Current Status of Women’s Health in India: Key Issues and Indicators

Women’s health in India sits at the intersection of biology, society, and economics. While the country has made measurable progress in reducing deaths during childbirth and infancy, the indicators still reveal deep gaps between rural and urban communities, between states, and between girls and boys. Examining the current status of women’s health means looking honestly at three interlinked areas: how infants and children survive their first years, how mothers fare during pregnancy and delivery, and what reproductive health challenges women navigate throughout their lives.

Why women’s health indicators matter 🔗

Health indicators for women and children are widely treated as a mirror of social development. They reflect how a society distributes nutrition, education, and medical care, and they tell us whether laws and welfare schemes actually reach the people they were designed for. When a country’s maternal mortality drops but its anaemia rates climb, it signals that the healthcare system has solved some problems while quietly leaving others unaddressed. India today shows exactly this mixed picture.

The most cited national source for these numbers is the National Family Health Survey (NFHS), supplemented by the Sample Registration System (SRS) and reports from the Registrar General. Together, they give a fairly granular view of how women and children are doing across states, social groups, and income brackets.

Infant and child mortality: a tale of two declines 🔗

The Infant Mortality Rate (IMR) measures how many children die before their first birthday per 1,000 live births. It is one of the most sensitive measures of a population’s health because infants are vulnerable to almost every weakness in the system, from poor sanitation to weak primary care.

India’s IMR has dropped dramatically over the past two decades. According to the Children in India 2025 report released by the Ministry of Statistics, the IMR has declined from 44 per 1,000 live births in 2011 to 25 in 2023, while the Under-Five Mortality Rate fell from 30 in 2022 to 29 in 2023. These are real gains, driven by wider immunisation coverage, more institutional deliveries, and programmes like the National Health Mission.

However, the headline numbers hide important patterns underneath.

Gender disparities in child survival 🔗

Biologically, male infants tend to be more fragile than female infants in the first weeks of life. In most countries, this means newborn boys die at slightly higher rates than newborn girls. India is unusual because this biological advantage for girls is partly cancelled out by social factors after the newborn period.

A study published in ScienceDirect on gender differentials in infant mortality found that female IMR declined from 81 to 39 deaths per 1,000 live births between 1990 and 2015, while male IMR declined from 78 to 35. By the SRS 2018 estimates, female IMR was 33 and male IMR was 32, showing that the gap has narrowed but a female disadvantage persists in many regions.

The reasons are structural rather than medical. Female children in some households receive less nutritious food, are taken to a doctor later when they fall ill, and may be enrolled less promptly in vaccination schedules. Research on geospatial trends in child mortality shows that the burden of high child deaths is borne by the marginalised: the IMR in the poorest 20 percent of the population is 2.5 times higher than in the richest 20 percent.

Regional and economic divides 🔗

The northern Empowered Action Group states, including Uttar Pradesh, Bihar, Madhya Pradesh, and Rajasthan, consistently report higher IMRs than southern states like Kerala and Tamil Nadu. Undernutrition is most pronounced in Bihar, Uttar Pradesh, Madhya Pradesh, and Rajasthan, with more than half of children in these states being underweight or stunted. The disparities are not only about geography but also about caste, tribal status, and household income, all of which shape access to safe delivery, nutrition, and immunisation.

Maternal health and mortality 🔗

The Maternal Mortality Ratio (MMR) is the number of women who die during pregnancy, childbirth, or within 42 days of pregnancy termination, per 100,000 live births. India’s MMR trajectory over the last three decades is one of the country’s clearest public health success stories, but it is also one of its most uneven.

The scale of progress and what remains 🔗

According to a decadal trends analysis published in the Journal of Family Medicine and Primary Care, India’s MMR currently stands at 97 per 100,000 live births, down sharply from levels exceeding 300 in the late 1990s. A separate large-scale analysis of nationally representative surveys found that the MMR declined by about 70 percent between 1997-98 and 2020, but an estimated 23,800 maternal deaths still occurred in 2020, with most of these in poorer states and among women aged 20-29.

Despite this progress, India still contributes a significant share of global maternal deaths. Recent estimates referencing The Lancet indicate that India accounts for roughly one in ten global maternal deaths, even though absolute numbers have fallen from about 1.19 lakh in 1990 to 24,700 in 2023.

Leading causes of maternal death 🔗

The medical causes of maternal death in India have remained remarkably consistent. The leading causes are obstetric haemorrhage at around 47 percent (and higher in poorer states), pregnancy-related infection at 12 percent, and hypertensive disorders of pregnancy at 7 percent. Unsafe abortion and obstructed labour also contribute meaningfully.

What makes these causes tragic is that they are largely preventable with timely access to skilled care. Postpartum haemorrhage, for example, can be managed effectively in a facility with trained staff and basic supplies. The fact that it remains the leading killer of mothers points to gaps in emergency obstetric care rather than to unsolvable medical mysteries.

Rural and urban disparities 🔗

The rural-urban gap in maternal health outcomes is one of the most persistent features of India’s health landscape. According to NFHS-5 data cited in recent maternal health research, institutional deliveries stand at 94.8 percent in urban areas compared to 85 percent in rural areas. Among tribal women, institutional delivery rates are even lower at around 78.2 percent.

