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The report entitled Economic Burden of Tobacco Related Diseases in India (please click here to download the Executive Summary), supported by the Ministry of Health & Family Welfare, Government of India and the WHO Country Office for India, was developed by the Public Health Foundation of India (PHFI).

The report estimates direct and indirect costs from all diseases caused due to tobacco use and four specific diseases namely, respiratory diseases, tuberculosis, cardiovascular diseases and cancers. The report also highlights that tobacco use and the associated costs are creating an enormous burden for the nation.

The total economic costs attributable to tobacco use from all diseases in India in the year 2011 for persons aged 35-69 amounted to Rs. 104500 crores of which 16 percent was direct cost and 84 percent was indirect cost. 

According to the report, massive direct medical costs of tobacco attributable diseases amount to Rs.16,800 crore and associated indirect morbidity cost of Rs. 14,700 crore. The cost from premature mortality is Rs. 73,000 crores, indicating a substantial productive loss to the nation, the report states. 


According to the United Nations' report (released in May, 2014) entitled Trends in maternal mortality estimates 1990 to 2013, (please click here to download): 


Indian scenario

• Maternal mortality ratio (MMR)* in India stood at 560 maternal deaths (per 100000 live births) during 1990, 460 during 1995, 370 during 2000, 280 during 2005 and 190 during 2013.

• As compared to India (MMR: 190 per 100000 live births), Brazil (MMR: 69) and China (MMR: 32) performed better in reducing maternal deaths.

• An Indian woman’s lifetime risk of maternal death** – the probability that a 15 year old woman will eventually die from a maternal cause – is 1 in 190, whereas for a Chinese woman it is 1 in 1800 and for a Brazilian woman it is 1 in 780. 

• At the country level, the two countries that accounted for one third of all global maternal deaths are India at 17 percent (50000) and Nigeria at 14 percent (40000). 

• The proportion of deaths among women of reproductive age that are due to maternal causes (PM)*** in India is 6.7 percent whereas for China it is 1.6 percent and for Brazil it is 2.8 percent.

• The ten countries that comprised 58 percent of the global maternal deaths reported in 2013 are: India (50000, 17%); Nigeria (40000, 14%); Democratic Republic of the Congo (21000, 7%); Ethiopia (13000, 4%); Indonesia (8800, 3%); Pakistan (7900, 3%); United Republic of Tanzania (7900, 3%); Kenya (6300, 2%); China (5900, 2%); Uganda (5900, 2%). 

• India could reduce MMR by 65 percent between 1990 and 2013.

• The present report has classified India among 96 countries with incomplete civil registration and/or other types of maternal mortality data.


Global scenario

• Every day, approximately 800 women die from preventable causes related to pregnancy and childbirth.

• Under MDG5, countries committed to reducing maternal mortality by three quarters between 1990 and 2015. Since 1990, maternal deaths worldwide have dropped by 45%. However, between 1990 and 2013, the global maternal mortality ratio (i.e. the number of maternal deaths per 100 000 live births) declined by only 2.6% per year. This is far from the annual decline of 5.5% required to achieve MDG5.

• 99 percent of all maternal deaths occur in developing countries. More than half of these deaths occur in sub-Saharan Africa and almost one third occur in South Asia.

• The maternal mortality ratio in developing countries in 2013 is 230 per 100 000 live births versus 16 per 100 000 live births in developed countries. 

• A woman’s lifetime risk of maternal death – the probability that a 15 year old woman will eventually die from a maternal cause – is 1 in 3700 in developed countries, versus 1 in 160 in developing countries.

• Maternal mortality is higher in women living in rural areas and among poorer communities.

• Young adolescents face a higher risk of complications and death as a result of pregnancy than older women.

• The major complications that account for 80% of all maternal deaths are: a. severe bleeding (mostly bleeding after childbirth); b. infections (usually after childbirth); c. high blood pressure during pregnancy (pre-eclampsia and eclampsia); and d. unsafe abortion. The remainder are caused by or associated with diseases such as malaria, and AIDS during pregnancy. Skilled care before, during and after childbirth can save the lives of women and newborn babies.

• While levels of antenatal care have increased in many parts of the world during the past decade, only 46 percent of women in low-income countries benefit from skilled care during childbirth.

• Other factors that prevent women from receiving or seeking care during pregnancy and childbirth are: poverty, distance, lack of information, inadequate services and cultural practices. 



* Maternal mortality ratio (MMR) is the number of maternal deaths during a given time period per 100000 live births during the same time period.

** Adult lifetime risk of maternal death is the probability that a 15-year-old women will die eventually from a maternal cause.

*** Proportion of deaths among women of reproductive age that are due to maternal causes (PM) is the number of maternal deaths in a given time period divided by the total deaths among women aged 15–49 years.



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