INFANT MORTALITY RATE (IMR)
1. Context
Kerala’s infant mortality rate is down to 5 per 1,000 live births, according to the Sample Registration System (SRS) Statistical Report-2023.
2. What is the Infant Mortality Rate (IMR)?
- The Infant Mortality Rate (IMR) is a key demographic and public health indicator that measures the number of deaths of infants under one year of age per 1,000 live births in a given year and population.
- In simple terms, it tells us how many babies do not survive their first year of life out of every 1,000 babies born alive.
- IMR reflects the overall health status, socio-economic conditions, and quality of healthcare services in a country. High IMR usually indicates issues such as malnutrition, poor maternal health, inadequate healthcare facilities, and lack of sanitation.
- Conversely, a low IMR shows improvements in medical care, immunization, maternal nutrition, and public health policies.
- For India, reducing IMR has been a central goal under various initiatives like the National Health Mission, Janani Suraksha Yojana, and Poshan Abhiyaan, as it is directly linked to the country’s progress on Sustainable Development Goals (SDG 3 – Good Health and Well-being)
3. What are the trends in India’s IMR in the last decade as per the SRS, 2023?
- Over the past decade, Delhi, Himachal Pradesh, and Karnataka have managed to cut their Infant Mortality Rate (IMR) by more than half, marking the most significant improvements on this key child health indicator.
- According to the 2023 Sample Registration Survey (SRS), India’s IMR has fallen by over 37% in ten years—from 40 infant deaths per 1,000 live births in 2013 to 25 in 2023.
- The country’s IMR dropped below the global average around 2021, and its pace of decline has been faster than worldwide trends. However, India still lags behind the Asian average of 17.4 deaths per 1,000 births.
- In the most recent data, the national IMR showed a one-point decline from the previous year, while the average improvement during the last five years has been 1.4 points annually.
- Among the larger states, Kerala stands out with a single-digit IMR—just five deaths per 1,000 live births—a level comparable with developed nations. Yet, Kerala also records the widest gender gap, with IMRs of nine for boys and two for girls.
- Smaller states like Manipur, Sikkim, and Goa, along with nearly all Union Territories, also report single-digit IMRs.
- At the other end of the spectrum, Chhattisgarh, Madhya Pradesh, and Uttar Pradesh have the highest IMRs in the country, each at 37, followed by Odisha and Assam, both at 30
- A report published earlier this week notes that the national average infant mortality rate (IMR) stands at 25 deaths per 1,000 live births. Referring to the findings, Kerala’s Health Minister Veena George highlighted that the State’s IMR is even lower than that of the United States, which recorded 5.6 deaths per 1,000 live births in 2022, and reaffirmed that Kerala has the lowest IMR in India.
- Kerala’s success is the outcome of consistent improvements in the health sector over the years. Data from the State’s Department of Economics and Statistics shows that the IMR stood at 7.42 in 2010, briefly rose to 8.2 in 2012, but has steadily declined since then.
- Further, the 2023 State Vital Statistics Report points out that institutional deliveries dominate childbirth practices in Kerala. In rural areas, 96.16% of deliveries took place in healthcare institutions, while in urban areas the figure reached 99.88%, reflecting strong access to maternal and child healthcare facilities
4. What are the factors behind the reduction in infant mortality in India?
The reduction in Infant Mortality Rate (IMR) in India over the past few decades is the outcome of a combination of healthcare interventions, socio-economic progress, and policy focus. Here’s an explanatory account:
- Improved antenatal, intranatal, and postnatal care has been central. Schemes like the Janani Suraksha Yojana (JSY) and Janani Shishu Suraksha Karyakram (JSSK) incentivized institutional deliveries and provided free maternal care, reducing risks during childbirth
- A large majority of births now take place in healthcare institutions, supported by programs under the National Health Mission (NHM) and better rural health infrastructure. Institutional births reduce complications, ensure trained attendance, and provide immediate neonatal care
- Expansion of the Universal Immunization Programme and the introduction of Mission Indradhanush helped protect children from life-threatening diseases such as measles, diphtheria, and pneumonia, thereby reducing infant deaths
- The setting up of Special Newborn Care Units (SNCUs), Nutrition Rehabilitation Centres (NRCs), and improved access to pediatric services has strengthened survival chances for vulnerable infants
- Government schemes like the Integrated Child Development Services (ICDS), Poshan Abhiyaan, and mid-day meals have improved maternal and child nutrition. Better maternal health directly lowers the risk of premature or underweight babies, a major contributor to infant deaths
- Education of women has led to greater awareness about hygiene, healthcare, and nutrition, resulting in healthier pregnancies and better childcare practices. States with higher female literacy, like Kerala, consistently show lower IMRs
- Flagship initiatives under the National Health Mission, such as the India Newborn Action Plan (2014), set specific targets for reducing neonatal and infant mortality. Regular monitoring through the Sample Registration Survey (SRS) has kept the issue at the forefront of policy action
5. Why are there interstate differences in IMR in India?
- The Sample Registration System (SRS) Statistical Report 2023 makes it clear that while India has achieved significant progress in reducing its Infant Mortality Rate (IMR), there are still striking differences between states. These interstate disparities arise from a complex interplay of health infrastructure, socio-economic development, governance, and social practices.
