Maternal mortality ratio, Sikkim

Maternal deaths per 100,000 live births over a three-year period. A maternal death is the death of a woman while pregnant or within 42 days of the end of pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.

Numerator

Maternal deaths in the SRS sample over three years, multiplied by a correction factor

Denominator

Live births in the SRS sample over three years (hundred-thousands)

Methodology

The Sample Registration System (SRS) is ORGI's large-scale demographic survey: in about 8,800 randomly selected villages and urban blocks (8,839 sample units covering about 9.0 million people in 2024, roughly 0.6% of the population) a resident part-time enumerator records births and deaths continuously, and an independent supervisor conducts a retrospective half-yearly survey. The two records are matched and unmatched events re-verified in the field (dual record system), which makes SRS India's reference source for vital rates at state level, since civil registration remains incomplete in several states. The sample is redrawn after each census; the frame in use from reference year 2014 is based on Census 2011. Source: SRS Special Bulletin on Maternal Mortality in India for the period, Table 1, MMR column. Causes of every SRS death are assigned by verbal autopsy; because maternal deaths are rare, three years of data are pooled, and each State's count of maternal deaths is multiplied by a correction factor (the ratio of female deaths by age group in SRS to the count yielded by verbal autopsy forms) to allow for under-count, mainly from out-migration. Estimates are published for India and 19 States: the 'EAG and Assam' States (Assam, Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Odisha, Rajasthan, Uttar Pradesh, Uttarakhand), the South (Andhra Pradesh, Telangana, Karnataka, Kerala, Tamil Nadu) and Gujarat, Haryana, Maharashtra, Punjab and West Bengal. The Bulletin's regional subtotals and its 'Other states' residual are not geographies and are not stored. IHO stores each period under its full years (2022-2024) and checks that every value lies inside its printed 95% confidence interval.

Caveats

Confidence intervals are wide (Kerala 24 in 2022–24, interval 0–50; State intervals are commonly 50–150 points wide), so a State's change from one period to the next is usually within noise. Successive periods share two of their three years, so they are not independent annual changes. No estimate exists for Delhi, Jammu & Kashmir, Himachal Pradesh, the North-Eastern States other than Assam, or the UTs. Reference years 2020–2021 cover the COVID-19 pandemic: deaths rose sharply in 2021 (India's crude death rate was 7.5 against 6.0 in 2020), and fieldwork was disrupted.