Maternal Mortality Ratio (MMR) Trends:
- Kerala’s MMR is rising, currently reported at 19 per one lakh live births, but the State Health Department estimates it at 29.
- The increase in MMR is due to a decline in fertility rates, not necessarily more maternal deaths.
Relevance : GS 2(Governance)
Declining Births:
- Kerala’s fertility rate has dropped to a historic low of 1.46 (2021 VSR), significantly below the replacement level fertility of 2.1.
- The State recorded 3.93 lakh births in the latest data, a decline from an average of 5-5.5 lakh annually in previous years.
Impact of Declining Fertility:
- Reduced births increase MMR despite stable maternal health outcomes.
- Kerala’s demographic transition is leading to fewer children born, with an expected future increase in elderly population and associated social challenges.
Demographic Transition:
- Kerala achieved replacement-level fertility in 1987-88 and saw a consistent decline in birth rates since 1991.
- The Total Fertility Rate (TFR) dropped to 1.46 in 2021, with projections suggesting further decline to 1.35.
Social and Economic Consequences:
- Migration of reproductive-age individuals for jobs or education is contributing to low birth rates.
- The proportion of elderly population is expected to surpass children in the next decade, creating challenges in caregiving and welfare.
Delayed Childbearing and Increased Risks:
- Rising age of marriage and delayed childbearing may lead to higher pregnancy-related morbidities.
- Though evidence is still limited, this could contribute to increased health risks for older mothers.
Population Data and Reporting Concerns:
- Official birth registration data is being debated, with discrepancies in reporting and delayed publication of the Vital Statistics Report (VSR) after 2021.
- The lack of accurate and timely data hinders a clear understanding of demographic trends.
Health Department’s Response:
- The State Health Department’s ongoing efforts to address maternal health challenges, despite the structural issues related to declining fertility, are facing mounting difficulty.
- Holding the MMR at 20 by 2030 seems increasingly unlikely due to demographic shifts.
