India Records 78% Decline in Under-Five Mortality (1990–2023)

According to the UN Inter‑agency Group for Child Mortality Estimation (UN IGME) 2024 report and a press release from India's Ministry of Health & Family Welfare on 28 June 2025, India has achieved a 78% reduction in the Under-Five Mortality Rate (U5MR)—far exceeding the global decline of 61% during the period 1990 to 2023

Term Definition
Under-5 Mortality Rate (U5MR) Under-5 Mortality Rate (U5MR) refers to the number of children dying before reaching five years of age, per 1,000 live births.

Key Statistics & Achievements

  • Neonatal Mortality Rate (NMR) fell by 70%, in contrast to the global average decline of 54%
  • Maternal Mortality Ratio (MMR) dropped by 86% since 1990 (from over 130 to 80 per lakh live births), well above the global reduction of 48%
  • Percentage of zero-dose children—those not receiving any routine vaccine—plummeted from 11% in 2023 to 0.06% in 2024, showcasing progress in equitable access
Term Definition
Neonatal Mortality Rate (NMR) Neonatal Mortality Rate (NMR) refers to the number of deaths of newborns within the first 28 days of life per 1,000 live births, indicating quality of maternal and newborn care.
Maternal Mortality Ratio (MMR) Maternal Mortality Ratio (MMR) is the number of maternal deaths per 100,000 live births, reflecting the quality of maternal healthcare and access to skilled birth attendants and emergency services.
Infant Mortality Rate (IMR) Infant Mortality Rate (IMR) is the number of deaths of infants under one year of age per 1,000 live births in a given year.
Zero-Dose Children Zero dose children are those who have not received even a single routine vaccine dose under the national immunization programme, indicating gaps in healthcare access, awareness, and outreach in vulnerable communities.

Contributing Factors

  • Universal Immunization Programme (UIP)
    • Now includes 12 vaccines, expanded progressively since 2014 to combat diseases like polio, rotavirus, pneumonia, measles–rubella, Japanese encephalitis, and tetanus
    • Annually vaccinates ~6 crore infants and 2.9 crore pregnant women across 1.3 crore immunisation sessions, driven by frontline ASHAs and ANMs
  • Targeted Campaigns
    • Mission Indradhanush (strengthened since 2017): Covered 46 crore children and 1.32 crore pregnant women
    • Zero Dose Implementation Plan 2024: Focused on 143 high-burden districts in 11 states to bridge the vaccination gap
    • Polio Eradication: Maintained polio-free status since 2014 through national and sub-national immunisation days
  • Digital & Community Outreach Tools
    • U-WIN platform digitally tracks vaccination status to ensure no child is overlooked
    • Public education via mass media, street plays, and digital campaigns has helped overcome vaccine hesitancy
  • Integrated Health Infrastructure
    • Schemes such as National Immunisation Days, Village Health and Nutrition Days (VHNDs), and multi-level task forces (state, district, block) ensure focused action and coverage

Global Recognition & Impact

  • India received the Measles and Rubella Champion Award from the Measles & Rubella Partnership at the American Red Cross headquarters in Washington D.C.
  • UN agencies have recognized India as a global exemplar in child health

Contextual Comparison

  • The countrywide U5MR fell from approximately 109 to 41 per 1,000 live births between 1992–93 and 2019–21 (NFHS data)
  • The latest Sample Registration System (SRS) 2019–21 report records U5MR at 31 per 1,000, IMR at 27, and NMR at 19
  • Notably, six Indian states, including Maharashtra, Kerala, and Tamil Nadu, have already met the SDG targets for child mortality .

Analysis

  • Public Health Systems Work: India’s experience proves that robust primary healthcare, especially immunisations led by community-level workers, can drastically improve health outcomes.
  • Data-Driven Targeting Matters: Precision interventions like Mission Indradhanush and zero-dose plans reflect a shift to data-informed and equity-oriented policymaking – a key governance lesson.
  • Tech + Community = Equity: Digital tools like U-WIN, paired with traditional community mobilization, enables last-mile delivery and closing the immunisation gap, resonating with GS2 & GS3 themes.
  • Global Leadership: India's achievement sets a strong precedent for other developing nations striving to fulfill SDGs, potentially shaping its diplomacy in development and health cooperation.