Social Factors and Lack of Awareness Affecting the High Maternal Mortality in Northeast-India.

Maternal mortality is a crisis worldwide. In 2017, globally 810 women succumbed to pregnancy and childbirth-related complications every day. Despite India reporting a progressive decline in maternal mortality, it accounted for 12% of the world's total maternal deaths. In the latest Maternal Mortality Ratio (MMR) report by the Registrar General of India, India documented 103 maternal deaths/1,00,000 live births, a modest reduction from the previous figures of 113 deaths/1,00,000 live births. Meanwhile, Assam recorded (2017-19) the highest maternal mortality rate of 205 deaths per 1,00,000 live births, almost twice the national average. About three-quarters of the maternal deaths documented in Assam belong from low-income setting tea plantation and daily wage communities in the char areas (riverine belt). Past demographic surveillance establishes hemorrhage, pregnancy induced hypertension (PIH), infections, and anemia as the principal causes behind maternal deaths. Furthermore, challenging communication, transport bottleneck, delayed health facility, repeated pregnancy especially in riverine belt, selective dietary traditions, malfunctional healthcare services, and existing socio-economic conditions intensify this tragedy.