1. Current Status
Kerala’s Maternal Mortality Ratio (MMR) has risen sharply from 18 to 30 per one lakh live births (2021–2023), as per the Sample Registration System (SRS) special bulletin.
Despite the rise, Kerala (along with Andhra Pradesh) continues to rank among the States with the lowest MMR in India.
2. Reasons for the Increase
COVID-19 Impact (2021):
Kerala reported 97 maternal deaths linked to COVID-19.
In 2021–22, MMR spiked from 32 to 51 due to increased maternal deaths (up to 220 cases).
Declining Live Births:
MMR is calculated as maternal deaths ÷ live births × 100,000.
Kerala’s annual live births have steadily fallen from 5–5.5 lakh earlier to below 4 lakh in recent years.
In 2023, live births totaled 3.93 lakh, expected to further dip to 3.54 lakh (2024–25).
With deaths steady (~120–140 per year), the shrinking denominator has inflated the ratio.
3. Long-Term Trends
Historically, Kerala’s MMR has been stable at 30–32 since 2014–15, based on Health Department’s line list data (actual maternal deaths recorded).
The sharp drop to 18 in SRS data (2020–22) was misleading, as it did not reflect the actual steady number of maternal deaths.
Experts had earlier warned that the figure of 18 was unrealistic.
4. Data Sources & Variations
SRS Data (official): Used in national reports and policy documents; derived from sample studies.
State Health Department (line list data): Captures every maternal death, considered more accurate by officials.
Variance between SRS and State data has been a persistent issue.
5. Maternal Death Profile
Kerala reports 120–140 maternal deaths annually over the last 5 years.
Safe motherhood has been a long-term focus of Kerala’s public health efforts.
However, reducing MMR further has become challenging due to:
Declining births.
The last-mile difficulty in tackling preventable maternal deaths.
6. Key Insights
The apparent “rise” in MMR does not necessarily mean maternal health has worsened.
It reflects the statistical effect of fewer live births combined with a relatively steady number of deaths.
Kerala still remains one of the safest States for motherhood, but policymakers must address the demographic shift and ensure continued maternal care.
