Infant Mortality Rate in India from 2004 to 2020, by state

At the national level, the IMR of India declined from 58 deaths per 1,000 live births in 2004 to 28 in 2020, representing a more than 50% reduction. This improvement reflects enhanced healthcare infrastructure, better maternal and child health services, and successful implementation of various public health initiatives. Kerala has consistently maintained its position as the state with the lowest IMR, declining from 12 in 2004 to 6 in 2020, comparable to many developed nations. Other southern states like Tamil Nadu (13) and Karnataka (19)  have also achieved significant reductions. Notably, some smaller states and union territories have shown exceptional progress, with Mizoram and Nagaland recording single-digit IMRs of 3 and 4 by 2020. However, substantial regional disparities persist. States like Madhya Pradesh (43), Uttar Pradesh (38), and Chhattisgarh (38) continuously reported higher IMRs despite showing improvement over the years. These states, part of the traditionally termed “BIMARU” states (Bihar, Madhya Pradesh, Rajasthan, and Uttar Pradesh), have historically struggled with health indicators. However, all have shown consistent improvement over the period. Northeastern states like Manipur (6) and Nagaland (4) have achieved remarkably low IMRs, while Assam (36) still facing challenges. This disparity within the northeastern region suggests that geographical challenges and varying healthcare infrastructure significantly impact infant mortality rates. Union Territories generally performed better. Puducherry achieved an IMR of 6 by 2020. However, some UTs like Dadra & Nagar Haveli have shown fluctuating trends, indicating the need for more consistent healthcare delivery systems. The most dramatic improvements were observed in states that started with high IMRs. Odisha, for instance, reduced its IMR from 77 in 2004 to 36 in 2020, while Rajasthan brought down its IMR from 67 to 32. These improvements suggest the successful implementation of targeted interventions in historically high-burden states. The data also shows that the rate of improvement has been more rapid in some periods than others, with many states showing accelerated progress in recent years. This could be attributed to increased healthcare spending, better implementation of health programs, and improved awareness about maternal and child healthcare practices.