Infant mortality: India - Revision history

Jyoti: /* 2014: Marked improvement in most states */

2026-06-01T22:10:06Z

‎2014: Marked improvement in most states

Jyoti: /* 2023 */

2026-05-29T19:40:38Z

‎2023

Jyoti: /* 1990-2010, 5% annual decline */

2026-04-18T07:50:21Z

‎1990-2010, 5% annual decline

Jyoti: /* 2015-16: Kerala at OECD level */

2025-12-04T04:50:55Z

‎2015-16: Kerala at OECD level

Jyoti: /* 2023 */

2025-09-25T17:50:06Z

‎2023

Jyoti: /* 2023 */

2025-09-25T17:05:58Z

‎2023

Jyoti: /* 2020 */

2025-09-25T17:03:58Z

‎2020

Jyoti: /* Chances of survival in 1st year */

2024-09-18T21:08:25Z

‎Chances of survival in 1st year

Jyoti: /* Trends */

2024-08-02T05:45:16Z

‎Trends

Jyoti: /* Madhya Pradesh */

2023-11-16T17:48:06Z

‎Madhya Pradesh

← Older revision		Revision as of 22:10, 1 June 2026
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	An all-India picture will emerge only after the system data for other states is released, which Bharadwaj assured would happen in the coming weeks.		An all-India picture will emerge only after the system data for other states is released, which Bharadwaj assured would happen in the coming weeks.

		+	==2014, 2024==
		+	[[File: Infant mortality in India, state-wise, 2014, 2024.jpg\| Infant mortality in India, state-wise, 2014, 2024 <br/> From: [https://epaper.indiatimes.com/article-share?article=25_05_2026_001_012_cap_TOI Rema Nagarajan & Atul Thakur, May 25, 2026: ''The Times of India'']\|frame\|500px]]
		+
		+	'''See graphic''':
		+
		+	'' Infant mortality in India, state-wise, 2014, 2024 ''
		+
		+	[[Category:Development\|IINFANT MORTALITY: INDIAINFANT MORTALITY: INDIAINFANT MORTALITY: INDIAINFANT MORTALITY: INDIAINFANT MORTALITY: INDIA
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		+	[[Category:India\|IINFANT MORTALITY: INDIAINFANT MORTALITY: INDIAINFANT MORTALITY: INDIAINFANT MORTALITY: INDIAINFANT MORTALITY: INDIA
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	==2015-16: Decline in Infant Mortality Rate==		==2015-16: Decline in Infant Mortality Rate==

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 '' Indian states with the highest and lowest infant mortality, 2023 ''
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← Older revision		Revision as of 07:50, 18 April 2026
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	Compared to India, Pakistan too hasn’t done a bad job. Against a neonatal rate of 54.8 per 1,000 births in 1990, it now stands at 42.7.		Compared to India, Pakistan too hasn’t done a bad job. Against a neonatal rate of 54.8 per 1,000 births in 1990, it now stands at 42.7.
		+
		+	==1990- 2024==
		+	[https://epaper.indiatimes.com/article-share?article=19_03_2026_008_004_cap_TOI March 19, 2026: ''The Times of India'']
		+
		+
		+	New Delhi : India has made significant progress in reducing child deaths over the past three decades, but deaths among newborns are a cause for concern, the United Nations Interagency Group for Child Mortality Estimation Report 2025 shows, reports Anuja Jaiswal .
		+	The country’s under-five mortality rate has declined from 127 deaths per 1,000 live births in 1990 to 27 in 2024. Since 2000, the rate has fallen from 92 to 26.6, a decline of about 71%.
		+
		+	“India has emerged as a leading global exemplar in reducing child mortality, with neonatal deaths down nearly 70% and under-five mortality falling by 79% since 1990,” Union health minister Jagat Prasad Nadda said in a post on X, attributing the gains to sustained investments in maternal and child health.
		+
		+	However, progress in reducing deaths among newborns has been slower. Neonatal mortality has dropped from 43.8 per 1,000 live births in 2000 to 16.7 in 2024, a reduction of about 62%.
		+	This gap means that newborns now account for the largest share of child deaths. Of the total under-five mortality rate of 26.6, about 16.7 deaths per 1,000 live births occurred in the first month of life in 2024, indicating that nearly two-thirds of child deaths are concentrated in this period.
		+
		+	“Conditions like premature birth, birth asphyxia and infections are major causes, and gaps in care — such as missed high-risk pregnancies, poor monitoring during delivery and lack of trained staff — further increase the risk. Improving the quality of care during pregnancy, childbirth and the first few days after birth is critical to saving more lives,” said Dr Arvind Kumar, principal director and head of paediatrics, Fortis Hospital, Shalimar Bagh.
		+
		+	In absolute terms, India records around 5.4 lakh under-five deaths annually, of which newborns account for nearly 3.9 lakh. Deaths among older children have declined more rapidly due to improvements in immunisation, nutrition and disease management.
		+	“In newborns, prematurity, birth asphyxia and sepsis are the leading factors, while in older children, pneumonia, diarrhoea and malnutrition are more common. Most of these deaths are preventable with proper antenatal care, early breastfeeding, good nutrition and timely immunisation,” said Dr Varun Vij, senior consultant, paediatrics and neonatology, Max Smart Super Speciality Hospital, Saket.
		+
		+	The data shows under-five mortality declined at an average rate of about 3.6% per year between 1990 and 2024, with faster reductions after 2000.
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		+	[[Category:Development\|IINFANT MORTALITY: INDIAINFANT MORTALITY: INDIAINFANT MORTALITY: INDIAINFANT MORTALITY: INDIAINFANT MORTALITY: INDIA
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		+	[[Category:India\|IINFANT MORTALITY: INDIAINFANT MORTALITY: INDIAINFANT MORTALITY: INDIAINFANT MORTALITY: INDIAINFANT MORTALITY: INDIA
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	==2000>2017: Under-5 mortality rate halved==		==2000>2017: Under-5 mortality rate halved==

