INFAN T MORTALITY AND MATERNAL

MORTALITY RATE IN INDIA

 Acknowledgement :

I'd want to convey my heartfelt appreciation and gratitude to our

professor as well as our supervisor Dr. Amita Sethi for providing
us with the chance to work on this wonderful project which also
aided us in conducting extensive study and learning about a
bunch of new topics. We are quite grateful to them. Second, I'd
want to thank my friends for their assistance in completing this
project .The completion of this undertaking could not have been
possible without the participation and assistance of my fellow
group members. Their contributions are sincerely appreciated
and gratefully acknowledged .It was quite useful in terms of
expanding our knowledge and abilities.
 OVERVIEW :

 Introduction :
 Infant Mortality Rate.
 Maternal Mortality Rate.
 INTRODUCTION :

 Infant Mortality Rate :

Infant mortality is the death of young children under the age of 1.
This death toll is measured by the infant mortality rate (IMR), which is the probability of deaths
of children under one year of age per 1000 live births.

 Infant Mortality rate :

Infant mortality rate formula

Infant mortality rate (IMR) is the number of
Deaths per 1,000 live births of children under
one year of age. The rate for a given region is the
number of children dying under one year of age,
divided by the number of live births during the year,
multiplied by 1,000.
THE STATE/ UT WISE DETAILS OF INFANT MORTALITY RATE (IMR) FOR
THE PERIOD FROM 2015 TO 2019 ARE AS FOLLOWS:

S. No. National/ State/ UT Infant Mortality Rate (per 1000 live births)

2015 2016 2017 2018 2019

ALL INDIA 37 34 33 32 30
1 Andhra Pradesh 37 34 32 29 25

2 A&N Islands 20 16 14 9 7

3 Arunachal Pradesh 30 36 42 37 29

4 Assam 47 44 44 41 40
5 Bihar 42 38 35 32 29
6 Chandigarh 21 14 14 13 13

7 Chhattisgarh 41 39 38 41 40

8 D&N Haveli 21 17 13 13 11

9 Daman & Diu 18 19 17 16 17

10 Delhi 18 18 16 13 11
11 Goa 9 8 9 7 8
12 Gujarat 33 30 30 28 25
13 Haryana 36 33 30 30 27
S. National/ State/ UT Infant Mortality Rate (per 1000 live births)
No.
2015 2016 2017 2018 2019
ALL INDIA 37 34 33 32 30
14 Himachal Pradesh 28 25 22 19 19

15 J & K including Ladakh 26 24 23 22 20

16 Jharkhand 32 29 29 30 27
17 Karnataka 28 24 25 23 21
18 Kerala 12 10 10 7 6
19 Lakshadweep 20 19 20 14 8
20 Madhya Pradesh 50 47 47 48 46
21 Maharashtra 21 19 19 19 17
22 Manipur 9 11 12 11 10
23 Meghalaya 42 39 39 33 33
24 Mizoram 32 27 15 5 3
25 Nagaland 12 12 7 4 3
26 Odisha 46 44 41 40 38
27 Puducherry 11 10 11 11 9
28 Punjab 23 21 21 20 19
29 Rajasthan 43 41 38 37 35
30 Sikkim 18 16 12 7 5
31 Tamil Nadu 19 17 16 15 15
32 Telangana 34 31 29 27 23
33 Tripura 20 24 29 27 21
34 Uttar Pradesh 46 43 41 43 41
35 Uttarakhand 34 38 32 31 27
36 West Bengal 26 25 24 22 20
COMMAND :
names= fw,col=rainbow(36), ylab= 'IMR(2015)',main='Infant Mortabarplot(year2015,lity Rate of 2015')
COMMAND :
YEAR2016 = C(34,16,36,44,38,14,39,17,19,18,8,30,33,25,24,29,24,10,19,47,19,11,39,27,12,44,10,21,41,16,17,31,24,43,38,25)
FW = C('ANDHRAP','A&N ISLAND','ARUNACHALP','ASSAM','BIHAR','CHANDIGARH','CHHATISGARH','D&N
HAVELI','DAMAN&DIU','DELHI','GOA','GUJRAT','HARYANA','HIMACHALP','J&K','JHARKHAND','KARNATAKA','KERALA','LAKSHADWEEP','M
ADHYAP','MAHARASHTRA','MANIPUR','MEGHALAYA','MIZORAM','NAGALAND','ODISHA','PUDUCHERRY','PUNJAB','RAJASTHAN','SIKKIM','
T&N','TELANGANA','TRIPURA','UP','UTTARAKHAND','WB’)
PIE(YEAR2016,LABELS= FW,,MAIN='2016 INFANT MRTALITY RATE')
COMMAND :
YEAR2017 = C(32,14,42,44,35,14,38,13,17,16,9,30,30,22,23,29,25,10,20,47,19,12,39,15,7,41,11,21,38,12,16,29,29,41,32,24)
FW = C('ANDHRAP','A&N ISLAND','ARUNACHALP','ASSAM','BIHAR','CHANDIGARH','CHHATISGARH','D&N
HAVELI','DAMAN&DIU','DELHI','GOA','GUJRAT','HARYANA','HIMACHALP','J&K','JHARKHAND','KARNATAKA','KERALA','LAKSHADWEEP','MADHYA
P','MAHARASHTRA','MANIPUR','MEGHALAYA','MIZORAM','NAGALAND','ODISHA','PUDUCHERRY','PUNJAB','RAJASTHAN','SIKKIM','T&N','TELANG
ANA','TRIPURA','UP','UTTARAKHAND','WB’)
BARPLOT(YEAR2017, NAMES=FW, XLAB= 'REGIONS',YLAB='YEAR 2017',COL=RAINBOW(36),MAIN='2018 INFANT MRTALITY RATE')
COMMAND :

