Facts About Infant Mortality Rate (IMR)

Infant mortality rate (IMR) is defined as “the ratio of registered death of children below 1 year of age in a given year to total number of live birth registered in the same year; usually expressed as rate per thousand live birth”.

It is one of the most universally accepted indicators of health status not only of infants, but also of whole population and of socioeconomic condition in which they live. In addition, IMR is a sensitive indicator of the availability, utilization, and effectiveness of health care, particularly peri-natal care. IMR is affected quickly and directly by specific health programmes.

There are wide variations between countries and regions in the level of infant mortality, due to various level of development. The world average IMR is about 50 per thousand live births. But it varies from 3 per thousand live births in some developed countries like Japan and Sweden to more than 100 per thousand live births in least developed countries like Afghanistan and Sierra Leone. Any further reduction in IMR in developed countries will depend upon preventing one of the principle causes of IMR namely congenital abnormalities.

In general IMR reflects the socioeconomic development of a country. Death in first four weeks is preventable by good health care. About half of all pregnant women in least developed countries do not get any antenatal care and 7 out of 10 babies are born without help from trained personnel’s, contributes to high mortality. Other major causes of IMR include malnutrition and high parity, low birth weight of the baby and congenital anomalies, diseases like diarrhea and infectious diseases. In the industrial world, the dominant factor in the decline of IMR is economic and social progress (quality of life), with medical services playing a secondary role. In the developing countries this is reversed. That is medical services (e.g. mass control of disease, immunization, antibiotics and insecticides) have made major impact and social development taking supporting role. That is the reason; infant mortality rates are reluctant to fall below present level, or falling very slowly in many developing countries.

Medical causes of IMR:

Neonatal mortality (0-4 weeks):

Low birth weight & prematurity.

Birth injury.

Sepsis.

Congenital anomalies.

Diarrheal diseases.

Acute respiratory infections.

Hemolytic disease of newborn.

Post-neonatal mortality (1-12 months):

Diarrheal diseases.

Malnutrition.

Acute respiratory diseases.

Accidents.

Other communicable diseases.

Factors affecting infant mortality:

Biological Factors: Birth weight, age of the mother, birth order (first born has highest chance of death & second born has least chance), birth spacing, multiple births, family size and high fertility.

Economic Factors

Cultural and social factors: Breast feeding, religion, early marriage, sex of child, quality of mothering (nursing), maternal education, quality of health care, broken families, illegitimacy, brutal habits and customs, bad environmental sanitation.

To prevent infant mortality prenatal and postnatal nutrition has to be improved. Breast feeding specially in developing countries has to be encouraged. Family planning methods has to be adapted to space births. Improvement of sanitation of community has to be done. Education of the mother (female literacy) has to be improved. General socioeconomic status of a country has to improve to reduce infant mortality.