INFANT MORTALITY AND ITS PREVENTION AND CONTROL

MEASURES IN INDIA

Presenter- PRAJNA.SHETTYModerator- Dr. Oliver D’souza

April 18, 2023 1

April 18, 2023

INFANT MORTALITY RATE

- the ratio of infant deaths registered in a given year to the total number of live births registered in the same year; usually expressed as a rate per 1000 live births.

- it is given by the formula: Number of deaths of children less

IMR = than one year of age in a year ×1000 Number of live births in the same year

2

April 18, 2023

Infant mortality in India

• 41 in the year 2012• 204 during 1911-15• Madhya Pradesh- IMR of 56, & Kerala- as low as 12

per 1000 live births during the year 2012.• Kerala, Maharashtra, Punjab, T.N, W.B, A.P,

Haryana, K’taka, Gujarat, H.P and Jharkhand have achieved IMR below national average of 42.

• Odisha, M.P, U.P, Assam and Rajasthan- IMR > 42!

3

April 18, 2023

Medical causes of infant mortalityNeonatal mortality (0-4 weeks)

Post-neonatal mortality(1-12 months)

1. Low birth weight and prematurity

2. Birth injury and difficult labour

3. Sepsis4. Congenital anomalies5. Haemolytic diseases of

newborn6. Conditions of placenta and

cord7. Diarrhoeal diseases8. Acute respiratory infections9. Tetanus

1. Diarrhoeal diseases2. Acute respiratory infections3. Other communicable

diseases4. Malnutrition 5. Congenital anomalies6. Accidents

4

April 18, 2023

Factors affecting Infant mortality1. BIOLOGICAL FACTORS(a) Birth weight: - babies of low birth weight and high birth weight are at special risk. - causes: poor nutrition during pregnancy..(b) Age of the mother: - IMR are greater when the mother is either

very young or relatively older.

5

April 18, 2023

(c) Birth order - the highest mortality is found among first

born, and the lowest among those born second.

- The risk of infant mortality escalates after the third birth.

- the fate of fifth and later children is always worse than the fate of the 3rd child.

6

April 18, 2023

(d) Birth spacing - repeated pregnancies- malnutrition and

anaemia in the mother- predispose to LBW.. - prematurely weaned- PEM, diarrhoea and

dehydration.

(e) Multiple births - Infants born in multiple births face a greater

risk of death than do those in single births due to the greater frequency of low birth weight among the former.

7

April 18, 2023

(f) Family size - the number of episodes of infectious diarrhoea, prevalence of malnutrition, and severe respiratory infections have been found to increase with family size.

- fewer children-better maternal care, a better share of family resources, less morbidity and greatly decreased infant mortality.

8

April 18, 2023

(g) High fertility high fertility and high infant mortality go

together.

2. ECONOMIC FACTORS The availability and quality of health care and the

nature of the child’s environment are closely related to socio-economic status.

9

April 18, 2023

3. CULTURAL AND SOCIAL FACTORS

(a)Breast feeding: Early weaning and bottle-

fed infants living under poor hygienic conditions are more prone to die than the breast-fed infants living under similar conditions.

10

April 18, 2023

(b) Religion and caste The differences are attributed to socio-cultural

patterns of living, involving age-old habits, customs, traditions affecting cleanliness, eating, clothing, child care and almost every detail of daily living.

(c) Early marriages ..teen-age mother- greater risk of neonatal and

post-neonatal mortality.

11

April 18, 2023

(d) Sex of the child Statistics show that female infant mortality is higher than the male infant

mortality.

(e) Quality of mothering

(f) Maternal education Women with schooling tend to marry later,

delay child- bearing and are more likely to practice family planning.

12

April 18, 2023

(g) Quality of health care Shortage of trained personnel like dais,

midwives and health visitors is another determinant of high mortality in India.

According to estimates only 47% of the deliveries are attended by trained birth attendants.

(f) Broken families

(g) Illegitimacy13

April 18, 2023

(j) Brutal habits and customs -depriving the baby of the first milk or

colostrum, frequent purgation, branding the skin, application of cow-dung to the cut end of umbilical cord, faulty feeding practices and early weaning.

(k) The indigenous dai ..untrained midwife- unhygienic delivery.

(l) Bad environmental sanitation14

April 18, 2023

Preventive and social measures

1. Prenatal nutrition - improve the state of maternal nutrition..

2. Prevention of infection - eg. Neonatal tetanus, UIP- protect against 6 vaccine preventable diseases.

3. Breast feeding - gastro-intestinal, respiratory infections and PEM.

15

April 18, 2023

4. Growth monitoring - all infants should be weighed periodically and

their growth charts maintained. - these charts help to identify children at risk

of malnutrition early.

5. Family planning - smaller sibship and longer spacing between

pregnancies are associated with improved infant and child survival.

16

April 18, 2023

6. Sanitation - poor sanitation and environmental

conditions exposes the infant to various infections.

7. Provision of primary health care - all those involved in maternity care ( obstetrician-local dai) should collaborate and

work together as a team.

17

April 18, 2023

- Prenatal care must be improved with a view to detecting mothers with “high-risk factors”, and those with prenatal conditions associated with high- risk are hospitalised and treated.

- “Special care baby units” : for babies weighing less than 2000g.

- Proper referral services.

18

April 18, 2023

8. Socio-economic development this must include spread of

education, improvement of nutritional standards, improvement of housing conditions, the growth of agriculture and industry and the availability of commerce and communication; in short it implies all round health and social development of the community.

19

April 18, 2023

9. Education Educated women generally do not have early pregnancies, are able to space their

pregnancies, have better access to information related to personal hygiene and care of their children, and make better use of health care services.

20

April 18, 2023

THANK YOU FOR LISTENING!

21