At a tertiary health-care level in India, which is mainly provided by medical colleges and advanced medical research institutes, specialised consultative care is given to patients who are referred from primary and secondary medical care, along with general care for the local community.1 The maternal mortality ratio in India has reduced by 78%, from 556 per 100 000 livebirths in 1990 to 122 per 100 000 livebirths in 2015–17, mainly because of an increase in institutional deliveries (from 18% in 2005 to 79% in 2016) and an effective referral system for emergency obstetric care.
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Mehta et al. (2020) studied this question.
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