Infant mortality still high in India

India stands at a poor 32 deaths per 1000 infants born, far behind its neighbours Nepal which has 29 infant deaths, Sri Lanka has 8, Bangladesh stands at 31 and China at 9. India is only ahead of its neighbour Pakistan where infant mortality stands at 66 per 1000. The data is for the year 2015.

As per the data of United Nations Inter Agency Group for Child Mortality Estimation, the highest infant mortality rate is in Angola which leads with 96 deaths, followed by Central African Republic with 92 and Sierra Leone with 87 infant deaths.

It is a matter of shame that after 70 years of independence, India is still struggling with 32 infant deaths per 1000 births. Infant mortality is counted on deaths of infants who die before reaching the age of one year. The rate of infant mortality in India which was 88 in 1990 or 27 years ago still stands at 36.3 per cent.

Of India’s neighbours, Sri Lanka has done the best with 8 deaths in 2015 from 18 in 1990, similarly China brought down infant mortality from 42 in 1990 to 9 in 2015, Bangladesh from 100 to 31 and Nepal from 98 to 29 during the same period.

Region-wise infant mortality has the sub-Saharan Africa leading with 56 infants dying  in 2015 as compared to 109 in 1990, followed by South Asia which stands at 42 during 2015 and 92 in 1990, the third region is Middle East and North Africa which stand at 20 down from 50 in the same period.

The world average is 32 down from 63 in the same period.

A UNICEF study says that in the last decade, infant mortality rate (IMR) decline in urban areas is much less sharper than in rural areas, narrowing the gap between the rural and urban.

IMR and under 5 mortality rate (U5 MR) among children born to illiterate mothers have been consistently higher than those born to mothers with any education.

However, the association between maternal education and child mortality becomes significant only when maternal education exceeds 8 years of schooling. For example, children born to mothers with at least 8 years of schooling have 32% lesser chances of dying in neonatal period and 52% lesser chances in the post-neonatal period, as compared to the illiterate mothers.

Infant and U5 mortality rates are highest among mothers under 20 years of age. The rates are lowest among the children born to mothers between the ages of 20-24, remain low up to 25-34 years of age, and increase again after that age.

There is a consistent and significant impact of birth intervals less than 24 months on child survival. For example, a child born within 24 months of the previous child has 68% higher risk of dying within the neonatal period and 99% higher risk of dying in the post-neonatal period. The risk further increases sharply if the previous child has died.

A short birth interval not only increases mortality risk of the subsequently born children, but also of those born earlier.

Analysis of the National Family Health Survey (NFHS)-3 revealed that neonatal mortality is lowest for children delivered at home by health professionals (19.8/1000 live births) and was highest for children delivered at home by traditional birth attendants (27.2/1000 live births). Mortality among those delivered in a hospital was in between the two (25.2/1000 live births).

IMR and U5 mortality rates are consistently lower among children living in families who accessed drinking water from a safe source as compared to those who accessed drinking water from an unsafe source. Similarly, the IMR and U5 mortality rates are consistently lower among children living in families with access to an improved toilet as compared to those who do not have such an access.

Between 1981 and2005, U5 mortality levels and its components have declined across all economic groups, as defined by the Standard of Living Index (SLI). The decline among Low SLI households has been the highest (37.7%), while High SLI households have shown the least decline.

Girls have lower mortality in the neonatal period, but then have higher mortality than boys thereafter throughout the childhood.

Due to lower Neonatal Mortality Rate (NNMR), IMR in girls had been lower than among boys during all five year periods since 1981. However, in recent years, due to slower decline in NNMR among girls, IMR among girls has become equal to that among boys.

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