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NEW DELHI — India has achieved a historic milestone in public health, recording a dramatic 79% reduction in under-five child mortality over the last three decades. According to the United Nations Inter-agency Group for Child Mortality Estimation (UNIGME) Report 2025 released this month, India’s strategic interventions have transformed the nation from a high-burden region into a global leader in child survival. While the world grapples with stalling progress in pediatric health, India’s under-five mortality rate dropped from 127 deaths per 1,000 live births in 1990 to just 26.6 in 2024, outperforming global averages and providing a scalable blueprint for other developing nations.
A Decisive Shift in Survival Trends
The UNIGME’s latest report, Levels & Trends in Child Mortality, reveals that India’s progress has significantly outpaced the global decline of 61% during the same period. The data paints a picture of a rapid epidemiological shift:
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Under-Five Mortality: Fell to 26.6 per 1,000 live births.
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Neonatal Mortality: Deaths within the first 28 days of life plunged 70%, from 57 to 17 per 1,000 live births.
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Infant Mortality: Reached 23.3 per 1,000 live births.
South Asia, buoyed largely by India’s domestic successes, saw a 76% drop in under-five deaths since 1990. This is particularly notable given that globally, 4.9 million children under the age of five still died in 2024—most from preventable or treatable causes. While global progress has slowed by over 60% since 2015, India has maintained a steady downward trajectory, averting millions of potential deaths.
The Engines of Change: Government Strategy and Innovation
Public health experts attribute this success to a “continuum of care” approach that targets both the mother and the child from pregnancy through early childhood. Central to this are several flagship programs:
1. Incentivizing Safe Births
The Janani Suraksha Yojana (JSY) and Janani Shishu Suraksha Karyakram (JSSK) have been “game-changers.” By providing cash assistance for institutional deliveries and removing out-of-pocket costs for drugs, transport, and diagnostics, these programs have boosted hospital births by over 40% in some regions. This shift away from unsupervised home births has directly reduced risks associated with maternal hemorrhage and neonatal asphyxia.
2. Digital and Physical Infrastructure
The expansion of Special Newborn Care Units (SNCUs) has provided high-quality medical intervention for fragile infants. Innovation has played a role here, too; Tele-SNCU digital monitoring now allows specialists in tertiary centers to provide real-time guidance to healthcare workers in remote, underserved districts.
3. The Immunization Shield
India’s Universal Immunisation Programme (UIP) remains one of the largest in the world. Through Mission Indradhanush, the government has vaccinated over 5.46 crore children against 12 life-threatening diseases. By 2024, the percentage of “zero-dose” children (those who have received no vaccines) plummeted to a mere 0.06% of the population.
Expert Perspectives: Celebrating Progress, Identifying Gaps
The international community has taken note of India’s “coordinated, standards-driven approach.” Union Health Minister Jagat Prakash Nadda noted that India has emerged as a “leading global exemplar,” citing the 79% decline as evidence of sustained political will.
However, clinical experts emphasize that the final stretch toward the Sustainable Development Goals (SDGs) will be the hardest. Dr. Arvind Kumar, Principal Director and Head of Paediatrics at Fortis Hospital, Shalimar Bagh, highlights the remaining clinical hurdles.
“Conditions like premature birth, birth asphyxia, and infections remain major causes of mortality,” Dr. Kumar noted. “Gaps in care—such as missed high-risk pregnancies and a lack of trained staff during delivery—further increase risk. Improving the quality of care during the first few days of life is critical if we are to reach single-digit mortality rates.”
Global Context and Public Health Implications
India’s success is a beacon for the 60 countries currently at risk of missing the 2030 SDG targets for child survival. While South Asia still accounts for 25% of global under-five deaths, the region is the fastest-improving in the world.
For the average citizen, these statistics translate into tangible societal benefits. A lower child mortality rate bolsters India’s “demographic dividend,” ensuring more children survive to reach school age and eventually join the workforce. For expectant parents, the strengthening of the public health net means that complications like birth asphyxia—once a common tragedy—are increasingly manageable through professional medical intervention.
Remaining Challenges and Limitations
Despite the celebration, the UNIGME report and independent researchers urge caution. Several “bottlenecks” remain:
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The Neonatal Burden: Deaths within the first month of life now account for over 60% of all under-five deaths. This suggests that while we have conquered many childhood infections, we are still struggling with the complexities of preterm labor and neonatal sepsis.
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Regional Disparities: While rural areas have seen faster gains than cities recently, high-burden states in the “BIMARU” belt still require intensified outreach compared to high-performing southern states.
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Quality vs. Quantity: Some critics argue that while JSY boosted the number of hospital deliveries, the quality of care in some rural facilities has not always kept pace, leading to preventable complications like eclampsia.
The Path to 2030
To reach the ambitious SDG target of single-digit mortality rates by 2030, India is now pivoting toward “quality-centric” care. This includes expanding zero-dose immunization plans in 143 priority districts and optimizing data from stillbirth surveillance—one of the first such guidelines globally—to identify and fix local healthcare weaknesses.
As a high-population, high-burden nation that has successfully “bent the curve,” India’s blueprint of coordinated scaling and digital innovation now offers a roadmap for peer nations like Pakistan and various sub-Saharan African countries.
Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.
References
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United Nations Inter-agency Group for Child Mortality Estimation (UNIGME). Levels & Trends in Child Mortality Report 2025. UNICEF, WHO, World Bank, UN DESA; March 2025. childmortality.org
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Hindustan Times. “India’s sustained efforts driving sharp decline in child mortality: UN Report.” March 18, 2026.
