Although its fertility rate has declined over the years, India has a population of well over a billion, and wide inequalities persist, despite significant improvements in health and education. Maternal mortality and gender discrimination remain high. Early marriage and pregnancy contribute to excessive maternal death among women under the age of 24. The low status of women, and the skewed sex ratio at birth, remain challenges. UNFPA collaborates with the government, civil society, the private sector, academia, the medical community, the media, judiciary and local communities to address these challenges.