2. DEFINITION
►IMR is defined as the ratio of infant deaths
registered in a given year to the total
number of live births registered in the same
year.
►It is expressed as a rate per thousand live
births.
IMR=
No. of deaths of children less than 1 year of age in a year
No. of live births in same year
× 1000
3. PREVENTIVE AND SOCIAL
MEASURES
There is no single specific health programme or a single set of action that can reduce
IMR.
Since the aetiology of infant and perinatal mortality is multifactorial,nothing less than a
multipronged approach will reduce infant and perinatal mortality.
Following measures are essential to reduce IMR.
4. 1.PRENATAL NUTRITION
► The risk of death begins to appear even before birth, if the mother is
malnourished. Therefore the very first need is to improve the state of
maternal nutrition.
► In a controlled study in India, poor women were fed an additional
500k.cal and 10gm of protein during the last 4 weeks of pregnancy.
► Their infant birth weights were on an average 300gms above those
infants born to the control group. This points to the need for food
supplementation programmes during pregnancy.
► ICDS in India is active in this field.
5. 2.PREVENTION OF INFECTION
► The major cause of sickness and death of children in India are
infectious diseases, many of which are preventable by immunization.
► The universal immunization programme launched in 1985 aims at
providing protection to all the expectant mothers and children against
6 vaccine preventable diseases, namely-diphtheria, whooping cough,
tetanus, polio, TB and measles and there by ensure greater child
survival.
6. 3.BREAST FEEDING
►The most effective measure for lowering
infant mortality is to promote breast
feeding, which is a safeguard against
gastrointestinal and respiratory infections
and PEM.
7. 4.GROWTH MONITORING
► It is low cost technology available for reducing infant
mortality.
► All infants should be weighed periodically at least once a
month and their growth charts maintained.
► These charts help to identify children at risk of malnutrition
early.
► Babies who do not thrive or show growth failure are given
special health care to pull them on to the road of health.
8. 5.FAMILY PLANNING
► The risk of death is greatly enhanced if the last child was
born less than 2 years ago, and if the mother already has 4
or more children.
► Smaller sib ship and longer spacing between pregnancies
are needed.
9. 6.SANITATION
► For infants and young children the risk of dying is very closely related
to the environment in which they live.
► Exposure to infections through contaminated food and polluted water,
lack of alimentary hygiene, flies and poor housing pose hazards which
the young cannot escape.
► This is why infant mortality rate is universally recognized not only as a
most important indicator of the health status of children, but also of
the level of social environment.
10. 7.PROVISION OF PRIMARY HEALTH
CARE
► All those involved in maternity care, from the obstetrician to the local
dai should collaborate and work together as a team.
► Prenatal care must be improved with a view to detecting mothers with
high risk factors and those with prenatal conditions associated with
high risk are hospitalized and treated.
► “SPECIAL CARE BABY UNITS” must be provided for all babies weighing
less than 2000gms.
► Proper referral services should be provided.
11. 8.SOCIO ECONOMIC DEVELOPMENT
► Since the causes of infant and perinatal mortality are also social, there
is no getting away from the fact that the ultimate solution for lowering
IMR and PMR lies in the socioeconomic development
► This must include spread of education literacy, improvement of
nutritional standards, provision of safe water and basic sanitation,
improvement of housing conditions, growth of agriculture and industry
and availability of commerce and communication.
12. 9.EDUCATION
► Education of females as a driving force for better health has been
extensively studied and documented.
► Educated women generally do not have early pregnancies, are able to
space their pregnancies, have better access to information related to
personal hygiene and care of their children and make better use of
health care services.
