Mumbai: In a concerning statistic, Maharashtra recorded 117,136 infant deaths—an average of nearly 46 deaths per day—between 2017 and 2023. Data procured by Hindustan Times through RTI shows that Mumbai reported the highest toll at 22,364, with other high-burden districts being Pune, Nashik, Chhatrapati Sambhajinagar and Akola. The number of deaths declined in 2020 during the Covid-19 pandemic but increased in subsequent years, reaching 17,436 in 2023.
Government officials attribute the rise to improved surveillance, increased institutional deliveries and better reporting systems post-pandemic. In contrast, health experts point to systemic issues—delayed referrals, inadequate infrastructure, and missed antenatal care—as key drivers.
Infant death is clinically defined as the death of a live-born baby before reaching one year of age.
Mumbai, despite leading in absolute numbers, showed a steady decline—from 4,071 deaths in 2017 to 2,832 in 2023. The sharpest drop came in 2020, with 2,649 deaths. Experts attribute this decline to stronger neonatal infrastructure, early institutional deliveries, and improved high-risk pregnancy tracking. However, Mumbai’s health system remains under strain due to a high volume of critical referrals from outside the city.
“Nearly 40% of infant deaths recorded in Mumbai are of babies referred from other districts, most of whom arrive in extremely critical condition,” said a senior BMC official. “It’s crucial to distinguish how many of these cases actually belong to the city.” BMC executive health officer Dr Daksha Shah did not respond to queries.
In contrast, neighbouring Thane has witnessed a sharp upward trend. The district recorded 6,562 infant deaths between 2017 and 2023, starting with 750 deaths in 2017 and rising consistently to reach 1,380 in 2023. According to local officials, Thane’s burden has increased partly because it receives referrals from Palghar, which lacks a district hospital.
Congress MLA Amin Patel raised the issue in the state assembly last year, pointing out that hospitals like Kalwa were overwhelmed by emergency deliveries. “Despite handling one of the highest referral loads, NICU (neonatal intensive care unit) beds and specialists remain inadequate,” he said. Dr Kailash Pawar, district civil surgeon of the Thane zilla parishad, did not respond to requests for comment.
Several other districts such as Nashik, Akola, Chhatrapati Sambhajinagar, Pune, Nagpur and Amravati showed concerning year-on-year spikes. However, Amravati, which had reported 1,307 deaths in 2021, has dropped out of the top five in recent years, possibly reflecting improved interventions or shifting health patterns.
Despite several attempts, health services commissioner Amgothu Sri Ranga Naik and state minister Prakash Abitkar did not respond to emails or calls.
While the sharp decline in infant deaths during 2020 may appear promising, experts say that it reflects underreporting. “Many women avoided hospitals due to the Covid fear, leading to more home births and unregistered deliveries,” said Dr Avinash Supe, former dean of KEM Hospital.
Birth asphyxia, prematurity, infections and low birth weight remain the leading causes of infant mortality. These clinical factors are often worsened by systemic issues such as delayed referrals, lack of transport, inadequate NICU capacity and staff shortages, particularly in rural and tribal areas. “Be it Mumbai or Pune, major hospitals receive a high volume of referrals,” said Dr Rajkumar Jagtap, medical officer, Pune. “Even with the best infrastructure, this constant influx contributes to high fatality rates. It’s a global pattern.”
Akola, which recorded one of the most alarming spikes in 2023, presents a similar case. District health officer Dr Baliram Gadhave stated that the surge partly reflected better reporting systems post-pandemic. “Also, being a referral hub, babies arrive at our NICUs with already low survival chances,” he said. “But despite the absolute numbers, Akola’s infant mortality rate (IMR) stands at 12.2, lower than the national average.”
Dr Abhay Shukla, public health expert, said that in many rural districts, the absence of adequate NICU beds, paediatric intensivists and trained neonatologists forced families to rush critically ill newborns to distant tertiary hospitals. “We saw the tragic consequences of this last year when multiple infant deaths occurred at Thane’s Kalwa Hospital and Nanded Government Medical College,” he said. Dr Shukla pointed out that despite budget allocations, funds meant for upgrading critical care infrastructure often remained underutilised, reflecting systemic neglect rather than a lack of resources.
