Infant Mortality in a Global Context

by

Jónína Einarsdóttir, Geir Gunnlaugsson

• LAST REVIEWED: 27 June 2017
• LAST MODIFIED: 27 June 2017
• DOI: 10.1093/obo/9780199791231-0184

Introduction

Infant mortality refers to deaths of infants who die before reaching one year of age and the infant mortality rate (IMR) accounts for the number of such deaths per 1,000 live births. There are no agreed international definitions of fetal deaths and stillbirths, which complicates international comparison. Yet, there are evident wide regional differences in IMRs and great cross-country variability. IMR is a sensitive indicator for infant health and well-being across nations and contributes indirectly to the human development index through its impact on estimated life expectancy at birth. IMRs have been declining in most countries, particularly in recent years in the era of the Millennium Development Goals 2000–2015. Contributing factors are complex but include for example improved maternity care and skilled birth assistance in addition to better post-neonatal clinical care and improved coverage of immunizations. Yet, neonatal mortality rates (within twenty-eight days from birth) continue to be high and most deaths of infants occur during the first week of life. Infant death has profound impact on respective communities and families, particularly the mothers whose expressions of grief and consternation are influenced by factors such as religion, socio-cultural context and individual history. It has been debated to what extent mother’s grief and emotional responses to infant deaths are shaped by high rates of infant mortality and fertility. Globally, there are huge regional differences in IMRs and great cross-country variability. Yet, global strategies to lower IMRs are formulated and interventions have been identified to be effective to reduce IMRs. This poses ethical dilemmas that include treatment decisions for extremely prematurely born infants in high tech neonatal intensive wards.

General Overviews

International organizations, national institutions and foundations publish informative websites with comprehensive information on infant and child mortality. The websites of the Global Health Observatory, UNICEF, and Countdown to 2030 give information about infant mortality, relevant definitions, up-to-date statistics of global, regional, and national trends and literature on the main causes of infant mortality and ways of combating it. Gapminder and Global Burden of Disease Study are authoritative websites with innovative visualizations of health-related data for infants and children, including time trends. DHS Program and UNICEF give country specific information on the health of infants based on surveys. Information on Every Woman Every Child and Healthy Newborn Network is guided by the Global Strategy for Maternal, Neonatal, Child and Adolescent’s Health. Centers for Disease Control and Prevention focus in particular on infant mortality in the United States and Eurostat on statistics in the European Union, including those on infant mortality.

• Centers for Disease Control and Prevention.

  Gives up-to-date information about infant mortality in the United States, causes, and measures to fight infant deaths.

• Countdown to 2030.

  A rich source on evidence-based interventions to lower maternal, newborn, and child mortality. Identifies research priorities, policy, and practice to combat child mortality and enhance maternal health with focus on seventy-five priority middle- and low-income countries.

• DHS Program: Demographic and Health Surveys.

  Collects and disseminates data on health and population in developing countries and includes over three hundred surveys in more than ninety countries. This is a rich source of information on diverse aspects of population health, including that on infant health and mortality.

• Eurostat.

  Provides health-related data on member states of the European Union, including perinatal, neonatal, and IMRs.

• Every Woman Every Child.

  Good source of information on maternal and infant health in the world. This UN Initiative addresses the major health challenges facing mothers, newborns, children, and adolescents around the world and puts into action the Global Strategy for their health and well-being.

• Gapminder.org.

  A nonprofit foundation that aims to improve policy and knowledge about crucial global health themes, including infant and child mortality and maternal health. Develops tools and presents complex data sets in a novel way that allows visualization of global trends and complex relationships, such as changes in infant mortality with time, and its relations with economic and social determinants.

• Global Burden of Disease Study.

  Gathers and analyzes global health data that are the foundation for the Global Burden of Diseases, Injuries, and Risk Factors Study, covering 188 countries in 2015. A rich source of health data by countries and level of development, with innovative visualizations for improved analysis and understanding of the burden of disease and risk factors calculated by the use of disability adjusted life year (DALYs).

• Global Health Observatory.

  World Health Organization website that provides data and analyses on infant mortality, global statistics and trends, relevant publications, and webpages,

• Healthy Newborn Network.

  Builds on Every Newborn, a joint action platform of maternal and newborn health professionals and practitioners who aim to reduce preventable newborn deaths and stillbirths. It builds on the UN Global Strategy for Women’s, Children’s, and Adolescents’ Health with particular focus on evidence based actions to improve newborn’s survival, health, and development.

• UNICEF.

  The annual State of the World’s Children is a rich source of data on global maternal and child health, including infant mortality. The website gives access to numerous publications every year on maternal, neonatal, and infant health, both in rich and poor countries. The Multiple Indicator Cluster Survey (MICS) monitors the situation of mothers and children in over fifty countries.