27 April 2012
By Umesh Isalkar
For every 1,000 live births in the city, 22 infants die within a year of their birth. In 2011 alone, 1,143 infants died, that too mostly due to preventable causes, such as premature birth, low birth weight, diarrhoeal diseases, etc. .
The number hovered around 25 in 2010; it came down to 22 per 1,000 live births in 2011.
“The city’s IMR rate is not that high. It is considerably less than the state average of 28. In 2001, Pune’s IMR rate was 32,” said S T Pardeshi, head, heath department, PMC.
“It came down to 25 in 2010 and further to 22 infant deaths per 1,000 live births in 2011. Efforts are on and we are confident of bringing it below 22,” he added.
Over 1,000 stillbirths or foetal deaths also occur in the city every year. These deaths are, however, not included in the infant mortality rate. The infant mortality rate takes into account deaths of infants who were born alive but died within a year of their birth.
Pardeshi said: “As per our analysis, the reasons for infants’ deaths are prominently premature birth, low birth weight, diarrhoeal diseases, respiratory tract infection, maternal disease and congenital diseases.”
The latest report on the causes of death, prepared by the State Bureau of Health Intelligence and Vital Statistics, also lists premature birth and low birth weight as the reasons for 39.8% of total infant deaths in the first year of life, followed by birth asphyxia at 10% and pneumonia and bronchitis at 8% between 2003 and 2008.
It also says birth defects or congenital malformation accounted for 6.37% deaths in 2008, the highest in the six years mentioned.
Experts, however, say most of the causes can be avoided with good mother and child care.
“Most of the reasons for infant mortality are preventable. For example, if good antenatal or pre–delivery care is provided to the mother, the baby will be born with good birth weight and maturity. This improves the survival and is a major determinant of a quality of life the baby will have in future,” said paediatrician Sharad Agarkhedkar.
“Common causes of premature birth are infection, multiple pregnancies, abnormal presentation of foetus and low lying placenta,” Agarkhedkar said.
“Such high risk pregnancies need special care and such a delivery should only be conducted in specialized centres, where paediatricians and obstetricians are available. Another reason for infant mortality is birth asphyxia in which the baby’s brain gets damaged due to lack of oxygen,” he added.
“This can be avoided by good monitoring, maintaining warmer temperature in the labour room and also availability of medical oxygen,” Agarkhedkar said.
Also, according to Agarkhedkar, the immunisation coverage, which is currently hovering at 85 to 90% can be increased to 100%, which will help in arresting the IMR rate.
Paediatrician Sanjay Lalwani said, “About 10–15% of the total deliveries are still conducted at home. This increases the chances of infant mortality. Efforts should be enhanced further to encourage expecting mothers to seek proper heath care.”
“Low birth weight is related to poor maternal nutrition and lack of antenatal care. It is observed that babies who had a birth weight of less than 2,500 gram, had a much higher risk of death than the babies born with a birth weight of more than 2,500 gram,” Lalwani said.
Cases such as congenital malformations may not be totally preventable.
However, other reasons such as diarrhoea, dehydration and deaths due to pneumonia still occur, though they are largely preventable with the help of vaccines and prompt medical intervention, Lalwani added.
“Fifty per cent infants die in the neonatal period, ie, one to six weeks of life. Hence, this problem is closely linked to better antenatal care, better delivery and post delivery care, breast feeding and good nutrition of the mother,” said gynaecologist Charuchandra Joshi, former president of the Pune Obstetric and Gynaecological Society.
The infant mortality rate of Maharashtra also declined by three points and the state government has attributed this to improved healthcare and better reach of health benefit schemes.
The Sample Registration System data for 2010 said the IMR (death in age group up to one year) has dropped from 31 deaths per 1,000 live births in 2009 to 28 deaths in 2010.Fact Sheet
- In developed countries like Japan and Sweden, the infant mortality rate (IMR) is as low as 4–5
- More female babies die in the first year of life than males. Due to society's preference for male child, better care and nutrition is given to male offspring as compared to female
- 50% infants die in the neonatal period of 1st to 6 weeks of life. Hence, this problem is closely linked to better antenatal care, better delivery and post delivery care, breast feeding and good nutrition of mother
- Premature delivery is an important cause of infant mortality
- Malnutrition, poor sanitation leading to various infections, diarrhoea, lack of protein and calories in diet resulting in poor resistance to infections –– babies succumb to infections –– are other important causes
- Mother's age at delivery, order of the child in family, family size, socio–economic condition, level of literacy, (especially of mother), important.
- Better primary health care of mother and child and stress on female literacy will go a long way to bringing IMR further down