YEAR2018 = C(29,9,37,41,32,13,41,13,16,13,7,28,30,19,22,30,23,7,14,48,19,11,33,5,4,40,11,20,37,7,15,27,27,43,31,22)
FW = C('ANDHRAP','A&N ISLAND','ARUNACHALP','ASSAM','BIHAR','CHANDIGARH','CHHATISGARH','D&N
HAVELI','DAMAN&DIU','DELHI','GOA','GUJRAT','HARYANA','HIMACHALP','J&K','JHARKHAND','KARNATAKA','KERALA','LAKSHADWEEP','M
ADHYAP','MAHARASHTRA','MANIPUR','MEGHALAYA','MIZORAM','NAGALAND','ODISHA','PUDUCHERRY','PUNJAB','RAJASTHAN','SIKKIM','
T&N','TELANGANA','TRIPURA','UP','UTTARAKHAND','WB’)
PIE(YEAR2018,LABELS= FW,COL=RAINBOW(36),MAIN='2018 INFANT MRTALITY RATE')
COMMAND :
YEAR2019 = C(25,7,29,40,29,13,40,11,17,11,8,25,27,19,20,27,21,6,8,46,17,10,33,3,3,38,9,19,35,5,15,23,21,41,27,20)
FW = C('ANDHRAP','A&N ISLAND','ARUNACHALP','ASSAM','BIHAR','CHANDIGARH','CHHATISGARH','D&N
HAVELI','DAMAN&DIU','DELHI','GOA','GUJRAT','HARYANA','HIMACHALP','J&K','JHARKHAND','KARNATAKA','KERALA','LAKSHADWEE
P','MADHYAP','MAHARASHTRA','MANIPUR','MEGHALAYA','MIZORAM','NAGALAND','ODISHA','PUDUCHERRY','PUNJAB','RAJASTHAN','
SIKKIM','T&N','TELANGANA','TRIPURA','UP','UTTARAKHAND','WB’)
PLOT(YEAR2019,TYPE = 'O', AXES= FALSE , XLAB= 'REGIONS', YLAB= 'IMR(2019)',LTY=2)
AXIS(SIDE=1,AT=1:LENGTH(YEAR2019),LABELS = FW)
AXIS(SIDE=2)
BOX()
INFANT MORTALITY RATE IN INDIA FROM 2008 TO
2014
• COMMAND :
IMR=C(32.31,30.15,49.13,47.5,46,44,43.19,37,34,33,
32,30)
PLOT(IMR,TYPE = 'B', XLAB='YEARS' , YLAB =
'INFANT MORTALITY
RATE',COL='BLUE',AXES=FALSE )
YEARS=C(2008,2009,2010,2011,2012,2013,2014,20
15,2016,2017,2018,2019)
AXIS(SIDE=1,AT=1:12,LABELS= YEARS)
AXIS(SIDE=2)
BOX()
 IMR RATE IN MADHYA PRADESH IS MAX.
• COMMAND : FROM
2015 TO 2019
IMRMADHYAPRADESH=C(50,47,4
7,48,46)
DATA=C(2015,2016,2017,2018,2019
)
DOTCHART(IMRMADHYAPRADE
SH,LABELS =
DATA,LCOLOR='MAGENTA',YLA
B = 'YEARS',XLAB = 'IMR IN
MADHYAPRADESH' , BG =
'YELLOW',PCH=21),MAIN = 'IMR
IN MADHYA PRADESH(2015-19)')
IMR RATE IN DELHI FROM
2015 TO 19

