Topic: Labour management, complications of 3rd stage, Antepartum and postpartum hemorrhage, resuscitation of the newborn
Question: Define IMR? List the major causes of IMR in India? What are the key steps that can bring down IMR in India?
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Infant Mortality Rate or IMR refers to the number of deaths of infants under one year of age per 1,000 live births. It is an important indicator of a nation’s health and development standards. IMR tends to be higher in developing countries due to greater health issues and poorer access to medical care.In India, the current IMR is 28 per 1,000 live births. This is a significant improvement from the IMR of 130 in 1970, but still higher than the global average of 26.
Some major causes of India’s high IMR are:
1. Poverty and lack of health care access: A large segment of India’s population lives in poverty and lacks access to health care services like immunizations, prenatal care, and emergency obstetric care. This makes infants more vulnerable to diseases and contributes to higher mortality rates. Improving affordability and availability of health care, especially in rural areas, can help reduce IMR.
2. Malnutrition: Many Indian infants suffer from malnutrition, low birth weight, and stunted growth due to lack of nutrition. This makes them more prone to health issues and reduces their chances of survival beyond infancy. Providing nutrition supplements and promoting breastfeeding can help.
3. Lack of sanitation: Poor access to clean water and sanitation leads to the spread of diseases like diarrhea, malaria and pneumonia in infants, causing higher IMR. Improving water, sanitation and waste disposal systems will help minimize health issues in infants.
4. Lack of education: Low literacy rates and lack of knowledge about health, hygiene and child care practices among mothers also contributes to high IMR. Educating women and mothers about these issues will enable them to make better decisions regarding infant health and care.
5. Rural-urban disparities: IMR tends to be significantly higher in rural parts of India compared to urban areas due to poorer availability and accessibility of health care in villages. Enhancing health infrastructure and services in rural India will help bring down national IMR.
6. Other factors: Additional factors like indoor air pollution, teen pregnancies, and lack of health insurance also contribute to India’s IMR to some extent. These too need to be addressed through policy and programs.
Some key steps to reduce IMR in India are:
1. Improving health care access: Set up more hospitals, health centers, especially in rural and poorer areas. Increase affordability by providing insurance coverage and subsidized care.
2. Improving nutrition: Provide nutritional supplements and advice for mothers and infants. Promote breastfeeding and complementary feeding.
3. Improving sanitation and hygiene: Increase access to clean water, toilets and better waste management. Educate about hygiene like hand washing and safe food handling.
4. Increasing women’s education: Educate women and mothers about health, nutrition and child care. Increase schooling opportunities for girls which impacts IMR.
5. Rural development: Improve living standards in villages by providing better housing, roads, electricity, transportation, etc. This enhances access to medical facilities and health care.
6. Improving data: Strengthen birth and death registration systems to obtain accurate data on causes of infant deaths. This helps determine targeted interventions.
7. Incentivizing institutional deliveries: Promote deliveries in hospitals and health centers where medical care can be immediately provided if needed. This prevents deaths during or just after birth.
8.Promoting immunization: This includes promoting vaccination programs to prevent common childhood illnesses.
The following table shows the IMR in India from 2015 to 2019:
| Year | IMR (per 1,000 live births) |
|---|---|
| 2015 | 38 |
| 2016 | 34 |
| 2017 | 32 |
| 2018 | 30 |
| 2019 | 28 |
The decline in IMR over the past few years is encouraging, but more needs to be done to bring it down further. By addressing the key factors that contribute to IMR and implementing targeted interventions, India can ensure that more infants survive and thrive.
In summary, a multi-pronged approach focused on health care access, poverty alleviation, improved nutrition, sanitation, women’s education, rural development, and data collection is needed to significantly reduce India’s IMR in coming years. Government programs and policies around maternal and child health also need to be strengthened to curb infant mortality and enable children to survive beyond their first birthday.
