{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T15:16:44Z","timestamp":1787930204908,"version":"build-2784847793"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    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\u2019s 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\u201319) 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\n                    <jats:italic toggle=\"yes\">char<\/jats:italic>\n                    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.\n                  <\/jats:p>","DOI":"10.4103\/ijcm.ijcm_371_23","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T14:00:10Z","timestamp":1768399210000},"page":"4-9","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Social Factors and Lack of Awareness Affecting the High Maternal Mortality in Northeast-India"],"prefix":"10.4103","volume":"51","author":[{"given":"Aniruddha","family":"Jakharia","sequence":"first","affiliation":[{"name":"ICMR-Regional Medical Research Centre, NE Region, Dibrugarh, Assam, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prapti Victoria","family":"Rozario","sequence":"additional","affiliation":[{"name":"ICMR-Regional Medical Research Centre, NE Region, Dibrugarh, Assam, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagadish","family":"Mahanta","sequence":"additional","affiliation":[{"name":"ICMR-Regional Medical Research Centre, NE Region, Dibrugarh, Assam, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"R2-20260416","article-title":"Sample Registration System-Special Bulletin on Maternal Mortality in India 2017-19, Office of the Registrar General and Commission Census of India (ORGI)"},{"key":"R3-20260416","doi-asserted-by":"crossref","first-page":"3342","DOI":"10.18203\/2394-6040.ijcmph20173842","article-title":"Maternal mortality at a tertiary care teaching hospital in Dibrugarh district, Assam: A retrospective study","volume":"4","author":"Hazarika","year":"2017","journal-title":"Int J Community Med Public Health"},{"key":"R4-20260416","doi-asserted-by":"crossref","first-page":"i1908","DOI":"10.1136\/bmj.i1908","article-title":"Assam: India\u2019s state with the highest maternal mortality","volume":"353","author":"Cousins","year":"2016","journal-title":"BMJ"},{"key":"R5-20260416","doi-asserted-by":"crossref","first-page":"496","DOI":"10.4103\/0019-5359.28979","article-title":"Study of health problems and nutritional status of tea garden population of Assam","volume":"60","author":"Medhi","year":"2006","journal-title":"Indian J Med Sci"},{"key":"R6-20260416","doi-asserted-by":"crossref","first-page":"146","DOI":"10.15537\/smj.2015.2.10289","article-title":"The impact of maternal iron deficiency and iron deficiency anemia on child\u2019s health","volume":"36","author":"Abu-Ouf","year":"2015","journal-title":"Saudi Med J"},{"key":"R7-20260416","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.21474\/IJAR01\/991","article-title":"Assessment of thyroid function among the individuals of tea garden community of Assam: A hospital based study","volume":"4","author":"Saikia","year":"2016","journal-title":"Int J Adv Res"},{"key":"R8-20260416","first-page":"196","article-title":"Prevalence of anaemia and role of haemoglobinopathy as an associating factor among the children belonging to the tea garden community of Assam, India","volume":"6","author":"Deori","year":"2016","journal-title":"Int J Health Sci Res"},{"key":"R9-20260416","first-page":"84","article-title":"Incidence of anaemia among the female tea garden workers in a tea plantation in upper Assam, India","volume":"110","author":"Das","year":"2012","journal-title":"J Indian Med Assoc"},{"key":"R10-20260416","doi-asserted-by":"crossref","first-page":"734","DOI":"10.4103\/jfmpc.jfmpc_274_17","article-title":"Prevalence of anemia among the women of child bearing age belonging to the tea garden community of Assam, India: A community-based study","volume":"7","author":"Panyang","year":"2018","journal-title":"J Family Med Prim Care"},{"key":"R11-20260416","doi-asserted-by":"crossref","first-page":"380","DOI":"10.4103\/2249-4863.161326","article-title":"Morbidity status of low birth weight babies in rural areas of Assam: A prospective longitudinal study","volume":"4","author":"Borah","year":"2015","journal-title":"J Family Med Prim Care"},{"key":"R12-20260416","doi-asserted-by":"crossref","first-page":"4543","DOI":"10.18203\/2320-1770.ijrcog20204807","article-title":"Maternal sepsis- an audit in a tertiary care center in South India","volume":"9","author":"Shivananda","year":"2020","journal-title":"Int J Reprod Contracept Obstet Gynecol"},{"key":"R13-20260416","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/j.cegh.2019.02.007","article-title":"Epidemiological study of maternal death in Assam","volume":"7","author":"Rane","year":"2019","journal-title":"Clin Epidemiol Glob Health"},{"key":"R14-20260416","doi-asserted-by":"crossref","first-page":"e000024","DOI":"10.1136\/bmjgh-2015-000024","article-title":"Ind OSS-Assam: Investigating the feasibility of introducing a simple maternal morbidity surveillance and research system in Assam, India","volume":"1","author":"Nair","year":"2016","journal-title":"BMJ Glob Health"},{"key":"R15-20260416","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1053\/j.ackd.2013.01.014","article-title":"The management of hypertension in pregnancy","volume":"20","author":"Kattah","year":"2013","journal-title":"Adv Chronic Kidney Dis"},{"key":"R16-20260416","doi-asserted-by":"crossref","first-page":"23905","DOI":"10.3390\/ijms161023905","article-title":"Cardiovascular