Invest more in India's extremely young

Infant mortality rate (IMR), the number of babies who die before their first birthday, for India is now at 28 for every 1,000 live births, just shy of the global average of 27. It lags behind most other G20 nations. There is a wide variation among the states, ranging from 43 in Madhya Pradesh to 3 in Mizoram. India's gradual reduction in IMR from 47 in 2010 to 28 in 2020 is noteworthy. But there is much more to do for every state to achieve the Sustainable Development Goal (SDG) target of 25 or less deaths per 1,000 live births by 2030.

State-level numbers are unsatisfactory, the range of improvement, 30-60%, indicative of a positive direction of travel. The national-level IMR numbers are down by 40%. Large states like Madhya Pradesh still have a very high number of 43 (down from 62 in 2010). Even in states with higher than national average IMR, the numbers are declining. Interestingly, in most states, the decline was sharper in the first half of the decade than in the second, exceptions being Kerala and Bihar. Improved delivery of government programmes focused on pregnant women has helped. The rural-urban variation is stark as well. Differentials in access to healthcare and, therefore, delivery of support for pregnant women are reflected in the variations among states, as well as in urban and rural areas.

Improved healthcare, particularly easy access to obstetricians and paediatricians, is critical to reducing the major causes of infant mortality like premature births, neonatal infections and birth asphyxia. India must continue to invest in reducing IMR. Improving healthcare delivery, ensuring support for pregnant women through regular check-ups and better diet, and improving neonatal care will go a long way to bring down the numbers.