India has recorded a significant decline in child mortality over the past three decades, emerging as a leading contributor to improved survival rates in South Asia, according to the latest report by the United Nations Inter-agency Group for Child Mortality Estimation (UNIGME) released this week.
The report highlights that India’s neonatal mortality rate has fallen by 70 per cent, dropping from 57 deaths per 1,000 live births in 1990 to 17 in 2024. Similarly, the under-five mortality rate has declined by 79 per cent, from 127 in 1990 to 27 in 2024. These gains position India among the fastest-improving high-burden countries, with sustained policy focus translating into measurable outcomes on the ground.
India drives regional progress
India’s progress has played a central role in improving child survival across South Asia. The region has witnessed a 76 per cent decline in under-five deaths since 1990 and a 68 per cent reduction since 2000. The under-five mortality rate across the region has fallen sharply from 92 deaths per 1,000 live births in 2000 to nearly 32 in 2024.
Despite still accounting for nearly a quarter of global under-five deaths, South Asia has recorded one of the fastest rates of improvement worldwide, with India leading the momentum among countries with a high disease burden.
Public health systems deliver results
The report attributes India’s success to sustained investments in public health systems and targeted interventions addressing preventable causes of child mortality. Diseases such as pneumonia, diarrhoea, malaria and complications at birth, once major contributors to child deaths, have seen a marked decline due to improved access to timely treatment and preventive care.
Large-scale programmes such as the Universal Immunisation Programme and Mission Indradhanush have expanded vaccine coverage, while facility-based newborn care and Special Newborn Care Units have strengthened the management of high-risk births. At the community level, frontline health workers have enabled early detection and care through home-based newborn interventions.
Schemes under the National Health Mission, including Janani Suraksha Yojana and Janani Shishu Suraksha Karyakram, have also improved institutional deliveries and ensured safer childbirth, particularly among vulnerable populations.
Persistent gaps and emerging priorities
Despite the progress, disparities remain. Government data shows that rural areas continue to record higher under-five mortality rates compared to urban regions, indicating uneven access to healthcare services.
The report underscores that a large proportion of child deaths remain preventable, calling for continued investment in primary healthcare, especially in antenatal care, skilled birth attendance, and early childhood interventions. Neonatal mortality, which now constitutes a larger share of under-five deaths, remains a key challenge.
Globally, child mortality has declined significantly, with under-five deaths falling by more than half since 2000 to 4.9 million in 2024. However, the pace of reduction has slowed by over 60 per cent since 2015, raising concerns about sustaining progress.
The findings reinforce that while India’s model demonstrates how scale, policy commitment, and last-mile delivery can drive transformation, continued momentum will be essential to meet Sustainable Development Goal targets and further reduce preventable child deaths.