As India observes National Newborn Week from November 15 to 21, 2025, Kerala has achieved an extraordinary public health milestone that has captured national attention. The southern state has successfully reduced its Infant Mortality Rate to just 5 deaths per 1,000 live births, according to recent government data released in September.
This remarkable achievement not only places Kerala significantly ahead of India's national IMR average of 25 but also enables it to outperform developed nations including the United States, which recorded an IMR of 5.6 deaths per 1,000 births last year.
The Foundation of Kerala's Success
Health officials and experts attribute this success to decades of consistent social investment and the state's robust public health infrastructure. Kerala's achievement stems from a comprehensive approach that combines maternal and child health policies with precisely targeted interventions.
The state health department, in communication with media outlets, highlighted that one of their primary challenges was addressing the persistently high rate of neonatal deaths - infants dying within the crucial first 28 days after birth. Major contributing factors included premature births, low birth weight, and birth asphyxia, a condition where newborns experience oxygen deficiency around the time of delivery.
Overcoming Significant Challenges
Kerala faced several obstacles in its journey to lower IMR. The state encountered rural-urban disparities, with tribal and coastal communities reporting higher infant mortality rates. Cultural barriers also presented challenges, including misconceptions about breastfeeding practices and resistance to vaccination programs.
Financial constraints added another layer of complexity, as Kerala's aging population demanded increased healthcare allocations, creating competition for resources dedicated to infant mortality reduction programs.
To counter breastfeeding myths, the state established Comprehensive Lactation Management Centres that collect and store breast milk for babies in need, ensuring optimal nutrition for infants regardless of maternal circumstances.
Comprehensive Health Initiatives
Kerala's health department collaborated with the National Health Mission and the Indian Academy of Paediatrics to implement a focused program across both public and private healthcare facilities. This coordinated effort resulted in an impressive 99.5% institutional delivery rate, meaning virtually all births now occur in medical facilities with proper care.
The state launched several specialized schemes addressing different aspects of maternal and child health:
Shalabham provides comprehensive screening for birth defects in newborns, covering visible abnormalities, functional defects, metabolic disorders, and neuro-developmental issues. The program detects conditions like congenital hypothyroidism, congenital adrenal hyperplasia, and various genetic disorders.
KARE (Kerala United Against Rare Diseases) manages and treats rare childhood diseases, offering access to specialized treatments and free life-saving medications for conditions such as Spinal Muscular Atrophy.
LaQshya focuses on improving infrastructure and quality processes in labor rooms while enhancing healthcare workers' skills. Under this initiative, twelve facilities have received 'LaQshya-certified' status for meeting National Quality Assurance Standards.
MusQan, a National Health Mission program, adopts a multi-pronged strategy to enhance public health services for children up to age 12, improving quality in Special Newborn Care Units and nutritional rehabilitation centers.
Hridyam: Tackling Congenital Heart Diseases
Recognizing congenital heart diseases as a major contributor to infant mortality, Kerala launched the web platform Hridyam in August 2017. This innovative program facilitates early identification, treatment, and follow-up care for children with heart conditions.
The initiative has registered 24,222 children for treatment, with 15,686 being under one year of age. More than 8,335 surgeries and medical interventions have been conducted through this program.
Eight government and private hospitals have been empanelled under Hridyam, including SAT Hospital in Thiruvananthapuram, which has established a specialized pediatric heart surgery department equipped with ECMO technology for complex cardiac procedures.
The program ensures emergency treatment within 24 hours and provides ventilator-equipped ambulance services. Screening occurs across multiple settings - government hospitals, homes, anganwadis, and schools - with echocardiograms conducted when symptoms appear, and treatment initiated at birth when heart disease is detected in the fetus.
Kerala's achievement demonstrates how targeted public health interventions, combined with strong infrastructure and community engagement, can produce world-class health outcomes even in developing regions. As India celebrates National Newborn Week, Kerala's success offers valuable lessons for other states striving to improve child survival rates.
