Answer:

Infant Mortality Rate (IMR) is the number of infants dying before reaching one year of age, per 1,000 live births in a given year. According to the 2011 Census report IMR in India stands at 40. India is unlikely to achieve the targets under the Millennium Developmental Goals. Many research studies conducted so far have indicated that, besides medico-clinical causes, the SOCIO-ECONOMIC factors are important determinants in high infant mortality.

♤ Economic Factors- Household income is measure determinant in the facilities that can be availed during maternity and after birth. Access to healthcare, prenatal care, nutrition, immunization and information about the care to be taken during pregnancy directly depends on the economic profile of the family. Rampant poverty and unemployment leads to absence of toilet facilities, sanitation and hygiene, particularly menstrual hygiene. It directly contributes in higher rates

♤ Social and cultural factors- Girls are married young & pressurized after marriage to conceive early. Resorting to foeticide to get rid of the girl child still is a common practice. Pregnant women are not fed adequately due to superstitious belief and a fear of growth of the foetus, lending the delivery difficult. Immunization of pregnant women is avoided as also the vaccination of the child. Restrictions on girls

in terms of education social roles reduce awareness about standard health practices leading to higher mortality.

Implications for Women:

♤ Health: Women suffer from mental and physical agony because of high infant mortality. Trauma of infant death affects the mental health of women. A low or sad mood, loss of interest in fun activities, changes in appetite, sleep, and energy, feelings of worthlessness, shame, or guilt and thoughts that life is not worth living are common implications because of infant mortality.

♤ Social: Social stigma attached to infant deaths leads to harassment, domestic violence and falling prey to superstitions.

♤ Economic: Morbidity and mental illness induced by infant mortality reduces capacity to participate in economic activity thereby increasing economic hardships for women.

Under the National Rural Health Mission (NRHM) the following programmes/schemes and awareness campaign is launched by the Government to reduce infant mortality rate:

♤ Janani Shishu Suraksha Karyakaram (JSSK) has been launched on which entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery including Caesarean section. The initiative stipulates free drugs, diagnostics, blood and diet, besides free transport from home to institution, between facilities in case of a referral and drop back home. Similar entitlements have been put in place for all sick infants accessing public health institutions for treatment.

♤ Navjaat Shishu Suraksha Karyakram (NSSK), a programme for training health care providers on essential newborn care and resuscitation.

♤ Village Health and Nutrition Days in rural areas as an outreach activity, for provision of maternal and child health services.

♤ Rashtriya Bal Swasthya Karyakram (RBSK), an introduction of child health screening for 4Ds i.e. defects at birth, deficiencies, diseases, development delays and their management among the children.

♤ Improving Infant and young child feeding practices including breastfeeding promotion.