Infant mortality rate in india: understanding the top 10 causes

11/03/26

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The past decade has seen significant improvements in child survival in India. Recent estimates indicate that the Infant Mortality Rate in India stands at around 25 deaths per 1,000 live births (SRS 2023). This is quite a big step forward from previous years, and the rate has gone down to around 25 in 2023, compared to 44 in 2011. The national average will remain near 2425, signifying even more positive change by 2025-26.

However, it is necessary to mention that most infant deaths can be prevented by providing quality healthcare, nutrition interventions, safe delivery interventions, and early newborn care. Understanding causes of infant mortality in India is essential for strengthening community awareness, improving service delivery, and ensuring every child has the best possible start in life. 

We work with Bal Raksha Bharat on government health and nutrition programmes to rationalise systems and improve outcomes for children, especially in underserved communities. In this article, we explain what the infant mortality rate is, share recent insights from India, and explore the leading causes and prevention strategies.

What is the Infant Mortality Rate (IMR)? 

Many people ask, ” What is the infant mortality rate, and why does it matter so much for a country’s development?

The Infant Mortality Rate (IMR) is defined as:

The number of deaths of children under the age of one year per 1000 live births in the same year.

In fact, this indicator is highly popular since it displays:

• The service and antenatal care of the mother.
• Healthy childbirth and infant interventions.
• Food and breastfeeding experiences.
• Immunisation coverage
• Hygienic and sanitary conditions.
• Timely access to infection treatment.

IMR vs Neonatal Mortality vs Under-Five Mortality

IMR is measured using data from sources such as:

• Sample Registration System (SRS)
  
• National Family Health Survey (NFHS)
  
• UNICEF and WHO global child survival databases
  

As IMR is a determinant that affects health care systems and household conditions, it is among the most crucial child survival determinants.

Current Infant Mortality Rate in India (2026 Insights)

As per the latest available national data, the Infant Mortality Rate in India is approximately 25 per 1,000 live births (SRS 2023).

Key national trends

India has shown significant progress over time:

• IMR declined from around 44 in 2011
  
• It reduced further to around 39 in 2014
  
• It reached approximately 25 in 2023
  

It is an indicator of improved institutional deliveries, immunization, mother care, and newborn services.

Rural and urban differences

Disparities remain across geography:

• Rural IMR is around 28
  
• Urban IMR is around 18

State variations

In some states, IMR rates remain higher than the national average, mainly in the central and northern regions of India. Traditional rates in other states, such as Madhya Pradesh and Uttar Pradesh, are relatively high compared to the southern states.

Neonatal deaths form the majority

A significant problem is that of neonatal deaths in terms of infant deaths, accounting for more than 73%. It means that the first month of life is the most critical period for survival.

India has development potential, and additional work will be required to reduce IMR, focusing on newborns, maternal diets, and early reaction to infections.

Top 10 Causes of Infant Mortality Rate in India

Understanding the causes of the infant mortality rate helps families, communities, and health systems focus on prevention. The causes of infant mortality in India are strongly linked to newborn health, infections, nutrition, and access to timely care.

The most widely known causes are as follows: they are based on national and global experience in child survival.

1. Prematurity and Low Birth Weight

In India, low birth weight and premature birth remain among the causes of infant mortality.

Common reasons include:

• Maternal malnutrition and anaemia
  
• Short intervals between pregnancies
  
• Lack of quality antenatal care
  
• Infections during pregnancy
  
• Early or high-risk pregnancies
  

Premies have specialised needs, such as warmth, feeding, and protection from infections.

2. Neonatal Infections (Sepsis, Pneumonia)

Neonatal infections are a major contributor to the Infant Mortality Rate (IMR), especially in the first month of life.

Common infections include:

• Sepsis
  
• Pneumonia
  
• Meningitis
  

Infections may occur due to:

• Unhygienic delivery conditions
  
• Poor cord care practices
  
• Delayed treatment after symptoms appear
  
• Lack of access to newborn intensive care
  

Early recognition and immediate medical care can prevent many of these deaths.

3. Birth Asphyxia and Birth Trauma

Birth asphyxia occurs when the child receives insufficient oxygen at birth. It is one of the most preventable causes of the Infant Mortality Rate.

It is linked to:

• Delayed access to skilled birth attendants
  
• Complications during labour
  
• Lack of emergency obstetric care
  
• Delays in referral and transport
  

The rates of mortality caused by birth asphyxia can be reduced through education of healthcare workers on the issue of neonatal resuscitation.

4. Congenital Anomalies

Congenital anomalies are structural or functional disorders present from birth.

Examples include:

• Heart defects
  
• Neural tube defects
  
• Genetic disorders
  

Other inborn diseases can be detected at an early age through antenatal screening, and some can be cured with immediate medical attention. 

5. Diarrhoeal Diseases

Infant death may also be caused by diarrhoea, Especially in areas with inadequate water, sanitation and hygiene facilities. 

Key risk factors include:

• Unsafe drinking water
  
• Poor sanitation
  
• Improper Infant feeding practices
• Delayed ORS and zinc treatment
  

Many diarrhoea-related deaths are preventable with hygiene awareness and early care.

