Approach :
- Intro – state facts on India’s IMR.
- Briefly mention the grim scenario of IMR with cross-country comparison.
- Mention few state-level data on IMR.
- Now elucidate the reasons for high incidence of IMR.
India’s Infant Mortality rate (IMR) isn’t a fringe issue. This is because, the number of infant deaths out of every 1000 live births is a marker of the overall health & well-being of the population. The latest data shows, India’s IMR is 28 for then reference year 2020, which has come down from 44 in the past decade. The corresponding dip in rural areas is from 48 to 31 and for urban areas it is 19 from 29.
The grim scenario : The national average masks the stark disparities between different states and between rural & urban. Despite the decline, still, 1 in every 36 infants die within the first year of their life at the national level. Many of our neighbors have fared better – Bangladesh’s IMR is 24, while Bhutan’s is 23 and Sri Lanka is leagues ahead with just 6. Even Brazil and China have much lower IMRs than India.
States’ statistics : Kerala, the only state, has a single digit IMR of 6. Among the smaller states, Mizoram leads the IMR chart with 3 infant deaths per 1000. India’s north-east like Tripura, Sikkim, Nagaland, etc. are well on saving babies. Same goes with Goa. However, the states that have trailed in human developments are the laggards – UP’s IMR is 38, Madhya Pradesh scores 43, Chhattisgarh scores 38 and Uttarakhand scores 24. Also, there is a huge gulf between cities & villages.
Reasons : Infant-mortality is the end result of a whole chain of interlinked challenges. A high IMR exposes the structural fault-lines.
- Continued prevalence of malnourished children. Particularly those with severe acute malnutrition have higher risk of death from common childhood illnesses.
- Malnourishment reduces immunity. While severe acute malnutrition get attention, a larger pool of children suffering from moderate malnutrition, also at risk, are somewhat overlooked.
- India has a large number of low-birthweight They are at a risk if they continue to be undernourished.
- The overall low quality of childcare during childbirth & after is also responsible.
- Poor maternal nutrition. The latest NFHS data tells 52% of pregnant women in the 15-49 age group are anemic, which is higher then NFHS (2015-16). The state-level data presents an alarming picture of rising anemia for both women & children. Hence, maternal anemia affects child survival and health.
- Infants in remote areas remain at risk due to inaccessibility or under-resourced PHCs.
- Underspending on public health as a percentage of GDP – above 1% for the past decade – has severely strained the public heath infrastructure. When overall spending on healthcare is low, problems will persist.
Infants are our future. They must survive if India has to thrive and become ‘Aatmanirbhar’. This can happen only if infant mortality is brought from the periphery to the centre of politico-social priorities in the country.