Data: Disparities Persist Despite Significant Reduction in IMR Across States & Regions
India’s Infant Mortality Rate (IMR) was 80 in 1991 but significantly reduced to 27 in 2021, which is slightly better than the global average that year. Across all states, there has been a noticeable decline in IMR over the past few decades. However, the pace and consistency of improvement vary significantly. Southern and some northeastern states are ahead, while central and northern states lag.
Infant Mortality Rate (IMR) is a key indicator that measures the probability of a child born in a specific year or period dying before reaching the age of one. It reflects the overall health and development of a country, particularly the effectiveness of maternal and child healthcare services. IMR is calculated as the number of deaths of infants under one year of age for every 1,000 live births. A high IMR often points to problems such as poor nutrition, limited access to medical care, and weak health infrastructure. A low IMR, on the other hand, suggests better living conditions, timely healthcare, and greater awareness of child health. Tracking IMR helps governments and health agencies monitor progress and focus efforts where they are most needed.
Explore this comprehensive dataset on India’s Infant Mortality Rates available on Dataful. It covers data from 1982 onwards, broken down by state, region, and gender.
India’s IMR was slightly better than the global average in 2021
According to World Bank data, the global IMR was 64 deaths per 1,000 live births in 1991. Over the years, it has seen a steady decline, reaching 28 in 2021 and further dropping to 27 in 2023. Meanwhile, India’s IMR, according to the annual Sample Registration System Survey released by the Registrar General of India, was higher at 80 in 1991. But it saw a sharper decline, reaching 27 in 2021, which is slightly better than the global average that year. In the early 1980s, India’s IMR was more than 100 deaths per 1,000 live births, meaning that more than 10% of children did not survive their first year.
Significant difference in IMR in rural and urban areas
There is a huge disparity in the IMR recorded in urban and rural areas. In 2009, the IMR in rural areas was 55, while in urban areas it was much lower at 34. Over the years, both have seen a steady decline, but the gap has remained noticeable. By 2015, rural IMR had dropped to 41, which was still higher than the urban IMR of 25 that year. It took until 2021 for the rural IMR to reach the level that urban areas had already achieved more than a decade earlier, back in 2010. As of 2021, the rural IMR stood at 30, while the urban IMR had further declined to 18.
Gender-wise data on IMR shows that female infants consistently faced slightly higher mortality rates than male infants for most of the past decade. In 2009, the IMR was 52 for females and 49 for males. This gap of 3 points persisted through several years, indicating a gender disadvantage in infant survival.
The gap gradually narrowed over time. By 2015, the female IMR was 39 compared to 35 for males. However, from 2016 onwards, the difference reduced further, with near-equal figures recorded in the following years. By 2019, the IMR stood at 31 for females and 30 for males. In 2020 and 2021, the gender gap fully closed, with both male and female IMRs equal at 28 and 27, respectively.
Pace of decline in IMR varies across states
Across all states, there has been a noticeable decline in the Infant Mortality Rate (IMR) over the past few decades. However, the pace and consistency of improvement vary significantly. States like Madhya Pradesh and Uttar Pradesh, which had the highest IMRs in 2009 with 67 and 63, respectively, have made considerable progress, reducing their rates to 41 and 37 by 2021. Odisha, Rajasthan, and Assam have also recorded sharp declines, each bringing their IMR down by over 25 points during this period.
In contrast, some states show slower or inconsistent progress. Chhattisgarh, for example, saw its IMR fall from 54 in 2009 to just 38 in 2021, remaining one of the highest in the country. Arunachal Pradesh experienced an increase in IMR after 2014, peaking in 2017, before dropping to 21 in 2021. Similarly, Tripura also recorded a peak in 2017 before falling in the following years.
As of 2021, the states with the highest IMR include Madhya Pradesh (41), Chhattisgarh (38), Uttar Pradesh (37), and Odisha (35). States that have consistently reported low IMR over the years include Kerala, Goa, Tamil Nadu, Delhi, and Sikkim. Kerala has maintained the best record with an IMR of just 6 in 2021, almost 1/5th of the national average.
Southern and some northeastern states are ahead, while central and northern states lag
Regional trends in IMR show a clear divide across India. Southern states such as Kerala, Tamil Nadu, and Karnataka consistently report low IMR, reflecting better healthcare systems. Northern and central states like Madhya Pradesh, Uttar Pradesh, and Chhattisgarh continue to have high IMR, although they have seen gradual improvements. Western states like Maharashtra and Gujarat show moderate IMR with steady progress. The northeastern region presents a mixed picture with states like Mizoram and Sikkim reporting low IMR, while others, such as Assam and Meghalaya, have higher rates. Overall, southern and some northeastern states are ahead, while central and northern states lag behind.
Noticeable gap in IMR in urban and rural areas in some states despite decline
If the IMR in urban and rural areas of states is compared, Kerala stood out in 2020 and 2021, where the IMR was higher in urban areas than in rural areas, contrary to the national pattern. States like Bihar, Tamil Nadu, and West Bengal have significantly reduced the rural-urban gap, bringing the difference in IMR down to less than 5. However, states such as Assam, Madhya Pradesh, and Uttar Pradesh still report large disparities between rural and urban IMR despite gradual improvements.
The data clearly shows that the IMR remains high in states with lower levels of overall development. A consistent rural and urban divide is also evident, with rural areas recording significantly higher IMR than their urban counterparts across most states. While child and maternal health programs have contributed to gradual & significant improvements over the years, the expected narrowing of the gap between states and between rural and urban areas has not been uniform.