The infant mortality rate (IMR) of Maharashtra has declined by three points and the state government has attributed the fall to improved healthcare and better reach of health benefit schemes.

The Sample Registration System data for 2010 says that 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.

“The drop can be attributed to various government schemes and programmes initiated to enhance mother and child healthcare. Besides, the government’s immunisation programme and the rate of institutional deliveries – births occurring in hospital set up – which has gone up to 90%, are among other prominent reasons,” said Vasudeve Rokade, assistant director (child health).
Home–based newborncare provided through Accredited Social Health Activists (ASHAs) has brought medical care within the reach of people in rural parts of the state. “The purpose of homebased newborn–care is to improve newborn practices at the community level and early detection and referral of sick newborns,” Rokade said.

The country’s infant mortality rate (IMR) too has shown a three point decline, going down from 50 deaths per 1,000 live births to 47. India thus moved closer to achieving the Millennium Development Goals (MDG) target of 30. While the IMR national average is 47, it stands at 51 in rural areas and 31 in urban centers.

The health and family welfare ministry estimates that 17 lakh children, under the age of 5, die every year. Of these, 13 lakh are infants. Another 7 lakh deaths occur within the first week. The main cause of death in 50% cases is malnutrition. Other main reasons attributed to child mortality are diarrhoea, pneumonia and measles.

The latest report on the causes of death prepared by the State Bureau of Health Intelligence and Vital Statistics also lists premature births and low birth weight as reasons for 39.8% of total infant deaths in the first year of life, followed by birth asphyxia and pneumonia. However, experts say most of the causes can be avoided with good care of mother and child.

“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, former president of the Indian Medical Association (IMA).

Paediatrician Shishir Modak, former president of the India Academy of Paediatrics, Pune branch, said, “About 10% to 15% of deliveries are still conducted at home. This approach significantly increases chances of infant mortality. Efforts should be further enhanced to inculcate the healthcare seeking behaviour among expecting mothers.”

Low birth weight is related to poor maternal nutrition and lack of antenatal care. It is observed that among those babies who had a birth weight of less than 2,500 grams were at a much higher risk of death than babies born with a birth weight of more than 2,500 grams, Modak said.

“The Janani Shishu Suraksha Karyakram provides for free transport, food and drugs and diagnostics to all pregnant women and sick newborns. It also promotes institutional delivery and eliminate out–of–pocket expenses, which act as a barrier in seeking institutional care. We hope to see further drop in infant mortality in the days to come,” Rokade said.

States where the infant mortality rate continues to remain higher than the national average are Assam (58), Bihar (48), UP (61), Chhattisgarh (51) and Meghalaya (55) Kerala, Goa, Manipur and Nagaland are the only four states that achieved an IMR below the MDG target so far. The same also holds true for Union territories like Andaman and Nicobar Islands, Chandigarh, Daman and Diu, Lakshadweep and Puducherry Bihar, Gujarat, Odisha, Punjab, Rajasthan, Tamil Nadu, Meghalaya, Sikkim and Tripura had shown a four–point decline in the IMR. Andhra Pradesh, Assam, Chhattisgarh, Haryana, Karnataka, Maharashtra, Delhi, Nagaland, Uttarakhand and Chandigarh showed a three–point decline

In developed countries like Japan and Sweden, the infant mortality rate (IMR) is as low as 4 More female babies die in the first year of life than male. Due to society's preference for male child, better care and nutrition is reserved for the male offspring 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 Mother's age at delivery, order of the child in family, family size, socio–economic condition, level of literacy, (especially of mother) are important factors Better primary healthcare to mother and child and stress on female literacy will go a long way in bring the IMR down further
Doctors think the mortality rate can and should come down further