Data: Infant Mortality Rate (IMR) in Rural areas 1.5 times the rate in Urban areas
Sai Krishna Muthyanolla
July 14, 2020
The recently released SRS 2018 data indicates that the Infant Mortality Rate (IMR) in Rural areas is 1.5 times the rate in Urban areas. Madhya Pradesh recorded the worst IMR while Kerala is the only state to have recorded IMR in single digits.
Child mortality is an indicator of the overall physical health, social, economic, and environmental conditions in a community where a child is born. It is also indicative of the health facilities available, water and sanitation, nutrition, education, immunization, and even the health of the mother and is therefore, used widely as an important indicator in health planning. Such data is used by policy makers, demographers, epidemiologists, social scientists, etc. to better understand the issues and arrive at measures to address the same. The ‘Infant Mortality Rate (IMR)’ is used to measure the death rate among infants or children less than one year old. IMR is defined as the number of deaths per 1,000 live births of children under one year of age.
Deaths of Children in the 0-4 age group account for more than 11% of all the deaths
As per SRS 2018, death of children aged in the 0-4 age group accounts for 11.5% of the deaths that took place in India in 2018. State wise data shows that 1 in every 5 deaths in Madhya Pradesh  in 2018 is that of a child in the 0-4 age group. In the Rural areas, the deaths in this age group accounted for 12.8% of all the deaths in 2018- ranging from 2.1% in Kerala to 21.9% in Madhya Pradesh. Meanwhile national average in urban areas was recorded as 8.2%, ranging from 1.9% in Kerala to 13.7% in Bihar.
IMR in India has reduced from 129 in 1971 to 32 in 2018, as per SRS report
The IMR has decreased considerably from 129 in 1971 to 110 in 1981 to 80 in 1991 and to 32 in 2018, according to the annual Sample Registration System Survey of 2018 released by the Registrar General of India.
In the period from 2013-2018, the IMR has decreased from 40 to 32. This means that on an average, the rate has dropped by 1.6 points annually. On the other hand,  Neo natal deaths or deaths of infants within 28 days of birth account for 71.7% deaths of infants in India, in 2018. This ranges from 79.4% in Odisha to 51.4% in Assam.
Female IMR is higher than that of Male infants
Gender wise data reveals that the IMR of female infants has always been higher than that of male infants. While in 2013, IMR for female infants was recorded as 42, the same for male infants was 39. The latest 2018 data shows that male IMR dropped to 32, and that for female infants is 33 indicating that the gap between the two has reduced over the years.
IMR in Rural areas is 50% more than the rate in Urban areas
Analysis of the infant mortality rates by residence, that is, in urban and rural areas also shows a decreasing trend in both urban and rural areas. While the rate has dropped from 27 to 23 in urban areas in six years between 2013 & 2018, the same in rural areas has decreased from 44 in 2013 to 36 in 2018.
The IMR in rural areas is 50% more than the rate in urban areas. This stark difference in IMR in the urban & rural areas is indicative of the difference in healthcare facilities, education, and other socio-economic factors. The difference is even more stark in certain states. For instance, in Assam, the rural IMR is 40 which is double the IMR recorded in urban areas.
Madhya Pradesh has the worst IMR of 48
State wise data shows that Madhya Pradesh continues to report the worst IMR among all the states. The IMR in Madhya Pradesh was recorded as 48 in 2018.  Uttar Pradesh, Odisha, Chhattisgarh, and Assam recorded an IMR of 40 and above in 2018. Rajasthan, with an IMR of 37 is also above the national average of 32.
Kerala ranks the best with an IMR of only 7, almost 1/5 of the national average. Delhi, Tamil Nadu, Himachal Pradesh, and Maharashtra recorded an IMR of less than 20. Data indicates that states with poor development indices recorded high IMR.
Male IMR higher than female IMR in some large states
Contrary to the national trend, the male IMR is higher than the female IMR in some large states. In Madhya Pradesh, the male IMR is 51 while the female IMR is 46, a gap of five. In Chhattisgarh, male IMR is 42 compared to the female IMR of 39. In Kerala, it is 9 in the case of male infants and 5 for female infants. In Uttarakhand, the male IMR was 33 compared to the female IMR of 28.
Implementation of child health schemes needs to be monitored
The data clearly indicates that  IMR is higher in states with poor development. Further, the IMR is significantly higher in rural areas compared to urban areas. Despite multiple child & maternal health programs, the gap between states & rural/urban areas hasn’t decreased as expected. There needs to be a targeted mission mode approach to close this gap with special emphasis on the laggard states & regions.
UNICEF data reveals that India’s IMR is much higher than the global average
Even though India has made significant progress in reducing IMR over the last few decades, the number is still high. According to UNICEF data updated in September 2019, India’s IMR is higher than the global average. India ranks 141 out of 198 countries. There are 140 countries which have a lower IMR than India. Countries like Brazil, Nepal, Indonesia, and Iraq have a lower IMR.
India still has a long way to go to improve on the global rankings. The sustainable development goals  call for reducing the preventable deaths of new-borns and children under 5 years of age, by bringing down neonatal mortality to at least as low as 12 per 1000 live births and under-5 mortality to at least as low as 25 per 1000 live births. Targeted approach coupled with better healthcare facilities, immunization, education & awareness, water and sanitation, and other socio-economic development programs are a must if India is to reach these goals.
Featured Image: Infant Mortality Rate[Photo Credit: AFP]