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Neonatal
and Post neonatal Mortality status
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IMR is conventionally disaggregated into
neonatal mortality, and post neonatal mortality. Neonatal
mortality refers to deaths during the first month of life. Post
neonatal mortality refer to deaths of infants aged one month to
less than a year. Determinants of neonatal mortality include
congenital factors, low birth weight, perinatal factors and as
well as exposure to infectious agents. Post neonatal mortality is
more affected by external factors like exposure to infection, poor
environment, child rearing practices, post neonatal nutrition etc.
In most countries initial reduction in IMR has been found to be
largely contributed by reduction in post neonatal mortality. As
IMR levels reach to reasonably low levels, say 30-50 infant deaths
per 1000 live births, further reduction in IMR is feasible only if
the neonatal or perinatal mortality reduce. Figure 1 shows that
both neonatal and post neonatal mortality in AP has gradually
reduced over the last three decades (1970s - 1990s).
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Figure 1: Decomposition of IMR into neonatal and
post neonatal mortality rates in Andhra Pradesh from the years
1971 to 1998. |
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Source: SRS 1970-98 |
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Post neonatal mortality has reduced at a faster
pace, as is to be expected. Figure 2 compares the declining trend
of neonatal mortality in AP with the neighboring states. The
comparative position of AP's time trend of neonatal mortality is
similar to the situation in case of overall IMR. The declining
trend of neonatal mortality in AP was similar to the experience of
other states like Tamil Nadu, Karnataka, Maharashtra. As in case
of IMR, Madhya Pradesh and Orissa have higher levels of neonatal
mortality compared to AP. |
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Figure 2: Neonatal mortality rates in Andhra Pradesh
and other neighboring states from the years 1971 to 1998. |
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Source: SRS 1970-98
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Faster decline of post neonatal mortality, along
with reduction of overall IMR shows neonatal mortality as an
increasing component of the overall IMR. This phenomenon is
evident from the decomposition of IMR estimates for the recent
NFHS survey shown in the Figure 3.
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Figure 3: Neonatal and Post neonatal mortality rates
in different states. 1998-99 |
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Source: NFHS 2 (India) p-194,
table: 6.6 |
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Figure 3 shows stacked bars of neonatal and post
neonatal mortality in south Indian states and other states
neighboring AP. The post neonatal component is shown as a band in
red color (darker grey scale) and the neonatal component is shown
in green (lighter grey scale). The color coding in Figure 3 is
same as that in Figure 1 where we examined time trend of neonatal
and post neonatal mortality in AP. In Figure 3 we see that Kerala
has the smallest bar i.e., lowest IMR and it's red band (post
neonatal component of IMR) is very thin compared to the green
(neonatal part of IMR). Other states have taller bars (higher
overall IMR) and larger red bands (relatively more post neonatal
mortality). Thus there is still a good deal of scope for the IMR
to decline with reduction in post neonatal mortality. For example,
in case of AP, IMR could be reduced to about 40/1000 live births,
if the post neonatal mortality were to reach a level comparable to
Kerala. |
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<<
BACK
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Updated by
Samatha Reddy
Dated: 17/08/2003 |
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