Sustainable development
goals (SDG) and Status
of Maternal Health in
India
Ms. Ellen Beck
Sustainable
Development Goals (SDGs)
• Also known as global goals
• Adopted by United Nations as a call to action to end poverty and
protect planet
• And to ensure that by 2030 all people enjoy peace & prosperity
• 17 SDGs are integratedted that
• Action in one area will affect outcome in another
• Development must balance economic , social and envioronmental sustainability
Millenium Developmen Goals
(MDGs)
• Established by United nations in 2000 and consisted of 8 international
Goal.
• Improving maternal health was goal no 5
• Target 5A: To reduce the MMR by 75% between 1990 to 2015
• Target 5B: To achieve universal access to reproductive health by 2015
SDG 3
• The goal is to ensure healthy lives and promote well-being for all at
all ages
• The targets of SDG 3 focus on various aspects of healthy life and
healthy lifestyle
• SDG 3 has 13 targets and 28 indicators to measure progress
• The first nine targets are outcome targets.
Sustainable Development Goal 3 (9
targets)
3.1 Reducing Maternal mortality
3.2. Ending all prventableNeonatal and child
mortality
3.3. Fighting infectious diseases
3.4. Rducing mortality from Noncommunicable
diseases
3.5. Preventing and treating Substance abuse
3.6. Reducing Road traffic Accidents
3.7 Universal access to Sexual and reproductive
health
3.8 Achieving Universal health coverage
Targets of SDG 3.1 & 3.2 by 2030
• Reduce the global maternal mortality ratio to less than 70 per 100,
000 live births.
• End preventable deaths of newborns and children under 5 years of
age, with all countries aiming to:
• Reduce neonatal mortality to at least as low as 12 per 1000 live births
• Under-5 mortality to at least as low as 25 per 1000 live births.
Indicators for Target 3.1
Targets help in measuring the progress :
• 3.1.1: Reduction in Maternal Mortality Ratio
• 3.1.2: Proportion of births attended by skilled Birth Attendents
Indicator 3.1.1: Reduction in
Maternal Mortality Ratio
• All women must have access to high quality care during pregnancy,
labor and the post-partum period.
• The presence of trained medical professional at every birth is
especially crucial because prompt diagnosis and treatment can mean
the difference between life and death for both the mother and the
infant.
• As long as complications are managed or prevented, the majority of
maternal deaths can be avoided.
Indicator 3.1.2: Proportion of births
attended by skilled Birth Attendents
• It is the percentage of childbirths attended by Skilled Birth attendent
• Skilled Birth Attendent is one who is competent to:
• Provide and promote evidence-based, human-rights based, quality, socio-
culturally sensitive and dignified care to women and newborns
• Facilitate physiological processes during labour and delivery to ensure a clean
and positive childbirth experience; and
• Identify and manage or refer women and/or newborns with complications.
Maternal mortality (WHO) Definition
• Death of a woman occuring during pregnancy, childbirth, or within 42
days of delivery
• Irrespective of duration and site of pregnancy, from any cause related
to or aggreavated by pregnancy or its management
• But not from accidental or incidental causes
Maternal Mortality Ratio
• MMR is the number of maternal deaths during a given time period per
100,000 live births during the same time period.
• Maternal mortality in a region is the measure of reproductive health of
women in the area.
• Maternal mortality ratio
• = (Number of maternal deaths/ Number of live births)x 100,000
• The maternal mortality ratio can be calculated directly from data collected
through vital registration systems, household surveys or other sources
Factors associated with high
maternal mortality
• Age- teenage pregnancy and >35 years
• Parity- primigravida and parity>4
• Low socio economic status
• lack of antenatal care
• Place of delivery- delivery in remote areas or home deliveries
• Delay in seeking medical care
Three Delays
• Delay in Seeking care
• Delay in reaching the facility
• Delay in recieving treatment
Status of global &
maternal health
WHO Summary findings (2022)
• Maternal mortality
• 95% of all maternal deaths occur in low and lower middle-income
countries in 2020.
• A maternal death occurred almost every two minutes in 2020.
• Skilled birth attendants
• 86% of births were assisted by skilled health professionals,
including doctors, nurses and midwives globally in 2022.
• Care by skilled health professionals before, during and after
childbirth can save the lives of women and newborns.
Status of maternal health
in India
Trends in MMR of India
MMR
2014 167
2016 130
2018 113
2020 97
Stratgies to reduce maternal
mortality
• The 3 most common causes of Maternal Mortality :
• Hemorrhage
• Sepsis
• Eclampsia
Interventions directed to specific
condition
• Prevention & control of Severe bleeding
• Prevention & control of Infection
• Prevention & treatment of eclampsia
• Prevention of unwanted pregnancies
Severe Bleeding
• Severe bleeding after birth also called ‘Post-partum hemorrhage’ is
the most common cause of death and can kill a healthy woman within
2 hours if she is unattended:
• Active management of 3rd stage of labor
• Use of misoprostol when skilled birth attendant is not available
• balloon temponad
• Use of USG in antepartum hemorrhage and first trimester bleeding
Prevention of infection
• Infection after childbirth can be eliminated if good hygiene is
practiced and if early signs of infection are recognized and treated in a
timely manner.
Six Cleans at delivery
• Clean Hands
• Clean Perinium
• clean delivery surface
• clean cord
• clean tying instuments
• clean cutting surfaces
Prevention & treatment of
preeclampsia & Eclampsia
• Pre-eclampsia should be detected and appropriately managed before
the onset of convulsions (eclampsia) and other dangerous
complications.
• Administrating drugs such as ‘magnesium sulphate’ for pre-eclampsia
lowers a woman’s risk of developing eclampsia.
Emergency Obstetric Care
• Administration of
• Antibiotics
• Uterotonics
• Magnisium sulphate for severe preeclampsia and eclampsia
• Assisted Vaginal delivery-Vaccume and forceps
• Manual Removal of placenta
• Removal of Products of conception-manually, Dilatation and
evacuation, vaccume
• Neonatal resuscitation with bag and mask
Comprehensive Emergency care
• Emergency obsteric care plus
• Facilty for cesarean section
• Facility for blood transfusion
Prevention of unwanted pregnancy
• To avoid maternal deaths, it is also vital to prevent unwated
pregnancies.
• All woman, including adolescents, provided access to contraception,
safe abortion services, and quality post-abortion care
Safe Motherhood Initiatives
• Family planning
• Antenatal, Intrapartum, postpartum care
• Post abortion care
• Control of sexually transmitted infections
• HIV nfection
Maternal & Child health Services
• CSSM - The child survival and safe motherhood program
• RCH- Reproductive and child health program
• NHM - National Health Mission
Thanks