SRS Bulletin Shows Major Inequalities Across States, Say Public Health Experts

Bhopal: Jan Swasthya Abhiyan (JSA), India has expressed serious concern over the findings of the latest Sample Registration System (SRS) Bulletin released by the Office of the Registrar General of India.
The report, says JSA India, shows that despite improvements in national health indicators, major inequalities continue across states, especially in infant mortality and maternal-child health outcomes.
According to the SRS Bulletin, India’s infant mortality rate (IMR) has declined to 24 per 1000 live births.
However, the burden remains alarmingly high in several states.
Chhattisgarh recorded the highest IMR in the country at 36, followed by Uttar Pradesh and Madhya Pradesh at 35 each.
These figures, says JSA India, reflect deep inequities in access to quality public healthcare, nutrition, maternal services, neonatal care, and social determinants of health. The continuing high IMR in poorer and underserved states highlights the urgent need for strengthening the public health system and ensuring universal access to affordable healthcare.
Union Government has allocated around ₹39,390 crore for the National Health Mission (NHM) in 2026-27, while overall health allocation has crossed ₹1.06 lakh crore, says JSA India.
The NHM remains the largest public health programme focused on strengthening primary healthcare, maternal health, newborn care, child health services, immunisation, nutrition support, and disease control programmes across states.
The organisation further pointed out that a major component of NHM expenditure is directed towards reproductive, maternal, newborn, child and adolescent health services.
Despite these allocations and years of public investment, many district hospitals, community health centres and primary health centres continue to suffer from shortages of specialist doctors, nurses, blood banks, ICU facilities, SNCUs, medicines, diagnostics, ambulances and referral transport systems.
JSAI emphasised that weak referral systems in public hospitals remain one of the key reasons behind preventable maternal and infant deaths.
Due to inadequate facilities at district hospitals and sub-district centres, pregnant women, newborns and critically ill children are frequently forced to travel long distances to tertiary hospitals and medical colleges.
Delays in referral, transport and treatment continue to cost lives, especially in rural, tribal and underserved regions.
The organisation said despite substantial public expenditure on maternal and child health programmes, no woman or child should die because of lack of oxygen, ICU care, blood availability, medicines, trained healthcare workers, safe transportation or timely treatment.
Every maternal death and every preventable child death reflects a serious failure of the healthcare delivery system and governance mechanisms.
JSA India demanded that the Government of India and state governments urgently increase public health expenditure to at least 3% of GDP, strengthen district hospitals and referral systems, ensure functional emergency obstetric and newborn care services at all district hospitals, fill vacant posts of healthcare workers, and improve ambulance and transport connectivity for rural populations.
The organisation also stressed that reducing infant and maternal mortality requires action on nutrition, anaemia, sanitation, poverty, gender inequality and social determinants of health.
JSAI called for a strong, equitable and accountable public health system that guarantees timely and quality healthcare for every mother and every child.
Convener and secretariat team of JSAI include Amulya Nidhi, Gouranga Mohpatra, Chandrakant Yadav, Sanjeev Sinha and Rahi Riyaz.