Of Infant Mortality Rate....

Setting a blistering pace, Tamil Nadu has halved its infant mortality rate (IMR) in the past decade while a bunch of other states – Maharashtra, Punjab, Karnataka – have shown significant decreases of around 40%. The overall IMR for the country has gone down by a third. This emerges from the latest vital statistics data for 2012 collected under the Sample Registration Scheme by the Census office.
The infant mortality rate is a count of deaths of infants under one year of age as a proportion of 1000 live births in the geographical unit in one year. It is considered a key indicator of health services, nutritional levels, poverty and educational level of the people. Reduction of IMR is one of the Millenium Development Goals.
The wide gap between rural and urban areas in infant death rates continues in India but has a declining trend. Rural IMR in 2012 was 46 infant deaths per 1000 live births while the urban rate was 28.
In fact the rural IMR declined slightly faster at 30 percent compared to the urban decline of 28 % since 2003.
But drilling down to the states, a varied story emerges that clearly links to the way public health is being tackled by governments. Tamil Nadu, with its extensive and relatively better run primary health services and nutrition programs has clearly emerged as a front runner in the reduction of infant mortality.
Manipur in the North-East and Goa on the west coast now lead the country with an IMR of just 10, surging past Kerala at 12. These IMRs are comparable to rich country standards. In Kerala, in the past ten years, IMR has marginally worsened, increasing by 9%.
Madhya Pradesh with an IMR of 56 in 2012 is at the bottom of the table among major states, with the worst rural IMR of 60 in the country. Its urban IMR is 37. Although Odisha and Rajasthan figure among the bottom five states in terms of IMR, both have shown a high rate of decline – about 35 percent - in the past decade. Like Uttar Pradesh and Bihar, they too carry the legacy of past neglect.
Karnataka is the only big-population state where urban IMR has worsened, increasing by 4%, despite a 40% decline in rural areas. In Andhra Pradesh and Assam, there has been only a small decline in urban IMRs. Other states where urban IMRs are worsening are Arunachal Pradesh, Nagaland and Uttarakhand.
The lack of a coherent national policy on urban health for a long time is a direct cause of this, even as urbanization is increasing all round.
In the North-East, Mizoram has seen a dramatic rise in infant mortality over the past decade. Its IMR has increased from an excellent 16 in 2003 to 35 in 2012.
Although one of the few states in the region not troubled with separatist bloodshed, its stagnating employment levels and poverty seem to be finding reflection in health indicators.