The Under-Five Mortality Rate (U5MR) saw a 78% decline, compared to the global reduction of 61%, reflecting India’s significant advancements in immunization coverage, newborn care, and child nutrition. The Infant Mortality Rate (IMR) also witnessed a 71% decrease, surpassing the 58% global average reduction.
In an era where Sustainable Development Goals (SDGs) guide the global conscience, India is quietly scripting a remarkable success story, one of maternal and child survival. While economies are often measured by GDP, the truest measure of a nation’s development lies in how it nurtures its mothers and children.
The recently released Sample Registration System (SRS) Report 2021 and global inter-agency assessments confirm that India’s progress in reducing maternal and child mortality not only outpaces its own past performance but also exceeds global averages. These sustained gains are the outcome of robust policy frameworks, ground-level interventions, and an unwavering political and administrative will.
A Nation’s Health Story
The journey of India’s maternal and child health over the past decade paints a remarkably hopeful and transformative trajectory, one that reflects the deep structural reforms, targeted interventions, and people-centric policies undertaken by the country.
One of the most notable achievements is the sharp decline in the Maternal Mortality Ratio (MMR), which fell from 130 deaths per 1,00,000 live births in 2014–16 to 93 in 2019–21. This nearly 29% reduction signifies not only better medical access but also increased awareness, institutional support, and improved antenatal and postnatal care for women.
In parallel, India has witnessed a substantial decline in the Infant Mortality Rate (IMR)—from 39 per 1,000 live births in 2014 to 27 in 2021—highlighting improved child healthcare services, vaccination coverage, and nutrition outreach. Similarly, the Neonatal Mortality Rate (NMR), a critical indicator of the first 28 days of life, dropped from 26 to 19 per 1,000 live births in the same period. These outcomes point to significant advancements in institutional deliveries, newborn stabilization care, and access to emergency obstetric and neonatal facilities.
Furthermore, the Under-Five Mortality Rate (U5MR)—a broader indicator of childhood well-being—has declined from 45 to 31 per 1,000 live births between 2014 and 2021, reflecting improvements in early childhood health, disease prevention, and community-based care models.
In addition to mortality indicators, the Sex Ratio at Birth has shown a promising improvement, rising from 899 in 2014 to 913 in 2021. This suggests progress in addressing long-standing issues of gender bias and the success of campaigns like Beti Bachao, Beti Padhao that seek to change social attitudes and protect the girl child.
Equally significant is the stabilization of the Total Fertility Rate (TFR) at 2.0 in 2021, down from 2.3 in 2014—indicating that India has effectively reached the population replacement level. This decline aligns with rising female literacy, enhanced family planning awareness, and increased access to reproductive health services.
Taken together, these figures are far more than just statistics. They represent millions of lives saved, children given a fairer start at life, and families spared from preventable tragedy. Most importantly, they signal a fundamental shift in India’s demographic and health narrative—from survival to dignity, and from crisis response to long-term resilience.
India’s Trajectory vs the World
India’s progress in maternal and child health has not only set new national milestones but has also positioned the country as a global exemplar in public health transformation. According to the United Nations Maternal Mortality Estimation Inter-agency Group (UN-MMEIG) Report 2025 and the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) Report 2024, India’s achievements represent far more than domestic improvements—they are now widely regarded as international benchmarks for health systems strengthening and impact-driven policymaking.
From 1990 to 2023, India achieved an extraordinary 86% reduction in Maternal Mortality Ratio (MMR), a performance that far outpaces the global average reduction of 48% during the same period. This dramatic improvement reflects a nationwide effort to enhance institutional deliveries, ensure skilled birth attendance, provide emergency obstetric care, and improve overall access to maternal health services—even in remote and underserved regions.
Similarly, the country has made remarkable progress in reducing child mortality. The Under-Five Mortality Rate (U5MR) saw a 78% decline, compared to the global reduction of 61%, reflecting India’s significant advancements in immunization coverage, newborn care, and child nutrition. The Neonatal Mortality Rate (NMR), which is often the most challenging indicator due to the critical care needs of newborns, fell by 70%—once again outpacing the global average decline of 54%. The Infant Mortality Rate (IMR) also witnessed a 71% decrease, surpassing the 58% global average reduction.
These figures are not just numbers—they are powerful indicators of how India has redefined what is possible in a low- and middle-income context, through a combination of visionary leadership, community-based health systems, evidence-based interventions, and inclusive governance. India’s trajectory demonstrates that with sustained political commitment and grassroots implementation, even the most complex health challenges can be overcome.
By consistently outperforming global trends, India has now emerged as a top-performing country in child survival, setting the pace for many other nations still grappling with high mortality rates. This progress is a strong testament to India’s strategic focus on maternal and child health under Sustainable Development Goal 3 (SDG 3)—”Ensure healthy lives and promote well-being for all at all ages.”
In doing so, India is not only saving lives but also reshaping global health narratives—proving that transformative change is possible when policy is rooted in purpose, and when every life is treated as a priority.
SDG 2030 Targets
The decentralization of health efforts has allowed several Indian states to outperform and achieve SDG targets ahead of schedule:
MMR ≤ 70 achieved by 8 states: Kerala (20), Maharashtra (38), Telangana (45), Andhra Pradesh (46), Tamil Nadu (49), Jharkhand (51), Gujarat (53), Karnataka (63).
