MCH - IMR

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Infant Mortality Rate(IMR)

Dr S L Jadhav

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Infant Mortality Rate(IMR)

The ratio of infant deaths registered in a given year

to the total no. of live births in the same year;

usually expressed as a rate per 1000 live births

IMR = No. of deaths in children< 1year x 1000

No. of live births in same year

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Importance of IMR

Important indicator of health status of

community( PQLI,HDI) , level of living,

effectiveness of MCH services

Largest single age category mortality

Deaths due to causes peculiar to this age group

Affected quickly by specific health programs

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Problem statement Beginning 20th century Developed world high

IMR , brought down by SE development

Developing countries: health services

Any further progress Developed : perinatology

Developing : SE development

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Problem statement

(2008)

World: 45

Sri Lanka 12

India 58

Japan 5

UNICEF : State of the Worlds children

2009

State IMR Female

literacy

CBR

Kerala 12 88 16.6

Maharashtra 33 68 17.9

Orissa 69 51 21.4

MP 70 50 28

Other states with high IMR:

Rajastahan, Assam, UP

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IMR

IM 17.2 % of total deaths

Approx 65% IM in 1st month

50% of this in 1st week Majority in 24-48 h after birth

Higher in females

Rural urban divide

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Medical Causes of IM

Neonatal LBW & prematurity

Birth injury

Difficult labour

Congenital anomalies Sepsis

Haemolytic disease

Conditions of placenta/cord

Diarrhoeal diseases ARI

Tetanus

Post-neonatal Diarrhoeal diseases

ARI

Other communicable

Malnutrition Congenital anomalies

Accidents

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Major cause IM(India)

Prematurity 57%

Respiratory inf 17

Congenital malformations 05 Diarrhoeal 04

Birth injury 03

Cord infection 02

Others 18

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Factors affecting IM

Biological

Economic

Cultural & Social

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Biological factors

Birth weight

Maternal age

Birth order

Birth spacing

Multiple births

Family size

High fertility

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Economic & Cultural & Social Factors

Economic Factors

Cultural & Social factors

Breast feeding Religion & caste

Early marriage

Gender of child

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Cultural & Social factors (contd)

Quality of mothering

Maternal education

Quality of health care Broken families

Illegitimacy

Brutal habits & customs

Indigenous dai

Environmental sanitation

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Preventive & social measures

Before Pregnancy

During pregnancy

During & soon after delivery

Post natal

Others

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Preventive & social measures Before Pregnancy

Child bearing at correct age

Well-spaced & wanted

Well nourished healthy mother Immunisation

Prevention of infection

Maternal literacy

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During pregnancy

Early registration

Detection of complications & intervention

Immunisation

IFA

Treatment of infections

Birth & emergency preparedness Diet

Prevention of violence

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During & soon after delivery

Safe & clean delivery

Early detection & treatment of foetal complications

Emergency obstetric care Newborn resuscitation

Newborn care : warmth cleanliness , care of cord etc

Special care : NICU/incubator

Early , exclusive breast feeding

Prevention & control of infections

Information on home care & counseling on danger signals

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Post natal

Breast feeding

Immunisation Nutrition

Growth monitoring

Protection of girl child

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Other measures

Primary Health care

SE development

Female education

MCH - IMR

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