting institutional deliveries, Pradhan Mantri Matru Vandana Yojana (PMMVY) for maternity benefits, and the RMNCAH+N strategy under the National Health Mission. State-level efforts like Tamil Nadu’s Emergency Obstetric Care and Madhya Pradesh’s Dastak Abhiyan are also playing a vital role.
5. Has India met the Sustainable Development Goal target for maternal mortality?
No. While India has made impressive progress and achieved the National Health Policy 2017 target of MMR below 100 by 2020, the SDG 3.1 goal of reducing MMR to less than 70 per 100,000 live births by 2030 is yet to be fully achieved. Sustained efforts are still required.
