By - Moa Jamir
The latest bulletin of the Sample Registration System (SRS) 2021, released by the Registrar General of India, has flagged a worrying trend for Nagaland. After nearly a decade of consistent progress, the state's Infant Mortality Rate (IMR)—the number of infant deaths (under one year of age) per 1,000 live births—rose sharply from 4 in 2020 to 7 in 2021, marking a 75% increase in a single year.
Though the number remains relatively small in absolute terms and is much lower than the national average of 27, the reversal is concerning—particularly for a state that once held the distinction of having the lowest IMR in India. From 21 in 2011, Nagaland’s IMR had steadily declined to just 3 by 2019—a remarkable public health achievement. However, in the span of two years, the rate has more than doubled, pointing toward emerging gaps in maternal and child healthcare delivery.
Two troubling signs stand out in the latest SRS bulletin: gender and rural-urban disparities. While the male IMR remained constant at 3, the rate for female infants doubled from 5 to 10 in one year, contributing significantly to the overall rise. At the same time, the rural IMR increased from 7 to 8, while the urban IMR was recorded at 4—highlighting persistent inequality in healthcare infrastructure, access, and quality across regions.
Data from the National Family Health Survey-5 (2019–21) paints a broader, though equally concerning, picture. Nagaland’s IMR was estimated at 23 per 1,000 live births, with rural areas at 25.8 and urban at 17.0. While these figures mark an improvement from NFHS-4 (2015–16), when the IMR stood at 29.5, they are significantly higher than SRS estimates. Such divergence is expected, as the SRS provides annual estimates through continuous demographic surveys, while NFHS collects periodic cross-sectional data. Differences in methodology, sample size, and recall periods account for the variation. Nonetheless, both sources agree on one critical point: infant mortality remains a challenge, particularly in rural Nagaland.
The Civil Registration System (CRS) 2023 report by the Department of Economics and Statistics adds another layer to this complex picture. While it places the IMR at a negligible 0.003—a figure that likely reflects underreporting or misclassification—it offers valuable insights into parental education levels. In 2023, only 77.51% of mothers in rural areas were literate, down from 81.36% in 2022. Of those, 63.72% had not completed matriculation. Fathers showed a similar trend, with literacy falling from 83.24% to 79.94%, and the majority not completing matriculation. Though education is not a direct determinant of infant mortality, maternal education is widely recognised as a key factor influencing child health, including immunisation rates, nutrition, and institutional deliveries.
The CRS data also shows that institutional deliveries in rural areas were abysmally low—just 4% in 2023, compared to 25% in urban areas. This reinforces the need to address healthcare disparities and strengthen maternal health services, especially in remote regions.
Further, NFHS-5 underscores the state’s lag in immunisation and nutrition. Only 57.9% of children aged 12–23 months were fully vaccinated—far below the national average of 76.4%. Vitamin A supplementation coverage was similarly low. Nutrition indicators, too, have worsened: 32.7% of children under five were stunted (up from 28.6% in 2015–16), and severe wasting rose from 4.2% to 7.9%.
These concerning trends raise questions about data oversight and accountability. Notably, the state’s Department of Health and Family Welfare, in its Annual Administrative Report 2024–25, cited the Stat’s IMR as 3, based on outdated 2019 data, (mis) representing it as the SRS 2021 figure. Such lapses may foster complacency and mislead stakeholders about the actual situation on the ground.
Nagaland’s achievements in reducing IMR over the past decade should be acknowledged. However, the recent uptick is not a statistical anomaly—it is a red flag. Policymakers must examine these trends holistically and respond with urgency.
