**Executive Summary**
This document contains the response of the Minister of State in the Ministry of Health and Family Welfare to Unstarred Question 1022 in Lok Sabha, to be answered on December 5th, 2025, regarding infant, child, and maternal deaths in Kerala. It includes data from the last ten years, causes of death, and steps taken by the government to reduce mortality. Relevant data is provided in the annexures.
**Key Points / Main Content**
* **Mortality Data in Kerala:**
* Infant Mortality Rate (IMR) and Under 5 Mortality Rate (U5MR) for the last ten years (data shown is from 2014 to 2023) are available in Annexure I.
* Maternal Mortality Ratio (MMR) for the last ten years (data shown is from 2014-16 to 2021-23) is placed in Annexure II.
* **Causes of Infant and Child Deaths (National Level):**
* Based on the SRS-RGI report for 2021-2023, major causes include prematurity & low birth weight, pneumonia, birth asphyxia & birth trauma, congenital anomalies, diarrhea, and sepsis.
* **Causes of Maternal Deaths (Kerala):**
* As reported by the State of Kerala, the major causes are haemorrhage, hypertensive disorders, sepsis and amniotic fluid embolism.
* **Government Initiatives:**
* Maternal and Child Death Reviews are conducted at State, district, and facility levels to identify gaps and implement corrective measures.
* The Ministry of Health and Family Welfare (MoHFW) provides technical and financial support for implementation of the Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition (RMNCAH + N) strategy under the National Health Mission (NHM).
* Several interventions are in place to improve maternal health outcomes across the country. Interventions listed are Janani Suraksha Yojana (JSY), Janani Shishu Suraksha Karyakram (JSSK), Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), LaQshya, Surakshit Matritva Aashwasan (SUMAN), Optimizing Postnatal Care, Functionalization of First Referral Units (FRUs), Setting up of Maternal and Child Health (MCH) Wings, Operationalization of Obstetric High Dependency Units & Intensive Care Units, Birth Waiting Homes (BWH), and Capacity Building of staff.
* Several interventions are in place to improve child health outcomes across the country. Interventions listed are Facility Based Newborn Care, Community Based care of Newborn and Young Children, Janani Shishu Suraksha Karyakram (JSSK), Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS), STOP Diarrhoea campaign, and Rashtriya Bal Swasthya Karyakram (RBSK).
**Impact Analysis**
**State of Kerala:**
* **Impact:** The State's health officials and healthcare system are impacted by the monitoring of mortality rates and the implementation of interventions.
* **Action Required:** Continue conducting Maternal and Child Death Reviews, implement corrective measures, and utilize the technical and financial support from MoHFW to improve health outcomes.
**Pregnant Women, Infants, and Children:**
* **Impact:** These are the direct beneficiaries of the government's health initiatives aimed at reducing mortality and improving healthcare access and quality.
* **Action Required:** Utilize the available healthcare services and programs, such as JSY, JSSK, PMSMA, RBSK, and others, to ensure safe deliveries, newborn care, and child health.
**Accredited Social Health Activists (ASHAs):**
* **Impact:** ASHAs play a crucial role in community-based healthcare, especially in improving child-rearing practices and identifying sick newborns and postpartum mothers.
* **Action Required:** Continue conducting home visits, promoting safe health practices, and referring high-risk cases for prompt treatment.
Key Entities Referenced
Ministry of Health and Family Welfare: The central ministry responsible for health-related policies and programs, including those addressing infant and maternal mortality.
Kerala: The state in India that is the primary focus of the questions regarding infant and maternal mortality rates.
National Health Mission (NHM): A national-level program under which the Ministry of Health and Family Welfare supports the implementation of strategies related to reproductive, maternal, newborn, child, and adolescent health and nutrition.
Janani Suraksha Yojana (JSY): A demand promotion and conditional cash transfer scheme promoting institutional delivery.
Janani Shishu Suraksha Karyakram (JSSK): A program that entitles pregnant women and sick infants to free delivery and treatment in public health institutions.
