Since Independence, for the first time, India’s demographic profile stands at a telling cusp. The median age of an Indian is around 29. We are the world’s most populous country. The gender balance has improved: NFHS 5 (National Family Health Survey) recorded 1,020 women for every 1,000 men, compared with 991 just a few years earlier. Women’s educational attainment has improved sharply, and India has made progress on several measures of gender parity. And yet, beneath these reassuring numbers, a quietly unfolding trend is the total fertility rate — at 2.0, it has fallen below the replacement level of 2.1.A recent study of women, aged 36 to 49, points to an emerging section of educated, urban and relatively affluent women remaining outside the traditional pathways of marriage and motherhood. Among women who do marry, the family structure is becoming leaner, with fewer children. The sample in this study, while certainly not representative of the entire social profile, seems to indicate a transition which cannot be ignored. Against this backdrop, one key health indicator assumes a particularly discernible significance — The Infant Mortality Rate.A country’s mortality profile is reflected, primarily, in two important health outcomes: life expectancy at birth and infant mortality rate. Life expectancy is influenced by a range of factors that have evolved substantially over time — medical awareness, advances in healthcare, nutrition, sanitation, and research and development in medicines and medical technology. Infant mortality, however, measures the number of infants who die before completing their first year of life, per 1,000 live births. And in a country undergoing the kind of demographic and social transition described above, it becomes particularly important to look closely at what drives this number.Our nation has made remarkable strides in improving its health outcomes. Life expectancy at birth, which was around 59 years in 1990, had risen to nearly 70 years by 2023. Infant mortality has fallen even more dramatically — from 84 deaths per 1,000 live births in 1990 to around 25 in 2023. India has made rapid strides in improving its health outcomes. Life expectancy at birth has risen substantially over the decades, while infant mortality has fallen sharply. Yet, when India is placed alongside its peers that have traversed faster on the health-development trajectory, the gap remains striking. Even within South Asia, Sri Lanka has achieved substantially better outcomes: in 2023, India’s infant mortality rate was about 17.5 per 1,000 live births compared with just 4.1 in Sri Lanka.Within the country, however, the national figure masks an untold story. There exist striking spatial variations in infant mortality across states — Kerala presents an impressive picture, with an infant mortality rate of just 8 deaths per 1,000 live births in 2024, compared with 35 in both Madhya Pradesh and Uttar Pradesh, against the national average of 24. Although these spatial variations can be explained by differences in NSDP (National State Domestic Product), health expenditure and access to healthcare, one significant metric that helps explain this striking disparity is female literacy.Female literacy, though a remote variable, has a remarkably strong influence on infant mortality rates. Studies show that states with higher female literacy tend to have substantially lower IMRs, implying fewer infant deaths per 1,000 live births. An educated woman is more likely to have greater awareness of maternal health, nutrition, hygiene, immunisation and the need to seek timely medical care for herself and her child. Education, therefore, creates a positive externality that is often glossed over. Furthermore, the education of the girl child is invariably discussed in terms of empowerment, greater labour-force participation and economic independence. Yet, there is another, less discussed, but potentially far more consequential link: educating a girl may also improve the chances that the child she eventually bears will survive its first year of life.Story continues below this adAmong the various health outcomes, the SUMAN Roadmap 2030, launched in June 2026, places special emphasis on reducing neonatal and infant mortality and on achieving the larger goal of zero preventable maternal and new-born deaths by 2030. Against this backdrop, it becomes even more imperative to take steps that improve female literacy and narrow the wide variations in female literacy across states. Evidence from both Indian and international studies point to female education as a potent instrument for improving child survival. Within India too, states with higher female literacy tend to record lower infant mortality; again, Kerala, with its exceptionally high female literacy, offers a striking illustration of this relationship. These findings underscore the importance of female education more than ever beforeWhile the SUMAN Roadmap gives us a roadmap for improving health outcomes, investing in female literacy is a sine qua non—a recipe that embeds a positive externality beyond the familiar gains of empowerment and greater labour-force participation. If educating the girl child can also improve the chances of a child surviving its first year of life, then female education is not merely a social investment; it is an investment in human survival and the health of the next generation.Naazneen Bhasin is an IPS officer; presently, IG CID and ATS, Haryana