• COMMAND :

IMRDelhi=c(18,18,16,13,11)
data=c(2015,2016,2017,2018,2019)
pc=c('magenta','red','lightblue','pink','yellow’)
pie(IMRDelhi,labels = data, col=pc , clockwise =
TRUE,init.angle = 90)
IMR RATE IN GOA IS MIN. FROM
2015 TO 2019

• COMMAND :

IMRGoa=c(9,8,9,7,8)
data=c(2015,2016,2017,2018,2019)
dotchart(IMRGoa,labels = data,lcolor='magenta',ylab =
'Years',xlab = 'IMR in Goa' , bg = 'yellow',pch=21)
CMPARISON BETWEEN
MADHYA PRADESH AND
GOA FROM 2015 TO 2019

• COMMAND :

Years = c(2015,2016,2017,2018,2019)
IMRGoa = c(9,8,9,7,8)I
MRMadhyaPradesh= c(50,47,47,48,46)
Myframe=data.frame(Years,IMRGoa,IMRMadhyaPradesh)
Myframe
boxplot(Myframe$IMRGoa, Myframe$IMRMadhyaPradesh,
names=c('Goa','MadhyaPradesh'),col= 'green')
 Interventions for improving Infant Mortality Rate (IMR):
Facility Based New-born Care:Sick New-born Care Units (SNCUs) are established at District
Hospital and Medical College level, New-born Stabilization Units (NBSUs) are established at First
Referral Units (FRUs)/ Community Health Centres (CHCs) for care of sick and small babies.
Community Based care of New-born and Young Children:Under Home Based New-born Care
(HBNC) and Home-Based Care of Young Children (HBYC) program, home visits are performed by
ASHAs to improve child rearing practices and to identify sick new-born and young children in the
community. Mother’s Absolute Affection (MAA):Early initiation and exclusive breastfeeding for
first six months and appropriate Infant and Young Child Feeding (IYCF) practices are promoted
under Mothers’ Absolute Affection (MAA).Social Awareness and Actions to Neutralize Pneumonia
Successfully (SAANS) initiative implemented since 2019 for reduction of Childhood morbidity and
mortality due to Pneumonia. Universal Immunization Programme (UIP) is implemented to provide
vaccination to children against life threatening diseases such as Tuberculosis, Diphtheria, Pertussis,
Polio, Tetanus, Hepatitis B, Measles, Rubella, Pneumonia and Meningitis caused by Haemophilus
Influenzae B. The Rotavirus vaccination has also been rolled out in the country for prevention of
Rota-viral diarrhoea. Pneumococcal Conjugate Vaccine (PCV) has been introduced in all the States
and UTs.Rashtriya Bal Swasthya Karyakaram (RBSK): Children from 0 to 18 years of age are
screened for 30 health conditions (i.e. Diseases, Deficiencies, Defects and Developmental delay)
under Rashtriya Bal Swasthya Karyakaram (RBSK) to improve child survival. District Early
Intervention Centres (DEICs) at district health facility level are established for confirmation and
management of children screened under RBSK.
 Maternal Mortality :
Maternal death or maternal mortality is defined in slightly
different ways by several different health organizations. The
World Health Organization (WHO) defines maternal death as
the death of a pregnant mother due to complications related
to pregnancy, underlying conditions worsened by the
pregnancy or management of these conditions.
This can occur either while they are pregnant or within six
weeks of resolution of the pregnancy.

