MCH - IMR
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Transcript of 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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Preventive & social measures
During pregnancy
Early registration
Detection of complications & intervention
Immunisation
IFA
Treatment of infections
Birth & emergency preparedness Diet
Prevention of violence
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Preventive & social measures
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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Preventive & social measures
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