India’s infant mortality rate (IMR) has reached a historic low of 25 deaths per 1,000 live births, according to the 2023 Sample Registration System (SRS) data from the Registrar General of India. This marks a steep fall from 40 in 2013 and represents an 80% decline since 1971, when IMR stood at 129. 1
Despite the progress, experts warn that neonatal deaths—those occurring in the first 28 days of life—still account for nearly 70% of infant deaths in India. A study in The Lancet Global Health found that prematurity, low birth weight, neonatal infections, and birth asphyxia together were responsible for nearly 78% of neonatal deaths. 2
Another paper in the Indian Journal of Pediatrics emphasised that interventions such as Kangaroo Mother Care (KMC), neonatal resuscitation training, and exclusive breastfeeding can substantially improve survival rates. 3
The national average conceals wide differences between states. Mizoram recorded IMRs as low as 3, while Kerala reported an IMR of 5, Ladakh reported IMRs as low as 4 and Goa's IMR is reported as 6. These states and UTs are supported by strong primary health systems and near-universal institutional deliveries. In contrast, Madhya Pradesh, Uttar Pradesh, and Chhattisgarh continue to report IMRs above 35, among the highest in the country. Research in BMC Public Health noted that such disparities are linked to maternal education, access to skilled healthcare, and nutrition levels. 4
Kerala is being praised by many doctors including Dr. Cyrus Abby Philips for achieving an IMR as low as 5, even lower in comparison to the United States.
The fall in IMR is partly credited to public health programs under the National Health Mission, which expanded maternal and child health coverage. Initiatives such as Janani Suraksha Yojana encouraged institutional deliveries, while Poshan Abhiyaan targeted malnutrition in women and children. Studies in BMJ Global Health have shown that scaling up antenatal care and skilled birth attendance directly correlates with reductions in neonatal mortality. 5
India has committed to achieving the Sustainable Development Goal (SDG) 3.2, which calls for an under-five mortality rate of 25 or fewer deaths per 1,000 live births by 2030.
While India has already achieved this target at the national level, the persistence of high neonatal deaths and state-level inequalities means further investment in NICU access, maternal nutrition, and early neonatal care will be critical.
UNICEF, in a statement on child survival in India, emphasised its continuing role. “At UNICEF, we are a proud and long-standing partner in this important journey. Together, we remain steadfast in our shared commitment: to support every child’s chance to survive and thrive, every mother’s access to quality care, and leaving no community behind,” the organisation said. 6
References:
Census of India – Sample Registration System (SRS)
Office of the Registrar General & Census Commissioner, India (ORGI). Sample Registration System (SRS)-Bulletin 2023 Volume 58-I. India: Census Digital Library. Published September 3, 2025. Accessed September 8, 2025. https://censusindia.gov.in/nada/index.php/catalog/46178.
The Lancet Global Health – Neonatal Mortality
Liu, Li, Shefali Oza, Dan Hogan, Yue Chu, Jamie Perin, Jun Zhu, Joy E. Lawn, Simon Cousens, Colin Mathers, and Robert E. Black. “Global, Regional, and National Causes of Child Mortality in 2000–13, with Projections to Inform Post-2015 Priorities: An Updated Systematic Analysis.” The Lancet Global Health 3, no. 1 (2015): e33–e54. https://doi.org/10.1016/S2214-109X(14)70397-2.
Indian Journal of Pediatrics – Interventions
Paul, Vinod K., Ramesh Agarwal, and Siddarth Ramji. “Strategies to Reduce Neonatal Mortality in India: An Overview.” Indian Journal of Pediatrics 85, no. 3 (2018): 193–202. https://doi.org/10.1007/s12098-017-2536-x.
BMC Public Health – Regional Disparities
Singh, Abhishek, and Abhishek Kumar. “Infant and Child Mortality in India: Levels, Trends, and Determinants.” BMC Public Health 13 (2013): 1–15. https://doi.org/10.1186/1471-2458-13-283.
BMJ Global Health – Health System Improvements
Nguyen, Ha, Anh Vo, and Zulfiqar A. Bhutta. “Reducing Neonatal Mortality in South Asia: Insights from Health System Strengthening Interventions.” BMJ Global Health 4, no. 6 (2019): e001501. https://doi.org/10.1136/bmjgh-2019-001501.
UNICEF – Child Survival in India
UNICEF India. “Every Child Alive: The Urgent Need to End Newborn Deaths.” UNICEF, 2023. Accessed September 8, 2025. https://www.unicef.org/india/reports/every-child-alive.
(Rh/Eth/ARC/MSM)