India has reached a historic low in child survival. The country’s infant mortality rate dropped to 24 deaths per 1,000 live births in 2024, down from 30 in 2019 — a 20% reduction in five years and the lowest figure the nation has ever recorded, according to the Sample Registration System (SRS) Report 2024.
At a glance
- Infant mortality rate: India’s IMR fell from 30 in 2019 to 24 in 2024, an average decline of roughly one point per year over the five-year period.
- Institutional deliveries: The share of births attended by medical professionals in hospitals rose from below 83% in 2019 to more than 95% in 2024, a shift health experts closely link to improved newborn survival.
- Neonatal mortality: Deaths within the first 28 days of life accounted for nearly 73% of all infant deaths in 2024, up from 67.6% in 2014, signaling where the hardest work now lies.
What’s driving the decline
The single biggest engine behind the improvement is a dramatic rise in medically attended births. When mothers deliver in hospitals — government or private — newborns gain immediate access to trained staff, resuscitation equipment, and early screening for complications. That chain of care has a direct effect on survival in the first hours and days of life.
Rural India drove a slightly larger share of the gains. Rural IMR fell 36% between 2012–14 and 2022–24, compared with 35% in urban areas. The overall national rate declined 37.4% across that same decade, a faster pace than the 33.2% drop recorded in the decade before it. Expanded maternal healthcare services, antenatal screening programs, and dedicated transport for pregnant women — such as Amma Vodi in Telangana — have all contributed.
These gains are part of a broader story of public health wins accumulating across low- and middle-income countries over recent decades, as primary care infrastructure reaches communities that previously lacked it.
States leading the way
The regional spread of results shows what’s possible when healthcare systems function well. Kerala recorded an IMR of just 8 deaths per 1,000 live births and the lowest neonatal mortality rate among larger states at 6. Goa and Sikkim posted the country’s best figures overall, each recording an IMR of 7.
Goa’s achievement stands out. The state improved from an IMR of 10.7 in 2023 to 7 in 2024. Rural Goa recorded an IMR of 5 — lower than its urban rate of 8 — reversing the national pattern where rural mortality consistently outpaces urban mortality. Tamil Nadu recorded 11, matching Delhi among the best-performing larger regions.
Tripura emerged as one of the clearest success stories in the northeast, reaching its lowest-ever IMR of 12 in 2024, down from 15 in 2023. Odisha cut its rate from 49 per 1,000 in 2014 to 28 in 2024, a reduction of 21 points over a decade, supported by institutional deliveries rising from roughly 72% to more than 97%.
Where progress stalled
Chhattisgarh recorded the highest IMR in the country at 36 deaths per 1,000 live births in 2024. Its experience complicates any simple story about institutional deliveries as the fix: the state’s hospital birth rate rose from over 77% to 97% between 2019 and 2024, yet its IMR fell only 18.3% between 2012–14 and 2022–24 — the weakest improvement among all states. Uttar Pradesh and Madhya Pradesh each recorded an IMR of 35.
Assam showed the widest rural-urban gap in the country, with rural IMR at 31 compared with 14 in urban areas. Bihar reported one of the largest gender gaps among major states, with an IMR of 25 for female infants compared with 21 for male infants. These disparities point to structural barriers — in nutrition, neonatal care quality, and equitable access — that hospital delivery alone cannot resolve.
Karnataka, which had cut its IMR by 55% over the previous decade, saw a marginal increase from 14 in 2023 to 15 in 2024. Health officials noted that statistical fluctuations become more common as rates approach single digits, and the long-term trend remains clearly downward.
The next frontier: the first 28 days
With IMR declining nationally, the report makes clear that neonatal mortality — deaths in the first 28 days — is now the defining challenge. Nearly 73% of all infant deaths in 2024 occurred in that window, up from 67.6% a decade earlier. India’s overall neonatal mortality rate stood at 18 deaths per 1,000 live births in 2024.
That shift reflects real progress: more infants are surviving beyond infancy’s earliest and most vulnerable weeks. But it also means the next phase of improvement depends less on getting mothers to hospitals and more on what happens after arrival — the quality of care for premature babies, infection control, maternal nutrition, and skilled support in the hours immediately after birth.
One in every 42 infants at the national level still dies before reaching the age of one. In rural India, the figure is one in every 37. That reality sits alongside the genuine achievement of reaching 24 per 1,000 — a reminder that population health gains, like reductions in mortality across many causes, tend to be uneven even as the overall trend bends in the right direction.
India’s record low IMR is a milestone earned through years of expanding healthcare infrastructure. The data now point clearly to where the effort must focus next: ensuring that every newborn, in every district, receives the quality of care that the best-performing states have already shown is achievable.
Read more
For more on this story, see: Times of India
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