Children born in urban India continue to have a much higher chance of surviving the first year than those born in rural India. The latest data on infant mortality rate (IMR) for 2019 released by the census office indicates the poor quality of maternal and child health services in rural areas as well as limited access to these.
The IMR of urban India is 20 (20 babies below one year dying out of every 1,000 babies born) compared to 34 in rural areas, showing a stagnation in the efforts to bridge the rural-urban divide. If anything, the gap has widened marginally in the five years to 2019.
While all states have narrowed the gap in IMR between rural and urban areas, the difference continues to be alarmingly high in Assam and MP, where rural areas account for 86% and 72% of the total population respectively. Odisha, Rajasthan and Gujarat have shown the most remarkable improvement in bridging the gap in IMR between rural and urban areas.

Rural Odisha had the second highest IMR of 68 in the country in 2009 while its urban IMR was 46. It steadily cut the gap to a single digit and by 2019, the rural and urban IMR were 39 and 30 respectively. Similarly, Gujarat too has significantly reduced the gap in the last decade. In 2009, the rural and urban IMRs were 55 and 33 respectively, which narrowed to 29 and 18 by 2019. The gap between rural and urban IMR (65 and 35) was the highest in Rajasthan in 2009, and its rural IMR was among the highest in India. It has not only brought down rural IMR, it has also narrowed the gap between rural and urban areas (38 and 25) by 2019, a significant improvement from where it had started.
Rural MP continued to have the highest IMR in the country in 2009 (72), 2014 (57) and 2019 (50). Though an IMR of 57 in 2014 was a huge improvement over 72 in 2009, by 2019 the pace of improvement had slowed down as rural IMR came down to just 50 in 2019. Moreover, the rural-urban gap remained the second highest after Assam, which also showed little progress in bridging the gap.
Several states have reduced the rural-urban gap in infant survival to single digits. The gap remains in double digits and almost unchanged between 2014 and 2019 in UP, where 78% of the population lives in rural areas. While better urban IMR in a state shows what is possible with the availability of better healthcare, even the urban IMR of many of these laggard states is higher than the rural IMR of better performing states, an indication of how far these states have to go.