complications of pregnancy","volume":"16","author":"Gongora","year":"2015","journal-title":"Int J Mol Sci"},{"key":"R17-20260416","first-page":"323","article-title":"A study on prevalence of PIH and its relation with platelet count","volume":"7","author":"Gogoi","year":"2017","journal-title":"Indian J. Appl Res"},{"issue":"Suppl 1","key":"R18-20260416","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1159\/000345165","article-title":"Global burden of maternal and child under nutrition and micronutrient deficiencies","volume":"61","author":"Ahmed","year":"2012","journal-title":"Ann Nutr Metab"},{"key":"R19-20260416","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1080\/03670244.2012.705701","article-title":"Nutritional Status and the impact of socioeconomic factors on pregnant women in Kamrup District of Assam","volume":"51","author":"Mahanta","year":"2012","journal-title":"Ecol Food Nutr"},{"key":"R21-20260416","first-page":"903","article-title":"Knowledge gaps in scientific literature on maternal mortality: A systematic review","volume":"84","author":"Gil-Gonz\u00e1lez","year":"2006","journal-title":"Bull World Health Organ"},{"key":"R22-20260416","article-title":"Press Note on Poverty Estimates, 2011-12: Government of India Planning Commission 2013"},{"key":"R23-20260416","first-page":"1179","article-title":"An analysis of health status of the state of Assam, India","volume":"4","author":"Paul","year":"2019","journal-title":"Research Review International Journal of Multidisciplinary"},{"key":"R24-20260416","first-page":"32","article-title":"Economic Survey of Assam 2001-2002 in Assam Human Development Report","year":"2003"},{"key":"R26-20260416","first-page":"413","article-title":"Issue of marginality and tea garden women in Assam, India","volume":"10","author":"Dhanaraju","year":"2019","journal-title":"The research journal of social sciences"},{"key":"R27-20260416","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s40985-020-00125-6","article-title":"Social determinants of maternal health: A scoping review of factors influencing maternal mortality and maternal health service use in India","volume":"41","author":"Hamal","year":"2020","journal-title":"Public Health Rev"},{"key":"R28-20260416","first-page":"225","article-title":"Social and biomedical causes of maternal mortality in Barpeta district of Assam- A community based study","volume":"4","author":"Kakoty","year":"2017","journal-title":"Indian J Forensic Community Med"},{"key":"R29-20260416","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1186\/s12960-019-0402-4","article-title":"The impact of India\u2019s accredited social health activist (ASHA) program on the utilization of maternity services: A nationally representative longitudinal modeling study","volume":"17","author":"Agarwal","year":"2019","journal-title":"Hum Resource Health"},{"key":"R31-20260416","year":"2022","journal-title":"Maternal Health, National Health Mission, Ministry of Health and Family welfare, Government of India"},{"key":"R32-20260416","doi-asserted-by":"crossref","first-page":"e1116","DOI":"10.1016\/S2214-109X(20)30319-3","article-title":"COVID-19 outbreak and decreased hospitalisation of pregnant women in labour","volume":"8","author":"Kumari","year":"2020","journal-title":"Lancet Glob Health"},{"key":"R33-20260416","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1002\/ijgo.13726","article-title":"Maternal death related to COVID-19: A systematic review and meta-analysis focused on maternal co-morbidities and clinical characteristics","volume":"154","author":"La Verde","year":"2021","journal-title":"Int J Gynaecol Obstet"},{"key":"R34-20260416","doi-asserted-by":"crossref","first-page":"629","DOI":"10.4103\/ijmr.ijmr_1938_21","article-title":"Clinical characteristics, outcomes, and mortality in pregnant women with COVID-19 in Maharashtra, India: Results from PregCovid registry","volume":"153","author":"Gajbhiye","year":"2021","journal-title":"Indian J Med Res"},{"key":"R35-20260416","doi-asserted-by":"crossref","first-page":"113567","DOI":"10.1016\/j.psychres.2020.113567","article-title":"Mental health of pregnant women during the COVID-19 pandemic: A longitudinal study","volume":"295","author":"L\u00f3pez-Morales","year":"2021","journal-title":"Psychiatry Res"},{"key":"R36-20260416","doi-asserted-by":"crossref","first-page":"e0256099","DOI":"10.1371\/journal.pone.0256099","article-title":"Shifting research priorities in maternal and child health in the COVID-19 pandemic era in India: A renewed focus on systems strengthening","volume":"16","author":"Mehta","year":"2021","journal-title":"PLoS One"},{"key":"R37-20260416","first-page":"2","article-title":"Metaverse in Indian health sector: A regime shift","author":"Sharma","year":"2022","journal-title":"Int J Convergence Healthc"}],"container-title":["Indian Journal of Community Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijcm.ijcm_371_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:07:30Z","timestamp":1787166450000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijcm.ijcm_371_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ijcm.ijcm_371_23","relation":{},"ISSN":["0970-0218","1998-3581"],"issn-type":[{"value":"0970-0218","type":"print"},{"value":"1998-3581","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2023-06-08","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-23","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}