Falling infant mortality rate is a good sign

It is a matter of some cheer that there is notable improvement in the Infant Mortality Rate (IMR), a vital parameter of the health of children and of society as such, over the past many years. It has fallen from 47 in 2010 to 28 in 2020, as per the latest figures based on the National Family Health Survey. IMR is the number of children per 1,000 live births that die before their first birthday. India’s IMR is now moving close to the global IMR standard of 27 but lags much behind that of other G-20 nations. Even other countries in South Asia -- Bangladesh, Sri Lanka and Nepal -- have a better IMR. While these countries have already achieved the Sustainable Development Goal target of 25 or fewer deaths by 2030, India has a lot of distance to cover.

The key feature of the country’s IMR situation is its unevenness. While Kerala’s IMR in 2020 was 6, it was 43 in Madhya Pradesh and 38 in UP. In Tamil Nadu and Karnataka, it was 15 and 19 respectively. It was 31 in rural areas and 19 in urban areas. To improve the national average, IMR has to be drastically brought down from its high levels in states that are also the most populous in the country. MP, UP and other states that did well in bringing down the rate from much higher levels have to work more. Several factors contributed to the improvement even during the pandemic, and these need to be reinforced further. It has been observed that in most states, the decline was sharper in the first half of the decade than in the second, except in Kerala and Bihar.

Improved health services now available for newborn children and mothers have helped to reduce the death of infants. Better and speedy access to healthcare, especially to obstetricians and paediatricians, is important for reducing premature births, neonatal infections and other problems. There is increasing realisation of the importance of giving birth in hospitals and that has helped. In UP, the rate of institutional deliveries has improved from 67% during NFHS-4 to 83% in NFHS-5. There is also improvement in routine immunisation coverage and diarrhoea infection rate. Community caregivers such as Anganwadi and ASHA workers have played a key role in this. These need to be built upon to reduce the mortality rate further. It should also be noted that improvement in IMR cannot be separated from other factors like general healthcare, nutrition, care of pregnant women and mothers, dietary needs, and better hygiene. The health of infants depends upon all these factors.