 "India's infant mortality rate hits historic low of 25; big states struggle")
Kerala continues to lead India in key health and population indicators, setting an example for other states to follow. The Sample Registration System (SRS) Bulletin 2023 highlights how Kerala has achieved remarkable progress in lowering infant mortality, stabilising population growth, and ensuring better health outcomes compared to the rest of the country.
Infant Mortality Rate (IMR) — considered a vital measure of healthcare quality — is just 5 per 1,000 live births in Kerala, the lowest among all bigger states and far below the national average. India’s overall IMR stands at 25 per 1,000 live births, less than one-fifth of the 1971 level of 129. Over the last decade, IMR has dropped by nearly 37.5 per cent, showing significant progress nationwide.
By contrast, states like Chhattisgarh, Madhya Pradesh, and Uttar Pradesh report the highest IMR at 37, meaning infant deaths there are seven times higher than in Kerala. Even relatively better-performing states like Haryana (26) and Jharkhand (29) lag far behind.
Among all states and Union Territories, Manipur leads the country with an IMR of just 3, even lower than Kerala’s figure. This highlights how targeted health interventions can deliver world-class results, even in smaller states.
India’s population indicators also reflect improvement. The birth rate has dropped sharply from 36.9 in 1971 to 18.4 in 2023, and the death rate has fallen from 14.9 to 6.4 over the same period. Rural areas saw a decline from 7.2 in 2022 to 6.8 in 2023, while urban areas recorded a fall from 6.0 to 5.7, pointing to a steady improvement in survival rates nationwide.
Rural-urban gap in infant mortality
The SRS 2023 data shows a clear rural-urban divide in infant survival. Rural India reports an IMR of 28 per 1,000 live births, which is significantly higher than the urban IMR of 18.
This means babies born in rural areas are over 50 per cent more likely to die before their first birthday compared to those born in cities. Limited access to hospitals, shortage of trained health workers, and delayed medical care can be the major reasons for this gap.
States like Chhattisgarh, Madhya Pradesh, and Uttar Pradesh see a much wider rural-urban difference, whereas Kerala shows almost no gap, reflecting equal access to healthcare across regions.
Top and bottom five states/Union Territories in terms of IMR
Top 5 states/UTs (Lowest IMR)
• Manipur – 3
• Ladakh – 4
• Kerala – 5
• Goa and Sikkim – 6
• Chandigarh and Puducherry – 7
Bottom five states/UTs (Highest IMR)
• Chhattisgarh – 37
• Madhya Pradesh – 37
• Uttar Pradesh – 37
• Odisha and Assam – 30
• Jharkhand and Rajasthan – 29
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