education improve health outcomes along with other benefits the government promotes collaboration between private and government clinics through the pradhan mantri surakshit matritva abhiyan program before 2017 the government focus on maternal mortality was learning about the causes of death to develop a plan for prevention. in 2017 the indian government shifted focus in its programs to instead detect risks then offer healthcare to prevent the death. a 2016 national survey expected to find that if a household loses a woman to maternal death, then other women in the household will seek more clinic services during pregnancy and after childbirth. contrary to expectation, the study instead found that after a maternal death, women instead avoid hospitals and instead seek support from a traditional birth attendant. reasons for this vary, but part of the explanation is that many of these women could go to the hospital for care but choose to avoid doing so. social factors which influence maternal mortality in india are income inequality in india; level of access to prenatal care and care in the postpartum period; level of woman's education; the position of the mother's community in the regional rural-urban divide; the mother's access to nutrition during pregnancy; the degree of local sanitation; and the caste position of the mother. the same health monitoring systems which track maternal mortality could also ask women to report other problems, such as lack of good treatment from hospital staff. healthcare in india measures and reports maternal mortality. offering general support services to women could improve many aspects of health care. public health initiatives from 2000-2015 india participated in the millennium development goal to improve maternal health. the government of india has started various public health initiatives to provide a safe and secure environment. some of these initiatives are - janani suraksha yojana (jsy), pradhan mantri matru vandana yojana (pmmvy), pradhan mantri surakshit matritva abhiyan (pmsma) poshan abhiyan and laqshya government have also taken initiatives on improving the infrastructure of the country by improving roads and providing free ambulance services at phc. history in 2018 the world health organization congratulated india for great reduction in maternal mortality since 2005. previous to that, various reports described high rates of maternal mortality in india. research maternal mortality is challenging to study because it is fairly uncommon, it can happen for various reasons, and it is challenging to report. the first nationally representative study of maternal mortality in all of india was in 2014. two major global studies in 2015 report maternal mortality in india and contribute to national planning. one study is the global burden of disease study, which in 2015 for the first time published a national report about india. the other is the 2015 report of the united nations maternal mortality estimation inter-agency group (un mmeig). for the earlier 2013 versions of these two studies, researchers noted that they used different data and analysis to come to different conclusions about changes over time of maternal mortality in india. in 2017 a report found no significant impact following a large study of 160,000 pregnant women who participated in a one-week educational program to improve maternal health and childbirth outcomes.