GOVERNMENT OFINDIA
MINISTRYOFHEALTHAND FAMILYWELFARE
DEPARTMENT OFHEALTH AND FAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION 1022
TOBE ANSWERED ON5TH DECEMBER 2025
INFANTDEATHSIN KERALA
1022: SHRIKODIKUNNILSURESH:
Will the Ministerof HEALTH AND FAMILYWELFAREbe pleasedtostate:
(a) the total number of infant deaths (0–1 year) and child deaths (1–5 years) reported from
Government andprivate hospitals inKerala during the last tenyears;
(b) the details of infant and child mortality, indicating causes of death andthe type of facilitywhere
the deaths occurred during the last ten financial years in the country, State/UT-wise and district-
wise;
(c) the total number of maternal deaths reported in Kerala during the last ten years, especially
deathsof pregnantwomen occurringduring labour,deliveryor immediately postpartum;
(d) the details of maternal deaths including medical causes, delays in referral, availability of
emergency obstetric care,district-wise andhospital-wise;
(e) whether any audits or investigations have been conducted into high-burden districts and if so,
the findingsthereof; and
(f) the steps taken by the Government to reduce infant, child and maternal mortality in Kerala
through improvedinfrastructure, manpower andemergencycare services?
ANSWER
THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND FAMILYWELFARE
(SMT. ANUPRIYAPATEL)
(a)AsperavailablereportofSampleRegistrationSystem(SRS)ofRegistrarGeneralofIndia(RGI),
Infant Mortality Rate (IMR) and Under 5 Mortality Rate (U5MR) during last ten (10) years for the
StateofKeralaisplacedatAnnexureI.
(b) The Office of Registrar General of India (RGI) publishes National level data on various
indicators. As per SRS-RGI report for the year 2021-2023, the major causes of infant and child
deaths are prematurity & low birth weight, pneumonia, birth asphyxia & birth trauma, congenital
anomalies,diarrhoea and sepsis.
Details for the previous years (from 2014–16 onwards) may be accessed from the reports as
indicatedbelow:
https://censusindia.gov.in/census.website/data/SRSCOD
(c)AspertheSpecialBulletinonMaternalMortalityRatio(MMR)releasedbytheRegistrarGeneral
ofIndia,theMMRofKeralaoverthelasttenyearsisplacedatAnnexureII.(d) As reported by the State of Kerala, the major causes of maternal deaths are haemorrhage,
hypertensive disorders, sepsis andamniotic fluidembolism.
(e) As reported by the State of Kerala, Maternal and Child Death Reviews are conducted at the
State, district and facility levels to identify gaps and implement corrective and preventive measures
toavertpreventable deaths.
(f) The Ministry of Health and Family Welfare (MoHFW) provides technical and financial support
for implementation of Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition
(RMNCAH + N) strategy under National Health Mission (NHM) based on the Annual Program
ImplementationPlan (APIP)submitted byrespective State / UT.
The details of interventions to improve maternal health outcomes all across the country including
Stateof Kerala,are placedbelow:
Janani Suraksha Yojana (JSY) is a demand promotion and conditional cash transfer
scheme for promotinginstitutional delivery.
Janani Shishu Suraksha Karyakram (JSSK) under which every pregnant woman and
sick infant is entitled to free delivery, including caesarean section, in public health
institutions along with provision of free transport, diagnostics, medicines, blood, other
consumables& diet.
Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) provides pregnant women a
fixedday, free of cost assured andqualityantenatal checkupbya Specialist/MedicalOfficer
onthe 9thdayof every month.
o ExtendedPMSMA(e-PMSMA) strategy was launched for individual tracking of
high-risk pregnantwomen till a safe delivery.
LaQshya improves the quality of care in labour room and maternity operation theatres to
ensure that pregnant women receive respectful and quality care during delivery and
immediatepost-partum.
Surakshit Matritva Aashwasan (SUMAN) aims to provide assured, dignified, respectful
and quality healthcare at no cost and zero tolerance for denial of services for every woman
and newborn visiting the public health facility to end all preventable maternal and newborn
deaths.
