AI Article Synopsis

  • - The study examines the Maternal Mortality Ratio (MMR) in India, focusing on various factors like maternal health indicators and system-level influences, using data from the National Family Health Survey and government sources to highlight regional differences.
  • - Analyzed through heatmaps and Bayesian models, findings indicate a general decline in MMR across most states, but some like Haryana and West Bengal show cyclical increases, particularly during the transition period of 2009-2013.
  • - The research highlights that health system factors, especially institutional delivery and skilled birth attendance, play a more significant role than individual factors in reducing MMR, emphasizing the need for more detailed district-level data for better insights.

Article 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.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11211505PMC
http://dx.doi.org/10.1038/s41598-024-65009-0DOI Listing

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