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Contributing factors for reduction in maternal mortality ratio in India.

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Title: Contributing factors for reduction in maternal mortality ratio in India.
Authors: Tolani, Himanshu, Neogi, Sutapa Bandyopadhyay, Pandey, Anuj Kumar, Khan, Pijush Kanti, Mishra, Sidharth Sekhar
Source: Scientific Reports; 6/27/2024, Vol. 14 Issue 1, p1-12, 12p
Subject Terms: MATERNAL mortality, DELIVERY (Obstetrics), HEALTH status indicators, GOVERNMENT report writing, MATERNAL health
Geographic Terms: INDIA
Abstract: Maternal mortality ratio (MMR) estimates have been studied over time for understanding its variation across the country. However, it is never sufficient without accounting for presence of variability across in terms of space, time, maternal and system level factors. The study endeavours to estimate and quantify the effect of exposures encompassing all maternal health indicators and system level indicators along with space–time effects influencing MMR in India. Using the most recent level of possible -factors of MMR, maternal health indicators from the National Family Health Survey (NFHS: 2019–21) and system level indicators from government reports a heatmap compared the relative performance of all 19 SRS states. Facet plots with a regression line was utilised for studying patterns of MMR for different states in one frame. Using Bayesian Spatio-temporal random effects, evidence for different MMR patterns and quantification of spatial risks among individual states was produced using estimates of MMR from SRS reports (2014–2020). India has witnessed a decline in MMR, and for the majority of the states, this drop is linear. Few states exhibit cyclical trend such as increasing trends for Haryana and West Bengal which was evident from the two analytical models i.e., facet plots and Bayesian spatio- temporal model. Period of major transition in MMR levels which was common to all states is identified as 2009–2013. Bihar and Assam have estimated posterior probabilities for spatial risk that are relatively greater than other SRS states and are classified as hot spots. More than the individual level factors, health system factors account for a greater reduction in MMR. For more robust findings district level reliable estimates are required. As evident from our study the two most strong health system influencers for reducing MMR in India are Institutional delivery and Skilled birth attendance. [ABSTRACT FROM AUTHOR]
Copyright of Scientific Reports is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Label: Title
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  Data: Contributing factors for reduction in maternal mortality ratio in India.
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  Data: <searchLink fieldCode="AR" term="%22Tolani%2C+Himanshu%22">Tolani, Himanshu</searchLink><br /><searchLink fieldCode="AR" term="%22Neogi%2C+Sutapa+Bandyopadhyay%22">Neogi, Sutapa Bandyopadhyay</searchLink><br /><searchLink fieldCode="AR" term="%22Pandey%2C+Anuj+Kumar%22">Pandey, Anuj Kumar</searchLink><br /><searchLink fieldCode="AR" term="%22Khan%2C+Pijush+Kanti%22">Khan, Pijush Kanti</searchLink><br /><searchLink fieldCode="AR" term="%22Mishra%2C+Sidharth+Sekhar%22">Mishra, Sidharth Sekhar</searchLink>
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  Data: Scientific Reports; 6/27/2024, Vol. 14 Issue 1, p1-12, 12p
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  Data: <searchLink fieldCode="DE" term="%22MATERNAL+mortality%22">MATERNAL mortality</searchLink><br /><searchLink fieldCode="DE" term="%22DELIVERY+%28Obstetrics%29%22">DELIVERY (Obstetrics)</searchLink><br /><searchLink fieldCode="DE" term="%22HEALTH+status+indicators%22">HEALTH status indicators</searchLink><br /><searchLink fieldCode="DE" term="%22GOVERNMENT+report+writing%22">GOVERNMENT report writing</searchLink><br /><searchLink fieldCode="DE" term="%22MATERNAL+health%22">MATERNAL health</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22INDIA%22">INDIA</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Maternal mortality ratio (MMR) estimates have been studied over time for understanding its variation across the country. However, it is never sufficient without accounting for presence of variability across in terms of space, time, maternal and system level factors. The study endeavours to estimate and quantify the effect of exposures encompassing all maternal health indicators and system level indicators along with space–time effects influencing MMR in India. Using the most recent level of possible -factors of MMR, maternal health indicators from the National Family Health Survey (NFHS: 2019–21) and system level indicators from government reports a heatmap compared the relative performance of all 19 SRS states. Facet plots with a regression line was utilised for studying patterns of MMR for different states in one frame. Using Bayesian Spatio-temporal random effects, evidence for different MMR patterns and quantification of spatial risks among individual states was produced using estimates of MMR from SRS reports (2014–2020). India has witnessed a decline in MMR, and for the majority of the states, this drop is linear. Few states exhibit cyclical trend such as increasing trends for Haryana and West Bengal which was evident from the two analytical models i.e., facet plots and Bayesian spatio- temporal model. Period of major transition in MMR levels which was common to all states is identified as 2009–2013. Bihar and Assam have estimated posterior probabilities for spatial risk that are relatively greater than other SRS states and are classified as hot spots. More than the individual level factors, health system factors account for a greater reduction in MMR. For more robust findings district level reliable estimates are required. As evident from our study the two most strong health system influencers for reducing MMR in India are Institutional delivery and Skilled birth attendance. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label:
  Group: Ab
  Data: <i>Copyright of Scientific Reports is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1038/s41598-024-65009-0
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        Text: English
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              Text: 6/27/2024
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