Infant mortality rate in India: still a long way to go.

Infant Mortality Rate (IMR) is regarded as an important and sensitive indicator of the health status of a community. It also reflects the general standard of living of the people and effectiveness of interventions for improving maternal and child health in a country. Compared to other indicators like crude birth rate, maternal mortality rate and under-five mortality rate etc, this indicator has always been accorded greater importance by the public health specialists because infant mortality is the single, largest category of mortality. Moreover, deaths during infancy are due to a particular mix of diseases and conditions to which the adult population is less exposed and less vulnerable. Changes in specific health interventions affect IMR more rapidly and directly and hence it may change more dramatically than the crude death rate in a population. This is clearly demonstrated in a developing country like India. In the 1960s, IMR in India used to hover around the 100 mark in the country. However, due to rapid strides that the country has taken in socio-economic development, health and education, average IMR is currently estimated to be around 60/1000 live births/year (SRS 2003).1 IMR has declined in both urban areas (40/1000 live births/yr) and rural areas (69/1000 live births/yr). Compared to an IMR of as low as 5/1000 lb/yr2 in countries such as Japan and Sweden the IMR in India is still quite high. However, it is close to the world average of IMR of 56/1000 (yr 2002)2. In fact, not only in India but in the developing world in general, the fall in IMR has been greater than in the developed world. Despite these successes, IMR is still in the unacceptable range and a lot needs to be done. To make matters worse, in a country like India, there are wide inter-state variations. We have extremely low IMR states states like Kerala (14/1000) while in 3-4 states IMR < 50 (T. Nadu, A.P., Maharashtra and Pb) but we also have high IMR states like Uttar Pradesh (83/1000) and Orissa (96/1000), Bihar, M.P. within each state also, there are wide rural-urban variations.