Trends in Maternal and Child Mortality in India and High-Burden States: Progress Towards SDG

Abstract

IntroductionL Despite national progress in reducing maternal and child mortality, disparities persist across India’s Empowered Action Group (EAG) states and Assam. These regions account for a disproportionate burden of Maternal Mortality Ratio (MMR), Neonatal Mortality Rate (NMR), and Under-5 Mortality Rate (U5MR). Sustainable Development Goal (SDG) 3.1 & 3.2 targets MMR <70 per 1,00,000 live births and NMR/U5MR <12 and <25 per 1,000 live births respectively by 2030.

Objective: To analyze maternal mortality, and child mortality trends across EAG states , Assam and India (2011-2023) and to comment on attainment of SDG targets.

Methodology: Secondary data from the Sample Registration System (SRS) were compiled for MMR(2010–12 to 2021–23), NMR, and U5MR(2011–2023)  across India, EAG states and Assam. Based on past decadal trend, MMR ,NMR and U5MR of India were projected for 2030.Average annual rate of change(AARC) of MMR,NMR and U5MR  was calculated  to analyze the trend of reduction in these indicators and projection for 2030.

Results: Uttarakhand showed the most substantial summed average annual rate of change(AARC) among all higher mortality cluster states. In terms of MMR and NMR, Jharkhand and Uttarakhand experienced the fastest reduction respectively (Jharkhand has already achieved the target for MMR). Uttarakhand showed quickest decline in U5MR.

Forecast projects India’s MMR and U5MR to decline to achieve SDG goal , if the current pace of reduction continues. Uttarakhand is the only EAG state  likely to achieve all the three targets.

Conclusion: The analysis highlights a sustained decline in maternal and child mortality across India. States such as Chhattisgarh, Uttar Pradesh, Madhya Pradesh, and Odisha lag behind the reduction and may require intensified interventions to meet the 2030 deadline. These findings emphasize the need for region-specific strategies, strengthened health systems, and focused investments in high-burden areas .