Vishleshan for Regulatory Exams, 10th September 2025: The Unfinished Fight for India’s Infants

All those candidates who are eyeing exams like RBI, SEBI, or NABARD exams will have to stay updated with all the important economic and regulatory updates. In today’s edition of Vishleshan, we’ll discuss Half a Victory: The Unfinished Fight for India’s Infants. These issues are highly relevant for all the upcoming competitive exams mentioned above. Keep reading to stay ahead with a clear understanding of today’s topic.

Half a Victory: The Unfinished Fight for India’s Infants

Context: While India’s infant mortality rate has hit an all-time low, the victory is incomplete. With widespread anaemia, 900,000 unvaccinated infants, and failing rural health infrastructure, the fight to ensure every child survives and thrives is far from over. Source: Business Standard

The provided article highlights a significant public health achievement in India: a historic drop in the Infant Mortality Rate (IMR) to 25 per 1,000 live births in 2023. This progress, a steep fall from 129 in 1971, is attributed to decades of improvements in healthcare and sanitation. However, the article also points out persistent challenges, such as sharp regional disparities in IMR, with states like Uttar Pradesh, Madhya Pradesh, and Chhattisgarh reporting rates as high as 37, in contrast to low-IMR states like Kerala (5) and Manipur (3). The article identifies gaps in immunisation, maternal and child nutrition (with high rates of anaemia), and a fragile healthcare infrastructure as key vulnerabilities that could threaten these gains. It suggests a multidimensional approach, focusing on strengthening primary healthcare, community participation, and addressing nutritional and infrastructural deficiencies.

Sample Registration System (SRS):

The Sample Registration System (SRS) is a large-scale demographic survey conducted annually by the Office of the Registrar General of India. Its purpose is to provide reliable annual estimates of key demographic indicators, including the Infant Mortality Rate (IMR), Birth Rate, and Death Rate, at both the national and sub-national levels. The administrative control and structure of the SRS fall under the Office of the Registrar General of India, which operates under the Ministry of Home Affairs, Government of India. The survey uses a dual-record system, involving a continuous enumeration of births and deaths by a resident enumerator and a six-monthly survey by a supervisor to ensure accuracy.

SRS Statistical Report 2023: An Overview

The SRS Bulletin for 2023 provides a comprehensive look at India’s demographic trends.

• Infant Mortality Rate (IMR): The IMR for 2023 is estimated at 25 infant deaths per thousand live births. This represents a significant decline of about 37.5% over the last decade, down from 40 in 2013. Rural areas have a higher IMR (28) compared to urban areas (18). The report highlights that states like Chhattisgarh, Madhya Pradesh, and Uttar Pradesh have the highest IMR at 37, while Manipur has the lowest at 3.
• Birth Rate: The national Birth Rate for 2023 is estimated at 18.4 per thousand population. It has drastically declined from 36.9 in 1971. The Birth Rate is consistently higher in rural areas (20.3) compared to urban areas (14.9). Bihar has the highest Birth Rate at 25.8, while Andaman & Nicobar Islands has the lowest at 10.1.
• Death Rate: The Death Rate in 2023 is estimated at 6.4 per thousand population. This is a substantial decline from 14.9 in 1971. The Death Rate is higher in rural areas (6.8) than in urban areas (5.7). Chhattisgarh recorded the highest Death Rate at 8.3, and Chandigarh the lowest at 4.0.

Conceptual Terms Explained:

• Infant Mortality Rate (IMR): This is a key public health indicator, defined as the number of deaths of infants under one year of age per 1,000 live births. A lower IMR generally signifies better overall health infrastructure and a higher standard of living.
• Birth Rate: Also known as the crude birth rate, it is a measure of fertility, representing the number of live births per 1,000 people in a given population over a specific period.
• Death Rate: Also known as the crude death rate, it is a simple measure of mortality, defined as the number of deaths per 1,000 people in a given population over a specific period.
• Natural Growth Rate: This is the difference between the birth rate and the death rate. It indicates how quickly a population is growing or shrinking due to births and deaths alone, excluding migration.
• Anaemia: A condition characterized by a deficiency of healthy red blood cells or haemoglobin, which can lead to fatigue and other health issues. The article notes that it affects 52% of pregnant women and 67% of children under five in India, directly impacting birth outcomes and infant survival.
• Antenatal Care: The medical and nursing care given to a pregnant woman, from conception until the start of labour. It is vital for preventing and managing health issues during pregnancy and ensuring a safe delivery.
• Integrated Child Development Services (ICDS): A government programme in India that provides food, preschool education, primary healthcare, immunisation, health check-ups, and referral services to children under 6 years of age and their mothers. Under ICDS, the Ministry of Women and Child Development runs three umbrella schemes; Mission Saksham Anganwadi and Poshan 2.0, Mission Shakti, and Mission Vatsalya.
• Poshan Abhiyaan: Also known as the National Nutrition Mission, it is a flagship programme by the Government of India to improve nutritional outcomes for children, pregnant women, and lactating mothers.
• Accredited Social Health Activist (ASHA): A community health worker instituted by the Ministry of Health and Family Welfare under the National Rural Health Mission (NRHM). ASHAs act as a bridge between the community and the public health system.

Analysis and Decoding the Issue:

While the drop in IMR to 25 is a major achievement, it masks a deep-seated inequality. The article and SRS data show a stark contrast between progressive states and those lagging behind. The high IMR of 37 in states like Uttar Pradesh, Madhya Pradesh, and Chhattisgarh is a significant concern. This disparity is not just regional; it is also a rural-urban divide, as indicated by the higher IMR of 28 in rural areas compared to 18 in urban areas.

The issue goes beyond healthcare and is a complex web of interconnected problems:

• Inadequate Infrastructure: Many primary health centres in poorer states lack basic obstetric facilities and essential equipment. The reported 70% vacancy in child specialists in Madhya Pradesh is a critical example of this infrastructural and human resource deficit.
• Nutritional Deficiencies: The high prevalence of anaemia among pregnant women and young children directly contributes to poor birth outcomes and infant mortality. This is a reflection of dietary insufficiency and poor access to supplements and antenatal care.
• Immunisation Gaps: Despite widespread immunisation programmes, the fact that more than 900,000 infants missed all vaccines in 2024 is a “worrying vulnerability” that puts communities at risk of preventable outbreaks. This suggests issues with access, awareness, and vaccine hesitancy.

The article suggests that success stories like Kerala, with an IMR of just 5, offer a blueprint for other states. Their model emphasizes investing in primary healthcare, community participation, and local governance. Initiatives like Telangana’s Aarogya Lakshmi programme, which provides a hot cooked meal to pregnant and lactating women, highlight the importance of targeted nutritional interventions.

In essence, while India has made commendable strides in reducing infant mortality, the gains are “patchy”. To ensure these gains are universal and sustainable, a holistic approach is needed. This involves not just medical interventions but also addressing social determinants of health, such as nutrition, sanitation, and social equity. The challenge now is to replicate the success of a few states across the entire country by bridging the persistent gaps in infrastructure, workforce, and public health campaigns.