Bihar Shows Dramatic Drop in Infant Mortality

By: Lakshita Bhagat

While Madhya Pradesh, Rajasthan, and Uttar Pradesh have brought down their IMR to 43, 32, and 38, Bihar has improved its IMR most impressively with 27 deaths per 1000 live births.

The much criticized and mocked Bihar has actually outperformed fellow laggards like Madhya Pradesh, Chhattisgarh, Uttar Pradesh and Rajasthan in a significant parameter: infant mortality rates. This was revealed by the latest Sample Registration Survey Report released last week by the Registrar General of India. This annual survey provides estimates for fertility (birth rate), mortality (death rate) and infant mortality (Infant Mortality Rate- death within one year of birth per thousand live births). The IMR serves as one of the critical indicators of population health because it is closely related to the socio-economic factors and conditions of living. Generally considered a laggard state on the mentioned parameters, it is interesting to note that the IMR has dropped considerably in Bihar. The IMR for Bihar has declined steadily over the decades.

Once stood at 63 deaths per 1000 live births in 1999, between 2015 and 2020, the IMR fell from 42 to 27 deaths per 1000 live births, which is even lower than the national IMR average of 28 deaths per 1000 live births. The decline appears even more significant when juxtaposed with socio-economically backward states known for poor maternal and child health indicators, the so-called BIMARU states (Bihar, Madhya Pradesh, Rajasthan, and Uttar Pradesh). In 2015, the IMR for all the BIMARU states lay in the bracket of 40-50 deaths per 1000 live births. While Madhya Pradesh, Rajasthan, and Uttar Pradesh have brought down their IMR to 43, 32, and 38, Bihar has improved its IMR most impressively with 27 deaths per 1000 live births.

Infant Mortality Rate in the BIMARU States, 2015-2020

Source: Ministry of Health and Welfare; Sample Registration System (SRS) Bulletin of Registrar General of India (RGI), 2022

This impressive performance can be attributed to various factors and policy interventions. The Janani Suraksha Yojana (JSY), launched under the National Health Mission in 2005, aimed at reducing maternal and infant mortality, is considered to have played an essential role in improving these vital health parameters. There has been a massive increase in institutional deliveries in Bihar, which has implications for IMR. The Universal Immunization Programme (UIP) and other community-based care programmes also play a vital role in infant health. Also, the state has been involved in carrying out women-related policy interventions in the domains of education and empowerment.

However, despite lowering infant mortality dramatically and performing considerably better among the BIMARU states, certain shortcomings and challenges remain. For instance, despite an enormous rise in institutional deliveries, antenatal care services remain underutilised. Accessibility and affordability of care services remain a concern as women from poor and lower caste backgrounds are less likely to opt for institutional deliveries and care services. The maternal mortality rate for Bihar is much higher than the national average. To further improve infant and maternal health and lower the corresponding mortality, it is crucial to update the health infrastructure, increase awareness and, most importantly, work towards enhancing socio-economic and living conditions.