← Older revision		Revision as of 04:50, 4 December 2025
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	Dr V Ramankutty, a paediatrician and public health professor of Achutha Menon Centre, in Sree Chitra Tirunal Institute for Medical Sciences and Technology, says it would have been better if the NFHS had indicated a range for the value that accounts for any sample size error. “I am not saying that the IMR of 6 is impossible or wrong. If the range of IMR is 5-7 or 4-8, that would be very good, but if it is 2-12, that's nothing to be happy about. To bring down IMR from such a low level of 12, high technology capital intensive interventions are needed. I don't think that kind of investment in newborn care has happened in Kerala,“ explained Dr Ramankutty .		Dr V Ramankutty, a paediatrician and public health professor of Achutha Menon Centre, in Sree Chitra Tirunal Institute for Medical Sciences and Technology, says it would have been better if the NFHS had indicated a range for the value that accounts for any sample size error. “I am not saying that the IMR of 6 is impossible or wrong. If the range of IMR is 5-7 or 4-8, that would be very good, but if it is 2-12, that's nothing to be happy about. To bring down IMR from such a low level of 12, high technology capital intensive interventions are needed. I don't think that kind of investment in newborn care has happened in Kerala,“ explained Dr Ramankutty .
		+
		+	===Better than the USA, 2025: The success story===
		+	[https://epaper.indiatimes.com/article-share?article=14_09_2025_023_004_cap_TOI Rema Nagarajan, Sep 14, 2025: ''The Times of India'']
		+
		+
		+	The latest Sample Registration System (SRS) report has highlighted a striking milestone for Kerala — the state had achieved an infant mortality rate (IMR) of 5, a figure lower than even the US (5.6). This achievement is all the more remarkable because for over two decades, between 1995 and 2015, Kerala’s IMR stubbornly refused to fall below 12-15. Breaking free of that stagnation took persistence, innovation, and a rare partnership between the state govt and the paediatrician community.
		+
		+	Infant mortality rate refers to the number of infant deaths under one year of age per 1,000 live births. Even at an IMR of 12, Kerala was well ahead of the rest of the country. However, while India’s IMR fell from roughly 75 to 37 in the same two decades, showing remarkable progress, Kerala’s IMR barely budged. This made the state govt take a hard look at what was holding Kerala back.
		+
		+	The contrast became sharper because maternal mortality had steadily declined. Kerala’s maternal mortality ratio (MMR) fell from 150 in the mid1990s to 61 in 2011-13. In the latest report, its MMR is 30. Rajeev Sadanandan, who was then with the department of health and family welfare in Kerala, credits this success to a confidential review of maternal deaths started by Kerala Federation of Obstetrics and Gynaecology (KFOG) in 2002. “They used to publish a fabulous report every three years called ‘Why Our Mothers Die’. Every maternal death review was seen as a learning exercise and not a fault-finding exercise. This provided a very clear evidence-based template to reduce maternal deaths,” explains Sadanandan.
		+
		+	''' LIKE MOTHER, LIKE CHILD '''
		+
		+	When Sadanandan returned to the health department in 2011, he urged the Kerala branch of the Indian Academy of Paediatrics (IAP) to adopt a similar approach for infant mortality. According to the then president of IAP’s Kerala branch, Dr Sachidananda Kamath, the association decided to take up the challenge of bringing down Kerala’s IMR to single digits.
		+	“With the help of the National Rural Health Mission and Kerala govt, IAP reviewed infant deaths in four districts,” says Dr Kamath. “We found that prematurity and congenital anomalies together accounted for more than 60% of infant deaths. We suggested interventions such as increasing the level of care and tackling deaths from heart diseases. Boosting neonatal care improved the survival of 28-week-old babies and even newborns weighing 900 gm were able to live.”
		+	However, congenital anomalies, which accounted for almost 30% of infant deaths, were more challenging to tackle as they required access to highly skilled surgeons, medical infrastructure and financial resources. “We decided to focus on congenital heart diseases, which is a significant proportion of congenital anomalies in infants,” says Sadanandan, who served as the health secretary for 11 years.
		+
		+	With leadership provided by paediatric cardiologist Dr Raman Krishna Kumar and foetal cardiologist Dr Balu Vaidyanathan in Amritha Hospital, Kochi, the govt launched Hridyam, the first ever population-level programme to address congenital heart diseases in a low-middle-income country. Its web-based application launched in 2017 serves as a registry where any physician in Kerala could add the name of a suspected case of congenital heart disease. Once listed, a paediatric cardiologist would review the online record within 24 hours and classify the case according to urgency. In case there was insufficient information, the cardiologist could direct the District Early Intervention Center at the local level to get further tests done. Patient registrations have risen steadily since launch.
