Kerala's maternal mortality ratio (MMR) has reached an all-time low of 18 per one lakh live births, according to the latest Sample Registration System (SRS) bulletin covering the years 2020-2022. This marks a decrease from 20 in the previous period of 2019-2021. However, health officials caution that this figure may not accurately reflect reality, as Kerala experienced 97 maternal deaths due to COVID-19 during this survey period.

Before the pandemic, Kerala had achieved an MMR of 30 by 2020, meeting one of the U.N. Sustainable Development Goals ahead of schedule. The second wave of COVID saw a significant rise in MMR, which nearly doubled compared to pre-pandemic levels. Official health department data indicated that maternal deaths rose sharply to 220 in 2021-22 due to COVID complications.

Despite these challenges, Kerala's Health department reported a decline in MMR to 28 for the year following the peak of COVID cases and currently estimates it at around 32 for the year 2023-24. The discrepancies between SRS figures and state health data arise from different methodologies used for calculating maternal deaths.

Kerala continues to lead India with the lowest MMR thanks to targeted initiatives aimed at improving maternal healthcare over recent years. Nonetheless, achieving further reductions remains challenging due to factors such as changing lifestyles and increasing rates of chronic conditions among women. The state recorded approximately 374,078 live births in recent years, suggesting that further declines in MMR may be difficult given its calculation method based on live births.

Original article

The text on Kerala's maternal mortality ratio (MMR) is replete with various forms of bias and language manipulation. One of the most striking examples is the virtue signaling that pervades the article. The author presents Kerala as a paragon of maternal healthcare, boasting that it has achieved an MMR of 18 per one lakh live births, which is an "all-time low." This framing creates a sense of triumph and progress, implying that Kerala is a leader in this field. However, this narrative is problematic because it glosses over the complexities and challenges involved in reducing MMR. By presenting Kerala's achievement as a straightforward success story, the author obscures the underlying structural issues that may be contributing to this decline.

Furthermore, the article exhibits cultural bias by assuming that Western-style healthcare initiatives are universally applicable and effective. The author notes that targeted initiatives aimed at improving maternal healthcare have contributed to Kerala's success, but fails to acknowledge alternative approaches or perspectives from non-Western contexts. This assumption reflects a broader cultural bias towards Western-centric solutions and ignores potential limitations or criticisms of these approaches.

The text also displays linguistic bias through its use of emotionally charged language. For instance, when describing the COVID-19 pandemic's impact on MMR, the author states that there was a "significant rise" in maternal deaths due to COVID complications. This phrase creates a sense of alarm and emphasizes the severity of the situation. However, this framing could be seen as manipulative because it does not provide context about how these numbers compare to pre-pandemic levels or other global trends.

Moreover, there are instances of selection and omission bias throughout the article. The author selectively highlights data points that support their narrative while omitting others that might contradict it. For example, when discussing Kerala's previous achievements in reducing MMR before the pandemic, they mention an MMR rate of 30 by 2020 but fail to provide comparable data for other states or countries in India.

The text also exhibits structural bias by implicitly defending systems of authority or gatekeeping within health departments and government agencies. When discussing discrepancies between SRS figures and state health data on MMR rates, the author attributes these differences to "different methodologies used for calculating maternal deaths." This framing suggests that these discrepancies are merely technical issues rather than reflecting deeper power dynamics or institutional biases within these organizations.

Additionally, confirmation bias is evident in how certain assumptions are accepted without question or presented with one-sided evidence. For instance, when discussing factors contributing to declining MMR rates in Kerala (e.g., changing lifestyles), there is no consideration given to alternative explanations or counterarguments from experts outside this specific context.

Framing and narrative bias can be observed through story structure usage throughout this piece: focusing primarily on positive developments while downplaying challenges; juxtaposing past successes against current difficulties; using catchphrases like 'lowest' without contextualizing them; emphasizing progress toward U.N.-defined goals without questioning their applicability; highlighting statistics which reinforce desired narratives while leaving out contradictory information – all contribute toward reinforcing positive perceptions about India’s performance regarding women’s health specifically within state-level contexts such as those found here today