U5MR ≤ 25 achieved by 12 states/UTs: Kerala, Delhi, Tamil Nadu, Jammu & Kashmir, Maharashtra, West Bengal, Karnataka, Punjab, Telangana, Himachal Pradesh, Andhra Pradesh, Gujarat.
NMR ≤ 12 achieved by 6 states/UTs: Kerala, Delhi, Tamil Nadu, Maharashtra, Jammu & Kashmir, Himachal Pradesh.
This state-level performance indicates that targeted interventions, tailored to local needs and contexts, are yielding exceptional results.
The Strategic Policy Backbone
The remarkable decline in maternal and child mortality rates in India is not a matter of chance—it is the direct result of meticulously designed policy interventions, backed by a visionary governance model that emphasizes inclusivity, accessibility, and dignity in healthcare delivery. The government’s strategic approach integrates flagship schemes, infrastructure expansion, and clinical innovations to address the multifaceted challenges of maternal and child health in a comprehensive manner.
Flagship Health Schemes
At the heart of this policy transformation is Ayushman Bharat—Pradhan Mantri Jan Arogya Yojana (PM-JAY), the world’s largest health assurance initiative. This landmark program provides an annual health coverage of ₹5 lakh per family, ensuring that financial constraints do not hinder access to quality healthcare, especially for vulnerable populations. Complementing this is the LaQshya Program, which focuses on enhancing the quality of maternal care in labor rooms and maternity operation theatres. It sets rigorous standards for clinical practices and facility management to ensure that mothers receive respectful and evidence-based care during childbirth. Another cornerstone initiative is the Janani Shishu Suraksha Karyakram (JSSK), which guarantees completely free and cashless services for all pregnant women delivering in public health institutions—including coverage for caesarean sections, medications, diagnostics, nutrition, and even transportation.
Infrastructure Development
Alongside these schemes, the government has significantly invested in expanding and upgrading health infrastructure. This includes the establishment of Maternity Waiting Homes, Maternal and Child Health (MCH) Wings, Obstetric High Dependency Units (HDUs), Sick Newborn Care Units (SNCUs), and Mother-Newborn Care Units, designed to offer specialized care during high-risk pregnancies and neonatal emergencies. These structured frameworks now support the management of approximately 300 lakh pregnancies and 260 lakh healthy live births annually, underscoring the scale and effectiveness of India’s maternal and child healthcare system.
Clinical Innovations
Furthermore, clinical innovations have played a vital role in improving survival outcomes, particularly among preterm and low-birth-weight newborns. The widespread use of antenatal corticosteroids for women in preterm labor has significantly improved neonatal outcomes by accelerating fetal lung development. Technologies like Continuous Positive Airway Pressure (CPAP) therapy are being implemented to support neonatal respiratory function in resource-limited settings. Moreover, structured follow-up screenings for congenital anomalies such as hearing and vision defects are ensuring early detection and timely intervention.
Crucially, the government is also investing in human resources for health. Thousands of skilled birth attendants, midwives, and community health workers are being trained to deliver high-quality, compassionate, and evidence-based care—even in India’s most remote and underserved areas. Their presence at the last mile ensures that policy reaches the people it is designed to protect and empower.
Data-Driven Governance
Behind India’s remarkable achievements in maternal and child health lies an often-overlooked force that has quietly transformed the way policies are implemented and monitored: real-time health data systems. In the digital age, timely, accurate, and actionable information is the foundation of effective governance—and India has embraced this principle with remarkable clarity and commitment.
Among the key pillars of this transformation are platforms like the Health Management Information System (HMIS) and the Mother and Child Tracking System (MCTS). These robust digital infrastructures have empowered health administrators, policymakers, and frontline workers with the ability to track service delivery, monitor outcomes, and detect gaps in real time. No longer are decisions delayed by outdated or fragmented data; today, policy adaptation and program refinement happen dynamically, in response to real-world developments on the ground.
Through HMIS, detailed health metrics are gathered and analyzed across thousands of public health facilities nationwide, covering indicators such as antenatal care, immunization, delivery outcomes, and child health services. MCTS, meanwhile, focuses specifically on tracking the continuum of care for mothers and children—ensuring that no woman or child falls through the cracks during pregnancy, childbirth, and early childhood.
These platforms also serve as powerful early warning systems, flagging anomalies such as rising maternal deaths or lapses in immunization coverage, allowing timely interventions. The integration of these systems with mobile technologies and frontline worker dashboards ensures that even at the community level, data becomes a tool for accountability, responsiveness, and citizen-centric governance.
India’s digital health data revolution represents a quiet but critical shift—from reactive to proactive health management, from guesswork to evidence-based action. It is this silent architecture of real-time intelligence that supports and sustains the visible achievements in maternal and child survival—and will continue to be a cornerstone as the nation moves towards achieving the SDG 2030 goals.
Health is Nation-Building
India’s success in reducing maternal and child mortality is a civilizational assertion of its ethos: जननी और बालक की रक्षा ही राष्ट्र रक्षा का मूल है। By blending technology with tradition, and policy with empathy, India is proving that socioeconomic progress need not come at the cost of dignity or inclusion. The road to SDG 2030 may be challenging, but India’s march is steady, inclusive, and driven by the firm belief that no mother should die giving life, and no child should be denied the right to live it fully.