		+
		+	“A lot of deaths happen even before the child reaches the hospital or gets a diagnosis. Hridyam sought to minimise this attrition by ensuring timely screening and referral. Since this involved screening babies, the collateral benefit of screening was that other conditions such as respiratory conditions got picked up. Pulse oximeter screening within 24-48 hours of birth could identify babies who were sick or who could die. This way, we were able to save a lot of babies,” says Dr Krishna Kumar. For this to work, hundreds of paediatricians, obstetricians and sonographers had to be trained to enhance their diagnostic skills. Private and public paediatric cardiac programmes that could be referral centres were identified and empanelled, even as the public sector capacity in three institutions was expanded.
		+
		+	Neonatal transport networks were also strengthened, but risks during transit remained. This is where foetal echocardiography came in. “Kerala’s newborn registry study showed that many babies died before reaching a centre to get surgery. A mother’s womb is the safest transport for a baby. So, the answer was to do foetal echo diagnosis during the mid-trimester scan, which is mandatory for all pregnancies. If a critical heart defect is suspected, the mother is referred to a person trained in foetal echocardiography. If that confirms a critical defect, the mother can be referred to a high-end centre for delivery so that the baby can be taken for emergency surgery soon after birth. It significantly improves the chances of survival,” explains Dr Vaidyanathan. These measures, combined with Kerala’s robust primary healthcare and female literacy, helped cut IMR to 5.
		+
		+	''' AUDIT MODEL '''
		+
		+	Death audits also played a pivotal role. But since neither doctors nor hospitals like to do them, how did the medical community adopt it? Dr VP Paily, one of the founders of KFOG, says confidentiality was key, with neither the identity of the patient nor that of the doctor or hospital revealed to assessors. “We only studied the circumstances of the death, the treatment given and whether it was preventable. There were some doubts initially, but once we gained the trust of the obstetricians, it was fine. This was important because 70% of births in Kerala happen in the private sector,” said Dr Paily. The govt, meanwhile, was happy to get robust data without spending any money. This model is now seen as a cornerstone of Kerala’s health gains.
		+
		+	Still, experts warn of challenges ahead. Former IAP national president Dr Kamath notes that while Kerala is ahead of the US, there are several developed countries that have done better. Italy, Singapore, Japan, Korea, Sweden, Norway, Finland, Slovenia, Estonia and the Czech Republic have the lowest IMR of 2. “Within Kerala, there are pockets where the IMR is much higher than 5. We need special strategies for tribal and vulnerable populations. We need to find out why prematurity is high in Kerala. We must take care of adolescent girls — our future mothers — and focus on their nutrition, exercise and the rise of non-communicable diseases among them. We need a good strategy to bring it down further.”
		+	Others caution against over-celebration. “All this about Kerala’s IMR being lower than the US is a bit misleading,” says Sadanandan. “SRS is at best an estimate, unlike the US which has an excellent statistical system. What matters is that we’ve managed to sustain single-digit IMR.”
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	==Jharkhand==		==Jharkhand==

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	[[Infant mortality: South Asia]]		[[Infant mortality: South Asia]]
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 Other states which saw a marginal increase in the gap included Bihar, Assam and Karnataka. In all states, the rural IMR was higher than in urban areas. But the gap between male and female IMR was greater in urban areas in many statesincluding Himachal Pradesh, Gujarat, Punjab, Rajasthan, Tamil Nadu, Kerala, Maharashtra and Haryana in 2011. By 2020, this trend was reversed in most of these states. UN data for 2020 shows that among countries where the IMR was above 20, India was the only one where male and female IMR were almost the same. In every other case, male IMR was higher than female IMR by at least 2 years. The only other countries where the gap between male and female IMRs was one or less were those where infant mortality has been reduced to single-digit levels.
-===2023===
+==2023==
 [[File: Indian states with the highest and lowest infant mortality, 2023.jpg| Indian states with the highest and lowest infant mortality, 2023 <br/> From: [https://epaper.indiatimes.com/article-share?article=20_09_2025_006_007_cap_TOI  Sep 20, 2025: ''The Times of India'']|frame|500px]]