The bulletin from the recent Sample Registration Survey 2024 provides the sharpest picture yet of India in the throes of demographic transition. As per the latest estimate, while the country’s birth rate has fallen between 2014 and 2024 and the death rate is down marginally, good gains have been reported with the Infant Mortality Rate (IMR), amid substantial progress made over the last decade. However, vast gaps persist between rural and urban areas and progress across the country is uneven, making the call for equitable growth and appropriate deployment of resources particularly sound.  

The country’s birth rate— live births per 1,000 population— fell from 21 in 2014 to 18.3 in 2024, while the death rate (deaths per 1,000 people) is down from 6.7 to 6.4. The IMR, recorded as the number of deaths per thousand live births, has dropped from 39 to 24. While the overall performance is creditable, indicating several measures being launched by the Centre and different State governments to improve healthcare outcomes, the disappointment is in the relatively worse performance in rural areas. In fact, they drag the country averages down substantially.  

For instance, while the rural birth rate fell from 22.7 to 20.2 in the given decade, the simultaneous decadal performance in the urban areas was better – the birth rate fell from 17.4 to 14.7. In the rural areas, death rate fell from 7.3 to 6.8 between 2014 and 2024, and in the urban segment, it was at 5.5 in 2014 and went up marginally to 5.6— still a better performance than in rural areas.  

The gains of urban areas in this bulletin are probably the most appreciable result in the field of IMR, dropping from 26 infant deaths per 1,000 live births to 17 by nine points. While it has dropped 16 points from 43 to 27 in the rural areas during the same period, it is still further away from the national target under the National Health Policy to reduce the IMR to single digits.  

The differences are also stark, with some States way ahead of the rest. Kerala and Tamil Nadu lead the way with better statistics in all these sectors. Kerala has the lowest natural growth rate (NGR) of 3.9, the rate at which a population increases or decreases due to births and deaths, excluding migration expressed as a percentage. It is also a crucial indicator of the demographic transition. Kerala also has a single-digit IMR (8), the lowest in the country. Tamil Nadu brings up the second position among the larger States, with a growth rate of 4.8 and an IMR of 11. Among the smaller States, Goa (4.2 NGR and 11 IMR) and among Union Territories, Andaman and Nicobar Islands (4.1 NGR and 9 IMR) lead the way.