A population-level impact assessment of the National Health Mission on maternal and child health outcomes in India

India launched the National Health Mission (NHM) in 2005 to reduce maternal and child mortality by providing equitable, affordable, and quality healthcare services. Studies evaluating the impact of NHM primarily focused on the uptake of maternal and child health (MCH) services, revealing a dearth of evidence on related health outcomes. Using annual time-series data, we estimated the population-level (intention-to-treat effect) impact of the NHM on MCH outcomes such as infant mortality rate (IMR), stillbirth rate, neonatal mortality rate (NMR), and maternal mortality ratio (MMR). Our results exhibit strong consensus on the positive impact on IMR in the post-NHM period, with a significant reduction in its rate and regional inequity. Conversely, our estimates show a moderate impact on stillbirth rate and an insignificant impact on NMR and MMR. Our findings inform policy decisions for strengthening the public health system to amplify the positive gains in MCH outcomes.