- One of the foremost reasons is the variation in healthcare access and quality across states. States such as Kerala, Tamil Nadu, and Himachal Pradesh have built strong public health systems, ensuring trained medical personnel, institutional deliveries, and neonatal care facilities are widely available.
- In contrast, states like Madhya Pradesh, Uttar Pradesh, and Chhattisgarh still struggle with underfunded health services, shortages of doctors and nurses, and poor rural health outreach, which contributes to persistently high infant deaths.
- Maternal and child nutrition also plays a decisive role. In states with high rates of malnutrition and anaemia among mothers, babies are more likely to be born underweight or premature, making them vulnerable to infections and early death. This is particularly evident in central and eastern states where poverty, food insecurity, and weaker implementation of nutrition schemes have kept IMR higher.
- Education and awareness further shape these differences. States with high levels of female literacy, such as Kerala and Tamil Nadu, tend to have mothers who are more aware of hygiene, breastfeeding, vaccination, and healthcare needs, directly lowering infant mortality. On the other hand, low female literacy in poorer states often limits health-seeking behaviour, leading to preventable deaths.
- Another factor is infrastructure beyond health services, including sanitation, drinking water, electricity, and transport. Kerala, with nearly universal institutional deliveries, has also ensured that roads and ambulances connect rural households to hospitals.
- In contrast, hilly, tribal, and remote areas in states like Odisha and Madhya Pradesh face access barriers that delay or prevent timely medical intervention.
- Social and cultural practices also shape the gap. In some regions, deep-rooted gender biases lead to differential care for male and female infants.
- The SRS 2023 highlights Kerala as having the lowest IMR overall, but also shows a sharp gender disparity—IMR for boys being higher than for girls. Such gendered patterns differ from state to state, contributing to uneven outcomes.
- Finally, governance and policy prioritisation explain a large part of the difference. States that have consistently invested in health and social welfare—through schemes for maternal care, immunisation drives, and nutrition—show sustained improvements. States where such programs remain weakly implemented or irregularly continue to report higher infant deaths despite overall national progress
6. Why are there interstate differences in IMR in India?
- Interstate differences in Infant Mortality Rate (IMR) in India arise because health outcomes are shaped by a mix of healthcare access, socio-economic development, nutrition, education, and governance, all of which vary widely across states.
- In states such as Kerala, Tamil Nadu, and Himachal Pradesh, IMR has dropped to single digits because of strong public health systems, high female literacy, widespread institutional deliveries, and effective implementation of maternal and child health schemes.
- These states have invested consistently in healthcare infrastructure, ensured better nutrition through schemes like ICDS and Poshan Abhiyaan, and created social awareness around immunisation, breastfeeding, and hygiene. Kerala, for instance, combines near-universal institutional deliveries with high maternal education levels, giving it one of the lowest IMRs in the country.
- By contrast, states such as Madhya Pradesh, Uttar Pradesh, Chhattisgarh, and Odisha continue to record high IMRs. The reasons include weak health infrastructure, shortage of trained medical staff, poor access to emergency neonatal care, and low coverage of institutional deliveries, especially in rural and tribal belts.
- Malnutrition and maternal anaemia are also more prevalent in these regions, leading to low birth weight and greater vulnerability to infections. Poor sanitation and lack of safe drinking water worsen child health outcomes, while low female literacy and limited awareness about healthcare practices restrict preventive care.
- Differences in policy implementation and governance also explain the gaps. States that have prioritised maternal and child health through effective rollout of schemes like Janani Suraksha Yojana, Janani Shishu Suraksha Karyakram, and Mission Indradhanush have seen sharper declines in IMR. Others lag because of weaker monitoring, limited resources, and uneven outreach
|
For Prelims: Infant Mortality Rate (IMR), Sample Registration System (SRS), Maternal Mortality Rate (MMR)
For Mains: GS II - Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.
|
|
Previous Year Questions
1. Consider the following statements (UPSC 2016)
1. The Sustainable Development Goals were first proposed in 1972 by a global think tank called the 'Club of Rome
2. Sustainable Development goals has to be achieved by the year 2030
Which of the statements given above is/ are correct
A. 1 Only B. 2 Only C. Both 1 and 2 D. Neither 1 Nor 2
2. Maternal Mortality Ratio (MMR) of India is released by which of the following office?
(NCL Staff Nurse 2020)
A. Office of Registrar General of India
B. Office of CAG
C. Office of Union Health Minister
D. Office of Statistical computation of India
Answers: 1-B, 2- A
|
Source: Indianexpress
