In recent years, the Indian National Health Mission (NHM) was introduced by the Government of India as an umbrella of health programs to cover reproductive and child health, adolescent health, and selected disease control programs. These programs were given a mandate to accelerate the achievement of the health-related Millennium Development Goals (MDGs) by 2015. Considerable progress toward realizing the MDG objectives has been achieved, especially reductions in infant and child mortality and improvement in measles vaccination coverage (MDG Goal 4), as well as the reduction of maternal mortality and an increase in the number of births attended by skilled personnel (MDG Goal 5). Nevertheless, an overall appraisal of the status of the indicators in 2015 reveals that many of the targets remained to be achieved. The analytical issue explored here is whether the targets were too high to achieve or whether Indian health policies were flawed or too long delayed. This article offers a state-wise analysis of the achievements in health indicators relating to MDGs 4 and 5. The rate of achievement for two time periods, pre-NHM and NHM until 2015, is analyzed here. Our key finding is that most of the targets were indeed infeasible, but that lack of achievement could be attributed to delays in planning; sometimes poor execution of the policies and programs; and to the economic, social, and political disparities within the country. Better organized and more innovative approaches at the state level could improve the realization of vital MDG targets, providing improved public health for all.

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