The United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) released its 2025 report highlighting a slowdown in global progress on child survival since 2015, while recognising India as a global “exemplar” for its sustained reduction in child mortality.
Key Global Highlights
The report estimates that 4.9 million children died before the age of five in 2024, including 2.3 million newborns, along with 2.1 million deaths among children and youth aged 5–24 years.
Child mortality remains highly concentrated geographically, with Sub-Saharan Africa accounting for 58% of under-five deaths, followed by Southern Asia (25%).
Although global under-five mortality has declined by more than half since 2000, the rate of progress has slowed by over 60% since 2015. This deceleration is attributed to reduced funding, unequal healthcare access, and persistent socio-economic disparities.
Malnutrition and Causes of Death
For the first time, the report integrates malnutrition as a direct cause of death, revealing that Severe Acute Malnutrition (SAM) alone accounts for over 100,000 deaths (around 5%) among children aged 1–59 months. Indirectly, its impact is far greater as it weakens immunity.
The primary causes of death vary by age group. Among newborns (0–28 days), preterm birth complications (36%) and birth-related complications (21%) are the leading causes. For children aged 1–59 months, infectious diseases such as pneumonia, diarrhoea, and malaria remain the major killers.
India’s Performance
India has achieved remarkable progress in reducing child mortality, emerging as a global success story.
The Under-Five Mortality Rate (U5MR) declined by 79%, from 127 (1990) to 27 (2024) per 1,000 live births. The Neonatal Mortality Rate (NMR) dropped by 70%, from 57 to 17, while the Infant Mortality Rate (IMR) reduced to approximately 23.3 per 1,000 live births in 2024.
Additionally, the Maternal Mortality Ratio (MMR) declined to 97 per lakh live births (2018–20), moving India closer to the Sustainable Development Goal (SDG) targets.
Key Drivers of India’s Success
India’s progress has been driven by systematic policy interventions and public health initiatives.
A major factor has been the promotion of institutional deliveries through schemes like Janani Suraksha Yojana, which ensured safer childbirth under skilled supervision.
The expansion of Special Newborn Care Units (SNCUs) and innovations like telemedicine have significantly improved neonatal survival. Preventive healthcare efforts, particularly the Universal Immunization Programme, have expanded vaccine coverage against deadly diseases.
Further, programs like POSHAN Abhiyaan and Anaemia Mukt Bharat have addressed malnutrition, while grassroots interventions by ASHA and Anganwadi workers under IMNCI have enabled early diagnosis and treatment.
Promotion of breastfeeding through initiatives like the MAA Programme has also played a critical role in improving infant immunity.
Major Challenges in India
Despite progress, several challenges persist. A significant concern is the high share of deaths occurring in the neonatal stage (first 28 days) due to prematurity, birth asphyxia, and infections.
Malnutrition remains a major underlying factor, with high levels of maternal anaemia leading to low birth weight and weak immunity among children.
There are also deep regional disparities, with states like Kerala and Tamil Nadu performing well, while others such as Uttar Pradesh and Bihar continue to face high mortality rates.
Additionally, inadequate healthcare infrastructure in rural and tribal areas, delays in emergency care, and poor quality of institutional care remain key bottlenecks. Diseases like pneumonia and diarrhoea continue to cause significant post-neonatal deaths, reflecting gaps in water, sanitation, and hygiene (WASH).
Way Forward
To further reduce child mortality, India must focus on the critical neonatal period (first 28 days) by improving quality of care during childbirth and immediate postnatal interventions.
Strengthening practices like Kangaroo Mother Care (KMC), early breastfeeding, and neonatal screening can significantly reduce deaths. Programs such as LaQshya must be effectively implemented to improve labour room quality.
Breaking the malnutrition cycle during the first 1,000 days of life is essential through strengthened nutrition programs. Greater focus is also needed on high-burden states and aspirational districts, along with better use of real-time data systems like U-WIN for targeted interventions.
Empowering frontline workers with training, tools, and incentives will be crucial for improving outcomes at the grassroots level.
Conclusion
The UN IGME 2025 report highlights both global challenges and India’s success story. While India has made significant strides in reducing child mortality, achieving SDG 2030 targets will require a converged approach across healthcare, nutrition, and sanitation sectors, ensuring that every child has a fair chance at survival and healthy development