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Despite falling IMR, sharp health inequalities persist across India: JSAI

By A Representative 
The health rights advocacy group Jan Swasthya Abhiyan India (JSAI) has expressed serious concern over persistent inequalities in infant and maternal health outcomes across India, despite improvements in national health indicators highlighted in the latest Sample Registration System (SRS) Bulletin released by the Office of the Registrar General of India.
According to the SRS Bulletin 2026, India’s Infant Mortality Rate (IMR) has declined to 24 per 1,000 live births. However, several states continue to report significantly higher mortality levels. Chhattisgarh recorded the highest IMR at 36, followed by Uttar Pradesh and Madhya Pradesh at 35 each.
JSAI said the figures expose deep inequities in access to quality public healthcare, nutrition, maternal services, neonatal care and other social determinants of health. The organisation stated that the continuing high IMR in poorer and underserved states underlines the urgent need to strengthen the public health system and ensure universal access to affordable healthcare.
The organisation noted that the Union Government has allocated around ₹39,390 crore for the National Health Mission (NHM) in 2026-27, while the overall health allocation has crossed ₹1.06 lakh crore. NHM remains the country’s largest public health programme focused on strengthening primary healthcare, maternal and child health services, immunisation, nutrition support and disease control programmes.
JSAI pointed out that a major share of NHM expenditure is directed towards reproductive, maternal, newborn, child and adolescent health services. However, it said many district hospitals, Community Health Centres and Primary Health Centres continue to face shortages of specialist doctors, nurses, blood banks, intensive care facilities, Special Newborn Care Units (SNCUs), medicines, diagnostics, ambulances and referral transport systems.
The organisation emphasised that weak referral systems in public hospitals remain a major reason behind preventable maternal and infant deaths. Pregnant women, newborns and critically ill children are often forced to travel long distances to tertiary hospitals and medical colleges because of inadequate facilities at district and sub-district centres, it said.
JSAI further stated that delays in referral, transport and treatment continue to cost lives, particularly in rural, tribal and underserved regions. It added that no woman or child should die due to lack of oxygen, ICU care, blood availability, medicines, trained healthcare workers, safe transportation or timely treatment.
The organisation demanded that the Centre and state governments increase public health expenditure to at least 3 per cent of GDP, strengthen district hospitals and referral systems, ensure functional emergency obstetric and newborn care services at all district hospitals, fill vacant healthcare posts and improve ambulance and transport connectivity in rural areas.
JSAI also stressed that reducing infant and maternal mortality requires sustained action on nutrition, anaemia, sanitation, poverty, gender inequality and other social determinants of health. It called for a strong, equitable and accountable public health system that guarantees timely and quality healthcare for every mother and child.

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