The Rajasthan Exemplar Report highlights the state’s significant progress in reducing maternal and newborn mortality between 2000 and 2018, surpassing most other high-mortality states. In 2018, Rajasthan achieved an MMR of 141 per 100,000 live births and an NMR of 26 per 1,000 live births—both lower than the averages for high-mortality states. These findings are part of the Exemplars in Maternal and Newborn Health Study, to understand positive outliers and inform policy and practice. 

Key Findings: 

• Major gains in antenatal care, institutional deliveries, and C-sections, particularly during the NRHM period, with the public sector accounting for over 70% of deliveries. 
• Expansion of health infrastructure, including more Community Health Centres (CHCs), improved emergency transportation, and establishment of maternal and child health wings in 38 hospitals and Sick Newborn Care Units (SNCUs) in every district. 
• Strong focus on quality of care through labour room cleanliness, clinician skills, and protocols, supported by national quality assurance programs (Kayakalp, NQAS) and tools like safe birth checklists. 
• Investments in health workforce development, including in-service nurse training, upgraded ANM/GNM schools with skill and IT labs, and strengthened ASHA Sahyogini support for community mobilisation. 
• Leadership in digital innovations, such as online systems for JSY and ASHA payments and Health Management Information Systems (HMIS) for accountability. 
• Decentralisation and financial flexibility under NRHM, coupled with accountability measures and robust partnerships with technical agencies and international partners. 
• Demand-side interventions like Janani Shishu Suraksha Karyakaram (JSSK) to reduce out-of-pocket expenses for maternal and newborn care. 

This report presents the Rajasthan sub-study and provides background information on the broader India study.