Imr

infant mortality rate
sub- community medicine

1. INFANT MORTALITY AND ITS PREVENTION AND CONTROL MEASURES IN INDIA Presenter- PRAJNA.SHETTY Moderator- Dr. Oliver D’souza 17 March 2015 1

2. 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 17 March 2015 2

3. 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! 17 March 2015 3

4. Medical causes of infant mortality Neonatal mortality (0-4 weeks) Post-neonatal mortality (1-12 months) Low birth weight and prematurity Birth injury and difficult labour Sepsis Congenital anomalies Haemolytic diseases of newborn Conditions of placenta and cord Diarrhoeal diseases Acute respiratory infections Tetanus Diarrhoeal diseases Acute respiratory infections Other communicable diseases Malnutrition Congenital anomalies Accidents 17 March 2015 4

5. Factors affecting Infant mortality BIOLOGICAL FACTORS 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. 17 March 2015 5

6. (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 3 rd child. 17 March 2015 6

7. (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. 17 March 2015 7

8. (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. 17 March 2015 8

9. (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. 17 March 2015 9

10. 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. 17 March 2015 10

11. (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. 17 March 2015 11

12. (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. 17 March 2015 12

13. (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) Illegitimacy 17 March 2015 13

14. (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 sanitation 17 March 2015 14

15. Preventive and social measures 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. 17 March 2015 15

16. 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. 17 March 2015 16

17. 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 March 2015 17

18. - 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. 17 March 2015 18

19. 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. 17 March 2015 19

20. 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. 17 March 2015 20

21. Thank you for listening!  17 March 2015 21