?Infant deaths? audit: Contextual factors contributing to Infant deaths in tribal district-Valsad, Gujarat (India)?

摘要

Background: A high Infant Mortality Rate (IMR) is suggestive of unmet health needs; especially to those who need health service the most. A number of community and facility based interventions under the umbrella of RMNCH+A strategy have been implemented to deal with infant mortality. But the number of Infant deaths continues to remain very high. The present study was aimed to understand pattern and various factors affecting Infant deaths by studying the existing review system of Infant death through analysis of Infant death verbal autopsy forms filled during year 2012-13 for Valsad district of Gujarat. Materials and Methods: The study was a descriptive study where verbal autopsy forms for all deaths in 2012-13 were collected and analyzed. Results: The contribution of Neonatal Mortality in the total Infant Mortality was 70 %. Of all the infants who died, 52 % were low birth weight babies and 8.1% had extreme low birth weight. Those Infants who were delivered at home (21.5%), 8% received medical care while 92% died without receiving any medical assistance. Prematurity followed by low birth weight and congenital anomalies were found to be the major reasons for infant deaths. Conclusion: Implementation and increasing the access of high impact cost effective interventions are possible at community and facility level to accelerate reduction in infant mortality and can be linked with existing preventive, promotive and curative health programs. Opportunities like NHM to bridge system loopholes, robust monitoring system and meticulous record keeping are needed to improve decision making process.