 Maternal mortality rate

The Maternal mortality rate (MMR) is the annual number

of female deaths per 100,000 live births from any cause
related to or aggravated by pregnancy or its management
(excluding accidental or incidental causes).
 MMR OF INDIA FROM 1997 TO
2017

• COMMAND :

MMR = c(398,327,301,254,212,178,167,130,122,113)
MMR
fw= c('1997-98','1999-01','2001-03','2004-06','2007-
09','2010-12','2011-13','2014-16','2015-17','2016-18’)
Fw
barplot(MMR, names = fw, ylab ='MMR in India', xlab=
'Time Period' , col= rainbow(7))
 MMR OF KERALA FROM 1997 TO
2017

• COMMAND :

MMRKerala=c(150,149,110,95,81,66,61,46,42,43)
f= c('1997-98','1999-01','2001-03','2004-006','2007-2009’,
'2010-2012','2011-13','2014-16','2015-17','2016-18’)
barplot(MMRKerala,names = f, xlab= 'Time Period’,
ylab ='MMR in Kerala', col = rainbow(12))
 COMPARISON OF MMR BETWEEN KERALA AND INDIA

• COMMAND :

MMRKerala = c(150,149,110,95,81,66,61,46,42,43)
MMRIndia=c(398,327,301,254,212,178,167,130,122,113)
boxplot(MMRKerala,MMRIndia,col= rainbow(12), names=
c('Kerala','India'),ylab= 'MMR(deaths per 100,000 live births)')
 MMR IN ASSAM

Assam = c(568,398,490,480,390,328,300,237,229,215)
f= c('1997-98','1999-01','2001-03','2004-06','2007-09','2010-
12','2011-13','2014-16','2015-17','2016-18')
barplot(Assam, names = f, xlab = 'years' , ylab= 'MMR in
Assam', col= rainbow(15))
abline(h=
c(100,200,300,400,500),lty=4 ,lwd=1 ,col=rainbow(36))
 MMR IN MAHARAHTRA FROM 1997 TO 2017

• COMMAND :

Maharashtra= c(166,169,149,130,104,87,68,61,55,46)
f = c('1997-98','1999-01','2001-03','2004-06','2007-09','2010-
12','2011-13','2014-16','2015-17','2016-18’)
barplot(Maharashtra, names = f, xlab = 'years' , ylab= 'MMR in
Maharashtra', col= rainbow(36))
abline(h= c(0,50,100,150),lty=4 ,lwd=1 ,col=rainbow(3))
COMPARISON OF MMR BETWEEN ASSAM AND MAHARASHTRA

• COMMAND :

boxplot(Assam, Maharashtra,
names=c('Assam','Maharashtra'),ylab='MMR(per 100,000 live
Births)', col=rainbow(8))
DECLINING MATERNAL MORTALITY RATIO –

As per the latest report of the Registrar general of India (RGI-SRS), MMR of India has
shown a decline from 212 per
1,00,000 live births in the period 2007-09 to 167
per 1,00,000 live births in the period 2011-13.
*The annual rate of decline of MMR during the period 2010-12 and 2011-13 is 6.2%.
*Assam continues to be the state with the highest MMR (300) followed by Uttar
Pradesh/Uttarakhand (285) and Rajasthan (244).
*Maharashtra (21.8%),Andhra Pradesh (16.4%),Haryana (13%),Tamil
Nadu(12.2%),Assam(8.5%), Gujarat(8.2%), Punjab(9%), Karnataka(7.6%) and Kerala
(7.6%) have
registered equal or higher decline as compared to
the national decline.
*States which have achieved an MMR of 100 per 1,00,000 live-births in 2011-13 are Kerala, Tamil Nadu, Maharashtra and
Andhra Pradesh. The States of Gujarat, Haryana,Karnataka and West Bengal have also reached the MDG-5 target.
*Additional efforts will be required for lowering the MMR, especially, in the States of Assam(300), Uttar Pradesh (285),
Rajasthan (244), Odisha (222), Madhya Pradesh/Chattisgarh(221) and Bihar/Jharkhand (208) which is quite high MMR as
compared to the national level.

