Kerala tops the chart as India makes significant gains in maternal and child health
As per Sample Registration System (SRS) Report 2021, Kerala is the best-performing state with the lowest maternal mortality ratio (MMR) at just 20 per lakh live births
Kerala continues to lead the nation in maternal and child health outcomes, as India reports a sharp decline in mortality rates across key indicators, bringing the country closer to achieving the Sustainable Development Goals (SDG) targets for 2030.
As per the Sample Registration System (SRS) Report 2021, released by the Registrar General of India, Kerala has emerged as the best-performing state with the lowest maternal mortality ratio (MMR) at just 20 per lakh live births—far ahead of the national average of 93.
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The state has also met or surpassed SDG targets in all child mortality indicators, including neonatal, infant, and under-five mortality rates.
Encouraging decline
India’s overall maternal and child health indicators have seen a steady and encouraging decline. The MMR dropped from 130 per lakh live births in 2014–16 to 93 in 2019–21, according to the Special Bulletin on Maternal Mortality.
This 37-point reduction reflects one of the most significant improvements globally, according to a release issued by the Ministry of Health and Family Welfare.
In child health, the Infant Mortality Rate (IMR) reduced from 39 per 1,000 live births in 2014 to 27 in 2021. Neonatal Mortality Rate (NMR) has similarly dropped from 26 to 19 per 1,000 live births, and the Under-Five Mortality Rate (U5MR) from 45 to 31 in the same period.
The sex ratio at birth has also improved from 899 in 2014 to 913 in 2021, signalling a positive trend toward gender equity.
On track to achieve SDG
According to the SRS 2021 report, eight states have already achieved the SDG target for MMR (≤70 by 2030). These include Kerala (20), Maharashtra (38), Telangana (45), Andhra Pradesh (46), Tamil Nadu (49), Jharkhand (51), Gujarat (53), and Karnataka (63).
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Kerala again leads among states that have met the SDG benchmark for Under-Five Mortality Rate (≤25), with just 8 deaths per 1,000 live births.
India outpacing world
India has also performed well on the global stage. The United Nations Maternal Mortality Estimation Inter-agency Group (UN-MMEIG) report, released in April 2025, shows India’s MMR has declined by 86% between 1990 and 2023—far surpassing the global reduction of 48% over the same period.
Similarly, the UN Inter-agency Group for Child Mortality Estimation (UN IGME) Report 2024 places India among the top performers in reducing child mortality.
From 1990 to 2023, the country has achieved a 78% drop in U5MR, a 70% decline in NMR, and a 71% fall in IMR, outperforming global reductions of 61%, 54%, and 58%, respectively.
Prioritising equitable access
Despite these successes, health officials caution that continued investment and vigilance are essential. “While we have made great strides, our goal is to ensure that no mother or child is left behind. We must continue to prioritise equitable access, especially in underserved areas,” a senior health ministry official said.
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With Kerala setting the benchmark and other states steadily improving, India appears well on track to meet—if not exceed—its SDG targets by 2030. The challenge now lies in maintaining momentum and bridging the gaps that still exist between regions.