6. Acute Respiratory Infections Beyond the Neonatal Period

Pneumonia remains a serious cause of death in infants beyond the neonatal stage.

Contributing factors include:

• Indoor air pollution
  
• Poor nutrition
  
• Delayed care-seeking
  
• Low immunisation coverage
  

7. Malnutrition and Feeding Difficulties

Malnutrition is not always recorded as the direct cause of death, but it significantly increases vulnerability to infections.

Feeding-related risks include:

• Low rates of exclusive breastfeeding
  
• Lack of early initiation of breastfeeding
  
• Inadequate complementary feeding after six months
  

Nutrition interventions directly influence child survival outcomes.

8. Vaccine-Preventable Diseases

Diseases such as measles, pertussis, and other infections can still contribute to infant deaths if immunisation coverage is incomplete.

Strengthening immunisation delivery remains essential to reduce the Infant Mortality Rate further.

9. Injuries and Accidents

Although less common compared to infections and neonatal causes, injuries can contribute to infant deaths, especially due to:

• Unsafe sleeping practices
  
• Burns and household accidents
  
• Lack of supervision in vulnerable settings
  

10. Ill-Defined and Other Causes

Some infant deaths are recorded under “ill-defined causes” due to:

• Lack of medical certification
  
• Death occurring at home without assessment
  
• Delayed reporting
  

Improving death reporting and health surveillance helps identify patterns and strengthens prevention.

Why These Causes Persist in India

The causes of infant mortality in India are closely linked to broader social and health system factors. While progress has been strong, challenges persist due to:

1. Poverty and household vulnerability

Families facing poverty may struggle to access nutritious food, transport to health facilities, and early medical care.

2. Rural-urban divide

Rural communities often face:

• Longer travel time to hospitals
  
• Fewer specialists
  
• Limited newborn care infrastructure
  

3. Maternal health and nutrition gaps

Maternal anaemia, undernutrition, and lack of antenatal care increase the risk of prematurity and complications.

4. Low awareness of newborn danger signs

Many families do not recognise early signs of infection, breathing difficulty, or dehydration.

5. Sanitation and hygiene barriers

Poor hygiene practices can increase infection risks for newborns and infants.

These factors collectively influence the Infant Mortality Rate (IMR) and highlight why multi-sector solutions are necessary.

Prevention Strategies and Government Initiatives

India has launched several programmes to address the Causes of Infant Mortality Rate, and these have contributed to steady progress. Continued strengthening and community participation will accelerate impact.

Key prevention strategies

• Quality antenatal care and early registration
  
• Maternal nutrition support and anaemia control
  
• Institutional deliveries with skilled staff
  
• Immediate newborn care and resuscitation support
  
• Exclusive breastfeeding for the first six months
  
• Full immunisation coverage
  
• ORS and zinc for diarrhoea management
  
• Hygiene, safe water, and sanitation improvement
  

Major government initiatives

Some important initiatives include:

• National Health Mission (NHM)
  
• Janani Suraksha Yojana (JSY) for institutional delivery support
  
• Home-Based Newborn Care (HBNC)
  
• POSHAN Abhiyaan for nutrition strengthening
  
• Routine immunisation programmes
  

At Bal Raksha Bharat, we work in alignment with these initiatives by strengthening community awareness, supporting frontline systems, and ensuring families are connected to essential services.

Conclusion

India’s progress in reducing the Infant Mortality Rate from around 44 in 2011 to approximately 25 in 2023 reflects the impact of sustained public health investment and improved service delivery. Yet, the majority of infant deaths remain preventable, especially those occurring in the neonatal period.

By focusing on maternal nutrition, safe deliveries, early newborn care, infection prevention, breastfeeding support, immunisation, and timely treatment, India can continue to reduce the Infant Mortality Rate (IMR) and ensure healthier beginnings for every child.

Bal Raksha Bharat remains committed to strengthening child survival outcomes through more than 60 programmes, working since 2004, and having impacted the lives of more than 10 million children across education, healthcare, nutrition, protection, inclusion, resilience, disaster relief, and emergency preparedness.

FAQs

How is the Infant Mortality Rate calculated?

The Infant Mortality Rate (IMR) is calculated as the number of deaths of infants under one year of age per 1,000 live births in a given year.

What is the current Infant Mortality Rate in India in 2026?

The latest national estimate shows an IMR of around 25 per 1,000 live births (SRS 2023). Projections for 2025–26 suggest it may remain around 24–25.

What are the primary causes of infant mortality?

The leading causes include prematurity and low birth weight, neonatal infections, birth asphyxia, congenital anomalies, pneumonia, diarrhoeal diseases, malnutrition, and vaccine-preventable diseases.

What is the difference between Infant Mortality Rate and Child Mortality Rate?

The Infant Mortality Rate measures deaths under one year of age per 1,000 live births, while child mortality often refers to deaths under five years of age.

Naveen Kumar

“Naveen is an SEO expert and digital marketing analyst at Bal Raksha Bharat with a passion for helping businesses grow online. With a data-driven approach, he specializes in boosting search rankings, driving traffic, and optimizing digital strategies. Follow for tips on SEO, content, and marketing trends."