TRENDS IN MMR IN SOME STATES OF INDIA-

1) In the years 1997-2013, the MMR(per 1,00,000 live births) in Andhra Pradesh has decreased substantially from 197 to 92 as per
SRS estimates.
2) In the years 1997-2013, the MMR(per 1,00,000 live births) in Assam has decreased substantially
from 568 to 300 as per SRS estimates.
3) In the years 1997-2013, the MMR(per 1,00,000 live births) in Bihar/Jharkhand has decreased
substantially from 531 to 208 as per SRS estimates.
4) In the years 1997-2013, the MMR(per 1,00,000 live births) in Gujarat first increased rapidly
from 46 to 202 but then got under control and dropped from 202 to 112 as per SRS estimates.
5) In the years 1997-2013, the MMR(per 1,00,000 live births) in Haryana has remained almost constant with not a much
big difference in values.The current MMR of Haryana is 127 as per SRS estimates.
6) In the years 1997-2013, the MMR(per 1,00,000 live births) in Karnataka has decreased substantially from 245 to 133 as per
SRS estimates.
7) In the years 1997-2013, the MMR(per 1,00,000 live births) in Kerala has decreased at the highest pace from 150
to 61, which is lowest among all the states of India as per SRS estimates.
8) In the years 1997-2013, the MMR(per 1,00,000 live births) in Madhya Pradesh/Chattisgarh has decreased substantially
from 441 to 221 as per SRS estimates.
9) In the years 1997-2013, the MMR(per 1,00,000 live births) in Maharashtra has decreased substantially from 166 to 68 as per
SRS estimates.
11) In the years 1997-2013, the MMR(per 1,00,000 live births) in Punjab has decreased
substantially from 280 to 141 as per SRS estimates.
12) In the years 1997-2013, the MMR(per 1,00,000 live births) in Rajasthan has decreased
substantially from 508 to 244 as per SRS estimates.
13) In the years 1997-2013, the MMR(per 1,00,000 live births) in Tamil Nadu has decreased
through the years from 131 to 79 as per SRS estimates.
14) In the years 1997-2013, the MMR(per 1,00,000 live births) in Uttar Pradesh/Uttarakhand
has decreased substantially from 606 to 285 as per SRS estimates.
15) In the years 1997-2013, the MMR(per 1,00,000 live births) in West Bengal has decreased
substantially from 303 to 113 as per SRS estimates.

* The states of Uttar Pradesh, Uttarakhand, Bihar, Jharkhand, Madhya Pradesh, Chattisgarh,
Assam, Rajasthan, Odisha and jammu & Kashmir are termed as Low performing states(LPS) while the remaining
states have been categorized as High performing states (HPS) acc. to the Janani Suraksha Yojana (JSY).
On concluding the report we can see that, on an average, India has shown growth and it's MMR levels has been
decreased over the years from 398 to 167.
 Interventions for improving Maternal Mortality Rate (MMR):
Janani Suraksha Yojana (JSY), a demand promotion and conditional cash transfer scheme was
launched in April 2005 with the objective of reducing Maternal and Infant Mortality by
promoting institutional delivery among pregnant women. Janani Shishu Suraksha Karyakram
(JSSK) aims to eliminate out-of-pocket expenses for pregnant women and sick infants by
entitling them to free delivery including caesarean section, free transport, diagnostics, medicines,
other consumables, diet and bloodin public health institutions. Surakshit Matratva Ashwasan
(SUMAN) aims to provide assured, dignified, respectful and quality healthcare at no cost and
zero tolerance for denial of services for every woman and newborn visiting the public health
facility to end all preventable maternal and newborn deaths. Pradhan Mantri Surakshit Matritva
Abhiyan (PMSMA) provides pregnant women fixed day, free of cost assured and quality
Antenatal Careon the 9thday of every month. LaQshya aims to improve the quality of care in
labour room and maternity operation theatres to ensure that pregnant women receive respectful
and quality care during delivery and immediate post-partum period. Comprehensive Abortion
Care services are strengthened through trainings of health care providers, supply of drugs,
equipment, Information Education and Communication (IEC) etc. Midwifery programmeis
launched to create a cadre for Nurse Practitioners in Midwifery who are skilled in accordance to
International Confederation of Midwives (ICM) competencies and capable of providing
compassionate women-centred, reproductive, maternal and new-born health care services.
 THANK YOU

 Presented to :  Presented by :

DR. Amita Sethi o 2021/12/140 : Shiva Sai

Assistant Professor
Ramjas College
University of Delhi
o 2021/12/143 : Abilasha
o 2021/12/144 : Harsh Raina
o 2021/12/147 : Mridul Manohar
o 2021/12/148 : Tanisha
o 2021/12/149 : Rigzangmo
o 2021/12/150 : Manudev