Kerala

Based on SRS 2024; SRS 2022–24; NFHS 2023–24; SRS 2020–24; 12-month mean to 3 Oct 2026.

• Infant mortality rate 94.5 / 100, 4% of total

  per 1,000 live births, SRS 2024

  Worst 608Best 5

  60 deaths per 1,000 is roughly where India stood in the mid-2000s; 5 is what the best-performing states and high-income countries achieve.

• Neonatal mortality rate 91.9 / 100, 4% of total

  per 1,000 live births, SRS 2024

  Worst 406Best 3

  40 per 1,000 is about India's mid-2000s level; 3 matches the best health systems.

• Under-five mortality rate 94.3 / 100, 4% of total

  per 1,000 live births, SRS 2024

  Worst 759Best 5

  75 per 1,000 is about India's level when SRS began reporting it; 5 matches the best health systems.

• Maternal mortality ratio 98.6 / 100, 4% of total

  per 100,000 live births, SRS 2022–24

  Worst 30024Best 20

  300 per 100,000 births is about India's level in the early 2000s; 20 is what high-income countries achieve.

• Fully vaccinated children aged 12–23 months 81.6 / 100, 4% of total

  %, NFHS 2023–24

  Worst 40.084.9Best 95.0

  40% is about India's level in NFHS-3 (2005-06); 95% is the coverage WHO cites for stopping measles spreading.

• Institutional births 99.5 / 100, 4% of total

  %, NFHS 2023–24

  Worst 40.099.7Best 100.0

  40% is about India's level in NFHS-3 (2005-06); the goal is every birth in a health facility, which several states already reach.

• Mothers with at least four antenatal care visits 83.7 / 100, 4% of total

  %, NFHS 2023–24

  Worst 30.088.6Best 100.0

  30% is below every state today and India's NFHS-3 level; WHO now recommends eight contacts, so four for every mother is a floor, not a stretch.

Strong 80+Good 65–79Fair 50–64Low under 50

1. Each marker is placed between a worst and a best goalpost: at the worst it scores 0, at the best 100, in between proportionally.
2. A system's score is the average of its markers.
3. The overall score is the average of the systems, each weighted equally. A missing system's weight is shared by the others; at least two systems are needed.
4. Only current markers with a clear better-or-worse direction count. A survey stays current for five years after its fieldwork ends; administrative data for two. Outbreak reports, HMIS (public data ends May 2021), health spending, and crude (not age-adjusted) chronic-disease rates are shown but not scored.
5. Small-sample estimates (bracketed survey values, single-city figures) are shown with a warning but never scored.

The full method