Infant Mortality Rate, Meaning, Current Status, Key Drivers

Infant Mortality Rate (IMR) refers to the number of deaths of children below one year of age per 1,000 live births in a specific year. It is widely used as a key indicator of public health infrastructure, maternal and child healthcare services, and socio-economic development. IMR is further divided into: 

• Neonatal Mortality Rate (NMR) refers to deaths occurring within the first 28 days of life. These are typically caused by prematurity, birth asphyxia, neonatal sepsis, and congenital conditions.
• Post-neonatal Mortality Rate refers to deaths occurring between 29 days and one year of life, which are more commonly linked to infections, diarrhoea, malnutrition, and lack of immunisation coverage.

Current Status of Infant Mortality Rate (IMR) in India

• India’s IMR stands at 24 deaths per 1,000 live births in 2024, down from 30 in 2019 as per Sample Registration System Report 2024 (SRS) 2024.
• Around 1 in every 42 infants in India still dies before completing one year of age.
• The rural–urban gap persists, with rural areas showing higher vulnerability (1 in 37) compared to urban areas (1 in 59).
• India has achieved a 37.4% decline in IMR between 2012–14 and 2022–24, reflecting faster improvement than the previous decade.
• Neonatal mortality rate stands at 18 per 1,000 live births (2024), indicating that newborn survival remains the key concern.
• Neonatal deaths account for 73% of total infant deaths, up from 67.6% in 2014, showing increasing concentration in the early life stage.
• Large inter-state variation persists, with Goa and Sikkim at 7, while Chhattisgarh (36), Uttar Pradesh (35), and Madhya Pradesh (35) remain high-burden states.
• Southern states such as Kerala (8), Tamil Nadu (11), and Telangana (17) continue to perform significantly better than the national average.
• Overall, India is nearing the global Infant Mortality Rate (IMR) average (~27), but still has a gap to bridge in neonatal survival and equity.

Key Drivers of Infant Mortality Rate (IMR) Decline

India’s decline in Infant Mortality Rate is driven by improved institutional care, expanded public health programmes, and state-specific innovations that have strengthened maternal and child health outcomes.

1. Rise in Institutional Deliveries

• Institutional deliveries increased from under 83% in 2019 to over 95% in 2024, ensuring safer childbirth under trained medical supervision and better emergency obstetric care.
• Rural India showed slightly faster improvement in IMR (36% decline) compared to urban areas (35%), reflecting the impact of targeted rural health interventions.

2. Government Schemes and Interventions

• Janani Suraksha Yojana (JSY) promotes institutional deliveries by providing cash incentives to poor pregnant women, reducing risky home births.
• Pradhan Mantri Matru Vandana Yojana (PMMVY) supports maternal nutrition and health through financial assistance during pregnancy and breastfeeding.
• Mission Indradhanush improves vaccination coverage for children and pregnant women in low-performing and high-risk areas.
• LaQshya Programme improves the quality of care in labour rooms and maternity operation theatres, ensuring safer deliveries.
• National Health Mission (NHM) strengthens primary healthcare systems, especially in rural, tribal, and underserved districts.
• POSHAN Abhiyaan focuses on reducing maternal and child malnutrition, which is a major cause of low birth weight and infant deaths.

3. State-Level Innovations

• Telangana reduced IMR from 35 (2014) to 17 (2024) through better antenatal care, nutrition support under Aarogya Laxmi, and transport support for pregnant women.
• Odisha reduced IMR from 49 (2014) to 28 (2024), supported by a sharp rise in institutional deliveries from about 72% to over 97%.
• Tripura achieved its lowest-ever IMR of 12 in 2024, reflecting strong and consistent improvements in public health services and overall development indicators.

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Challenges in Reduction of Infant Mortality Rate (IMR)

Despite consistent decline in IMR, India continues to face structural gaps in neonatal care, uneven health system performance, and deep regional inequalities that slow further progress.

• Neonatal deaths dominate IMR, as 73% of infant deaths in 2024 occur within 28 days, with NMR still high at 18/1,000, showing limited progress in newborn survival.
• Quality gap in institutional deliveries, reflected in Chhattisgarh’s IMR of 36 despite 97% institutional delivery coverage, highlighting weak intrapartum and postnatal care.
• Wide inter-state variation, ranging from Goa & Sikkim (7) to UP, MP, and Chhattisgarh (35–36), indicating uneven health system strength.
• Rural–urban divide persists, as seen in Assam (rural IMR 31 vs urban 14), due to poor access, delayed referrals, and weak infrastructure.
• Maternal anaemia and malnutrition, leading to low birth weight and preterm births, which significantly increase neonatal risk.
• Weak neonatal care capacity, especially shortage of functional SNCUs, NBSUs, trained staff, and critical care support in high-burden states.
• Gender-based disparities, such as Bihar (female IMR 25 vs male 21), reflecting socio-cultural bias in childcare and nutrition.
• Postnatal care gaps, including weak follow-up, infection management, and newborn monitoring after discharge.