Science
Kerala Achieves Historic Low in Infant Mortality Rate at 5

Kerala has reached a significant milestone in public health, with its infant mortality rate (IMR) falling to an all-time low of 5 per 1,000 live births, according to the latest Sample Registration Survey (SRS) for the reference year 2023. This figure is notably five times lower than the national average of 25, demonstrating the effectiveness of the state’s health initiatives. Impressively, Kerala’s IMR is even lower than that of the United States, which stands at 5.6.
Systematic Approach to Healthcare
This achievement marks a significant triumph for Kerala’s health system, which is unique in the country for maintaining a single-digit IMR without any urban-rural divide. Kerala first recorded a single-digit IMR of 7 in 2018 and subsequently dropped to 6 in 2019. The journey towards achieving this target began in 2010, driven by the State Health department in collaboration with the Indian Academy of Paediatrics (IAP). Prior to this, the IMR had stagnated at 12 for several years.
A comprehensive statewide study conducted by the IAP in 2013 identified that 75% of infant deaths occurred during the neonatal period, with 59% of these deaths happening within the first week of life. Prematurity contributed to 35% of the infant deaths, while congenital heart diseases accounted for 28%.
The systematic approach adopted by Kerala focused on several critical areas. This included proper auditing of infant deaths, development of clinical guidelines, investment in neonatal intensive care units (NICUs), and rigorous training for healthcare professionals. The state has achieved recognition for its efforts, with 16 public hospitals receiving the LaQshya national accreditation and six hospitals earning the MusQan certification for child-friendly services.
Innovative Health Initiatives
Among the key initiatives launched is a comprehensive newborn screening program aimed at detecting birth defects and congenital disorders. Additionally, the flagship program Hridyam, initiated in 2017, focuses on the early detection and treatment of congenital heart anomalies in infants. The program has made a measurable impact, as deaths related to congenital heart disease dropped by 41% in its first two years, contributing to an overall 21% decrease in infant deaths.
To date, approximately 8,450 infants have benefited from the Hridyam program, underscoring the state’s commitment to improving infant health. Through these comprehensive and targeted measures, Kerala not only sets a benchmark for public health in India but also serves as an exemplary model for other states looking to enhance their healthcare systems.
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