Kerala has quietly pulled off a public health milestone that even the United States might envy. According to the latest Sample Registration System (SRS) report, the state’s infant mortality rate (IMR) has dropped to 5 per 1,000 live births —lower than the US figure of 5.6. For context, this is the same state that, for two decades (1995–2015), was stuck at an IMR of 12–15, despite being far ahead of the rest of India. While India’s IMR fell dramatically from about 75 to 37 over that same period, Kerala’s IMR barely shifted during that period.
This puzzled health officials, especially since maternal health was improving rapidly. Kerala’s maternal mortality ratio (MMR) dropped from 150 in the mid-1990s to 61 in 2011–13, and now stands at an impressive 30. A key driver was the Kerala Federation of Obstetrics and Gynecology (KFOG), which began confidential maternal death audits in 2002 under…
