Infant Mortality - Measuring IMR

Measuring IMR

The infant mortality rate correlates very strongly with, and is among the best predictors of, state failure. IMR is therefore also a useful indicator of a country's level of health or development, and is a component of the physical quality of life index.

However, the method of calculating IMR often varies widely between countries, and is based on how they define a live birth and how many premature infants are born in the country. Infant mortality rates can be flawed depending on a nations’ live birth criterion, vital registration system, and reporting practices. Certain practices of measurements have the potential to be underestimated. Measurements provide a statistical way of measuring the standard of living of residents living in each nation. Increases and decreases of the infant mortality rate reflect social and technical capacities of a nations’ population. The World Health Organization (WHO) defines a live birth as any born human being who demonstrates independent signs of life, including breathing, voluntary muscle movement, or heartbeat. Many countries, however, including certain European states and Japan, only count as live births cases where an infant breathes at birth, which makes their reported IMR numbers somewhat lower and raises their rates of perinatal mortality.

Although many countries have vital registration systems and certain reporting practices, there are a great number of inaccuracies, particularly in undeveloped nations, in the statistics of the amount of infants dying. Studies have shown in comparing three information sources: official registries, household surveys, and popular reporters, the “popular death reporters” show the greatest amount of accuracy. Popular death reporters include indigenous midwives, gravediggers, coffin builders, priests, and more—essentially people who knew the most about the child’s death. In developing nations, access to vital registries, and other government run systems pose difficulties for poor families to record births and deaths due to a variety of reasons. These struggles force stress on families, and make them take drastic measures in unofficial death ceremonies for their deceased infants, as well as inaccurately reflect a nations infant mortality rate. Popular death reporters provide information first hand from inside sources gaining reliable facts that: provide a nation with accurate death counts, meaningful causes of deaths that can be measured/studied, and allow a sense of relief and meaning to a child’s death which may give families less pain/grievance.

UNICEF uses a statistical methodology to account for reporting differences among countries:

Another challenge to comparability is the practice of counting frail or premature infants who die before the normal due date as miscarriages (spontaneous abortions) or those who die during or immediately after childbirth as stillborn. Therefore, the quality of a country's documentation of perinatal mortality can matter greatly to the accuracy of its infant mortality statistics. This point is reinforced by the demographer Ansley Coale, who finds dubiously high ratios of reported stillbirths to infant deaths in Hong Kong and Japan in the first 24 hours after birth, a pattern that is consistent with the high recorded sex ratios at birth in those countries. It suggests not only that many female infants who die in the first 24 hours are misreported as stillbirths rather than infant deaths, but also that those countries do not follow WHO recommendations for the reporting of live births and infant deaths.

Another seemingly paradoxical finding, is that when countries with poor medical services introduce new medical centers and services, instead of declining, the reported IMRs often increase for a time. This is mainly because improvement in access to medical care is often accompanied by improvement in the registration of births and deaths. Deaths that might have occurred in a remote or rural area, and not been reported to the government, might now be reported by the new medical personnel or facilities. Thus, even if the new health services reduce the actual IMR, the reported IMR may increase.

Collecting the accurate statistics of infant mortality rate could be an issue in some rural communities in developing countries. In those communities, some other alternative methods for calculating infant mortality rate are emerged, for example, popular death reporting and household survey. The country-to-country variation in child mortality rates is huge, and growing wider despite the progress. Among the world’s roughly 200 nations, only Somalia showed no decrease in the under-5 mortality rate over the past two decades.The lowest rate in 2011 was in Singapore, which had 2.6 deaths of children under age 5 per 1,000 live births. The highest was in Sierra Leone, which had 185 child deaths per 1,000 births. The global rate is 51 deaths per 1,000 births. For the United States, the rate is eight per 1,000 births.

Infant mortality rate (IMR) is not only a group of statistic but instead it is a reflection of the socioeconomic development and effectively represents the presence of medical services in the countries. IMR is an effective resource for the health department to make decision on medical resources reallocation. IMR also formulates the global health strategies and help evaluate the program success. The existence of IMR helps solve the inadequacies of the other vital statistic systems for global health as most of the vital statistic systems usually neglect the infant mortality statistic number from the poor. There are certain amounts of unrecorded infant deaths in the rural area as they do not have information about infant mortality rate statistic or do not have the concept about reporting early infant death.