Trends in perinatal and neonatal mortality in India

Let us firstly define the various mortality indicators in respect of infants.

1.    Infant Mortality rate (IMR): It stands for number of infant dying under one year of age i.e. in a year  per 1000 live births of the same year.

2.    Neo-Natal Mortality Rate (NNMR): It stands for number of infant dying within the first month of life (to be more specific under 28 days) in a year per 1000 live births of the same year.

3.    Post-Natal Mortality rate (PNMR): It stands for number of infant deaths at 28 days to one year of age per 1000 live births of the given year.

4.    Peri-Natal Mortality rate (PMR): It stands for number of still births (SBs) plus infant deaths within first week of delivery per 1000 live births in a year.

5.    Early Neo- Natal Mortality rate (ENNMR): It stands for number of infant deaths within first week of delivery per 1000 live births in a year.

It is very clear that IMR = NNMR + PNMR and PMR = ENNMR + SBR or

ENNMR = PMR - SBR.

Although in case of India the infant mortality rate (IMR) has reduced quite considerably from 114 in 1980 to 47 in 2010 (44 in 2011), it compares very poorly with the advanced countries and some developing countries. The observed fall in IMR has been mostly in post-neonatal mortality, with the result that neonatal deaths (33 in 2010) now account for over 70% of all infant deaths. Among neonatal deaths, early neonatal deaths are around 76%.  The overall peri-natal mortality rate (PMR) in India is still 32 per 1000 live and still births as of in the year 2010.  However, PMR differs widely in different states, urban/rural areas, and different hospitals and so on. PMR is seen to correlate better with social development than economic development of the representative community. The causes of peri-natal deaths suggest poor health of mother and poor health facilities and are hence potentially preventable. Various studies have shown that PMR can be significantly reduced within a short span of time.