India’s maternal mortality rate has for the first time dropped below 100 per 100,000 live births, in line with a steady decline over the past two decades.

Eight states are now past a target set by the United Nations for 2030.

The country’s maternal mortality rate declined to 97 during the period 2018-2020 from 113 during 2016- 18 and 130 during 2014-16, according to a special bulletin on maternal mortality released on Tuesday by the Registrar General of India, a Union home ministry department.

The latest figures also show wide variations in the rates across states — from the highest 195 in Assam followed by 173 in Madhya Pradesh and 167 in Uttar Pradesh to the lowest 19 in Kerala.

“Multiple initiatives, some of them launched over 15 years ago, have driven this steady decline,” said Sanjay Mohanty, professor and head of the population policies department at the International Institute of Population Sciences, Mumbai.

Among key initiatives was the Union health ministry’s Janani Suraksha Yojana launched in 2005 to maximise institutional deliveries.

In 2004-05, surveys had found that only 40 per cent of women delivered babies in institutions.

The proportion has increased to 88 per cent in 2019-21. The health ministry starting in 2005-06 also launched a programme under which accredited social health workers (ASHAs) would support maternal and child care services, including prenatal care services to expectant mothers across rural India.

“All of these efforts have culminated in the figures we see now — over the past five years, some of these initiatives have been further intensified,” Mohanty said.

Besides Kerala, seven other states had rates during 2018-20 below the UN’s Sustainable Development Goal global target of 70 per 100,000 live births — Andhra Pradesh (43), Gujarat (57), Jharkhand (56), Karnataka ( 69), Maharashtra (33), Tamil Nadu (54) and Telangana (43).

The findings in the special bulletin come from the Registrar General of India’s Sample Registration System, a nationwide demographic survey designed to provide reliable estimates for different health indicators, including maternal mortality.

The sample size was a population of over eight million in urban and rural areas. The 25 per cent decline in maternal mortality from 130 in 2014-16 to 97 in 2018-20 is part of a 70 per cent fall from 398 in 1997-98 to 99 in 2019-2020, estimated last year by researchers in India and Canada who had used SRS and other data.

The 2021 study on maternal mortality by scientists at the IIPS and the University of Toronto had cautioned that some states lagging behind on maternal mortality would require special additional interventions for further declines.