OptimizingPostnatal Care aims to strengthen the quality of postnatal care by laying
emphasis on detection of danger signs in mothers and incentivizing Accredited Social
Health Activists (ASHAs) for prompt detection, referral & treatment of such high-risk
postpartum mothers.
Functionalization of First Referral Units (FRUs) by ensuring manpower, blood storage
units, referral linkagestoimprove the accesstoqualityof care for pregnant women.
Setting up of Maternal and Child Health (MCH) Wings at high caseload facilities to
improve the qualityof care providedtomothersandchildren. Operationalization of Obstetric High Dependency Units & Intensive Care Units (Obst.
HDU & ICU) in high case load tertiary care facilities across the country to handle
complicatedpregnancies.
Birth Waiting Homes (BWH) are established in remote and tribal areas to promote
institutional delivery andimprove accesstohealthcarefacilities.
Capacity Building of staff in Skilled Birth Attendance (SBA), Daksh, Dakshata along with
BEmONC, CEmONC andLSAS to provide comprehensive quality care during delivery at a
healthfacility.
The details of interventions to improve child health outcomes all across the country including State
of Kerala,are placedbelow:
Facility Based Newborn Care: Special New-born Care Units (SNCUs) are established at
District Hospital and Medical College level, Newborn Stabilization Units (NBSUs) are
established at First Referral Units (FRUs)/ Community Health Centres (CHCs) for care of
sick andsmall babies.
Community Based care of Newborn andYoung Children: Under Home Based New-born
Care (HBNC) and Home-Based Care of Young Children (HBYC) program, home visits are
performed by ASHAs to improve child-rearing practices and to identify sick newborn and
youngchildreninthe community.
Janani Shishu Suraksha Karyakram (JSSK): Sick infant up to one year of age is entitled
to free treatment in public health institutions along with the provision of free transport,
diagnostics, medicines,bloodand consumables.
Social Awareness andActions to NeutralizePneumonia Successfully (SAANS) initiative
implemented since 2019 for reduction of childhood morbidity and mortality due to
Pneumonia.
STOP Diarrhoea campaign is implemented for promoting use of ORS and Zinc and for
reducingmorbidityandmortality due tochildhooddiarrhoea.
Rashtriya Bal Swasthya Karyakram (RBSK): Children from 0 to 18 years of age are
screened for 32 health conditions (i.e.Diseases, Deficiencies, Defects and Developmental
delay) underRashtriya Bal Swasthya Karyakram (RBSK) to improve child survival. District
Early Intervention Centres (DEICs) at district health facility level are established for
confirmationandmanagement of childrenscreenedunderRBSK.
*****Annexure I
Annexure referred to in reply to part (a) of Lok Sabha Unstarred Question No. 1022
for reply on 5th December 2025
Status of Infant Mortality Rate and Under 5 Mortality Rate in the State of
Kerala
Infant Mortality Rate (IMR) Under 5 Mortality Rate (U5MR)
2014 12 13
2015 12 13
2016 10 11
2017 10 12
2018 7 10
2019 6 9
2020 6 8
2021 6 8
2022 7 9
2023 5 8
Unit: Per 1000 live births
Source: Sample Registration System (SRS) of Registrar General of India (RGI)
https://censusindia.gov.in/census.website/data/SRSSTATAnnexure II
Annexure referred to in reply to part (c) of Lok Sabha Unstarred Question No. 1022
for reply on 5th December 2025
Status of Maternal Mortality Ratio (MMR) in the State of Kerala
2014-16 46
2015-17 42
2016-18 43
2017-19 30
2018-20 19
2019-21 20
2020-22 18
2021-23 30
Unit: Per 1,00,000 births
Source: Special Bulletin on Maternal Mortality Ratio (MMR),
Sample Registration System (SRS) of Registrar General of India
(RGI)
https://censusindia.gov.in/census.website/data/SRSMMB