State-level data reinforces this divide. Recent MMR estimates by state show that Kerala, Maharashtra, and Tamil Nadu have already crossed the SDG target of MMR below 70, while Assam (195), Madhya Pradesh (173), and Uttar Pradesh (167) lag significantly behind. After adjustment for education and other variables, the risks of maternal death are highest in rural and tribal areas of north-eastern and northern states.

The three delays framework 🔗

Public health researchers often describe maternal deaths using the “three delays” model: delay in deciding to seek care, delay in reaching a facility, and delay in receiving adequate treatment once there. In rural India, all three operate at once. A woman may not recognise warning signs, may not have a vehicle to reach the nearest facility, and may arrive at a centre that lacks blood supplies or a specialist. The community-based emergency referral systems set up in places like Purulia were direct responses to these compounded delays.

Reproductive health challenges 🔗

Maternal mortality is the visible tip of a much larger reproductive health iceberg. Most women in India navigate a series of less dramatic but cumulative health challenges through their reproductive years, and these conditions both reflect and worsen their overall status.

Skilled birth attendance and antenatal care 🔗

Access to a trained birth attendant is one of the single most important determinants of whether a mother and her newborn survive delivery. India has made significant strides through schemes like Janani Suraksha Yojana, which provides cash incentives for institutional delivery, but coverage remains uneven.

According to NFHS-5 key insights compiled by UNFPA, approximately 11 percent of mothers remain unreached by a skilled birth attendant or are not accessing institutional facilities. This is the “last mile” population, often comprising tribal women, residents of remote villages, and women from the most economically disadvantaged households. The quality of antenatal care also varies sharply: receiving four or more antenatal visits, the WHO recommended minimum at the time of NFHS-5, was far from universal, and post-natal care utilisation in rural areas is limited.

The anaemia crisis 🔗

Anaemia is perhaps the most pervasive and under-discussed women’s health problem in India. It rarely makes headlines because it does not usually kill quickly, but it sap energy, increases the risk of complications during pregnancy, lowers immunity, and reduces the productivity of an entire generation of women.

The numbers are sobering. NFHS-5 data shows that the prevalence of anaemia among all women aged 15-49 has risen to 57 percent from 53.1 percent in NFHS-4. More than half of pregnant women, around 52.2 percent, are anaemic, an increase from 50.4 percent in NFHS-4. In other words, anaemia has worsened even as other indicators have improved.

A study of Aspirational Districts published in BMC Public Health found that anaemia prevalence in these focus districts climbed from 58.7 percent in NFHS-4 to 61.1 percent in NFHS-5, with over 60 percent of Aspirational Districts experiencing an increase. Scheduled Tribe women, women with multiple children, and women from the poorest quintile face significantly higher odds of being anaemic.

Despite the Anemia Mukt Bharat campaign launched in 2018, awareness and treatment gaps persist. A knowledge, attitudes, and practices survey of 1,460 women across six states found that while 79.8 percent supported iron supplementation in principle, only 29.5 percent reported regular treatment practices, and awareness of dietary and micronutrient factors remained low.

Nutrition and the double burden 🔗

An interesting and worrying shift noted in NFHS-5 is that, for the first time, the proportion of women aged 15-49 who are overweight or obese (24 percent) now exceeds those who are underweight (18.7 percent). India is now contending with a double burden of malnutrition: many women remain undernourished and anaemic while others, often in the same households, are sliding into obesity and lifestyle disease risks. Both ends of this spectrum complicate pregnancy outcomes and long-term health.

Access, autonomy, and decision-making 🔗

Reproductive health is not only about clinics and supplements. It is also shaped by whether women can make decisions about their own bodies, marriages, and family size. Districts with low age at first birth, low contraceptive use, and higher numbers of children per woman tend to report higher MMR, as shown in district-level MMR research. Early marriage and early childbearing are health risks, not just social issues, because adolescent bodies are physically less prepared for pregnancy.

The bigger picture 🔗

Taken together, the indicators tell a consistent story. India has built impressive infrastructure for safe delivery and child survival, and the macro numbers reflect that. But the country has not yet closed the gaps between regions, social groups, and genders. A girl born in rural Assam, a Scheduled Tribe mother in central India, and an adolescent bride in a high-burden state continue to face significantly worse odds than their counterparts in Kerala or urban Maharashtra.

Improving women’s health from here on requires moving beyond coverage to quality, beyond institutional delivery to continuous care, and beyond iron tablets to addressing the social conditions that produce anaemia, early marriage, and gender bias in the first place.

What do you think? Why do you think India’s anaemia rates have continued to rise even as maternal and infant mortality have fallen, and which interventions do you believe would do the most to close the rural-urban gap in women’s health outcomes?

References

1. https://www.usthadian.com/children-in-india-2025-report-insights/
2. https://www.sciencedirect.com/science/article/abs/pii/S0190740920312986
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206872/
4. https://pmc.ncbi.nlm.nih.gov/articles/PMC12178503/
5. https://pubmed.ncbi.nlm.nih.gov/34455679/
6. https://vajiramandravi.com/current-affairs/maternal-mortality-in-india/
7. https://www.class24.study/current-affairs/maternal-mortality-ratio-in-india-current-situation-trends-and-main-reasons-8271
8. https://www.thelancet.com/article/S0140-6736(07)61460-3/fulltext
9. https://india.unfpa.org/sites/default/files/pub-pdf/nfhs_5_key_insights.pdf
10. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-17789-3
11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12697413/
12. https://pmc.ncbi.nlm.nih.gov/articles/PMC10021851/