India’s IMR showed 3 Point Decline, dropping from 50 to 47 Deaths per 1000 Live Births

India’s infant mortality rate (IMR) showed a 3 point decline, dropping from 50 deaths per 1,000 live births to 47, as per government data released on 28 December 2011. India thus moved closer to achieving the Millennium Development Goals (MDG) target of 30. While the IMR national average is 47, it stands at 51 in the rural areas and 31 in the urban regions.

According to estimates available with health and family welfare ministry, 17 lakh children under five die annually, out of which 13 lakh are infants. Another 7 lakh deaths occur within the first week. The main cause of death in 50 per cent of cases is malnutrition. Other top reasons attributed to child mortality are- diarrhea, pneumonia and measles.

State-wise Analysis

According to the latest Sample Registration System (SRS), conducted by the Registrar-General of India, the two worst performing States, Madhya Pradesh and Himachal Pradesh showed an impressive 5 point decline. In MP, the figure dropped from 67 in 2009 to 62 in 2010 and in HP, it dropped from 45 to 40.

Madhya Pradesh and Himachal Pradesh were the two best performers as they brought down the number of child deaths by five points. Madhya Pradesh and Himachal Pradesh stood out with a five-point drop each in one year. However, the figure stood at 62 deaths per 1000 in MP. In Himachal, the infant mortality rate was 40. However, despite MP’s good performance in the last one year, on a national level MP along with Odisha and Uttar Pradesh are the three worst performers with an IMR above 60.

The IMR declined by three points in Karnataka and Delhi. Both states fared better than the national average. While it dropped from 41 in 2009 to 38 in 2010 in Karnataka, in Delhi, the drop was from 33 to 30.

Bihar, Gujarat, Odisha, Punjab, Rajasthan, Tamil Nadu, Meghalaya, Sikkim and Tripura had shown a four-point decline in the IMR. Andhra Pradesh, Assam, Chhattisgarh, Haryana, Karnataka, Maharashtra, Delhi, Nagaland, Uttarakhand and Chandigarh showed a three-point decline.

In Jharkhand, Uttar Pradesh, West Bengal, Jammu and Kashmir, Manipur and Andaman and Nicobar Islands, the IMR came down by two points.

 
States where the infant mortality rate continue to remain higher than the national average include Assam (58), Bihar (48), UP (61), Chhattisgarh (51) and Meghalaya (55).

IMR increased by one point in Kerala, Mizoram and Dadra and Nagar Haveli.

Kerala, Goa, Manipur and Nagaland are the only four states that achieved an IMR below the MDG target so far. The same also holds true for Union territories Andaman and Nicobar islands, Chandigarh, Daman and Diu, Lakshadweep and Puducherry. It remained static in Lakshdweep and Puducherry.


Neo-natal deaths

However, neo-natal deaths (babies who die within 28 days) continue to be a challenge where 34 babies are still dying for every 1000 born. Efforts would have to be concentrated on home-based newborn-care as 52 per cent of child deaths took place in the first 28 days of birth.

Initiatives to control child mortality

Home-based newborn-care through Accredited Social Health Activists (ASHAs) was initiated by providing an incentive of Rs. 250. The purpose of home-based newborn-care is to improve newborn practices at the community level and early detection and referral of sick newborns.

The Janani Shishu Suraksha Karyakram, providing for free transport, food and drugs and diagnostics to all pregnant women and sick newborns has been put in place to further promote institutional delivery and eliminate out-of-pocket expenses, which act as a barrier to seeking institutional care.

Facilities such as Special New Born Care Units, New Born Stabilisation Units and New Born Baby Corners at different levels with at least one at the district level are expected to be put in place.

The mother and child tracking system also evoked a huge response, with 1.32 crore women and 82.6 lakh children already registered.