Overview

• Madhya Pradesh, Chhattisgarh and Uttar Pradesh reported the highest IMR at 37, while Manipur was lowest at 3 and Kerala was the only large state at a single digit with 5.
• Kerala reports no rural–urban gap in infant deaths according to state data, as Delhi, Himachal Pradesh and Karnataka logged the steepest decade-long reductions.
• Rural IMR fell from 44 to 28 over the decade and urban IMR from 27 to 18, indicating gains across settings though gaps persist.
• India’s birth rate declined to 18.4 and the death rate to 6.4 in 2023, roughly half their 1971 levels, underscoring a broader demographic transition.
• Experts credit expanded neonatal care, immunisation and new NICUs for most recent gains while warning further progress will depend on targeted, quality-focused efforts in high-burden states.