Measuring well-being

Infant mortality rate acts as an indicator of how well a nation cares for its citizens

Published: Saturday 31 July 1999


and economists look at the latest gross domestic product ( gdp) figures to see how their nations are doing. I look at the infant mortality rate or imr . It is the number of babies out of every 1,000 born who die before they reach their first birthday. For instance, in 1998, Finland had the world's lowest imr of 3.5, that is 996.5 out of 1000 infants born reached the age of one. The highest infant mortality rate -- 195 -- was in Sierra Leone in West Africa. About one in every five did not survive for even a year.

Babies die because their mothers receive poor health care, poor nutrition and little education. They die because they have been exposed to disease or pollutants before or after they are born. Thus, imr is a sensitive measure of the degree to which a society has mastered the basics of life and health and made them available to its most vulnerable members.

imr data is full of surprises, among them the relatively high number for a developed country like the us (7.0). Babies born in the us are twice as likely to die as Finnish babies. The imr is higher than many developed countries such as Japan (3.8), Germany (4.9), France (5.1), Italy (5.8), Spain (4.7) or Sweden (3.9).

If it looks like the difference between an imr of 7.0 and 3.5 is small, multiply it by the annual 4 million births in the us and you see that if the rate in the us were as low as Finland's, 14,000 babies would be saved each year, 38 each day, 1 each hour. The explanation that comes to my mind is that we do not treat all the citizens at par with each other. imr for white population in the us is 6.0, while for the black population it is 14.2.

The Hunger Project once set an imr value of 50 as an arbitrary but reasonable target for all the world's nations. A country that allows more than five per cent of its babies to die can hardly be called developed. The imr all over Europe is below 50. Asia has made astonishing progress in infant survival, especially countries such as Malaysia (10), South Korea (11), Sri Lanka (16.5) and China (31, an amazingly low rate for a poor country that produces over 20 million babies a year). Asian nations that do not make the target are few to list. Some of them are Afghanistan (150), Bangladesh (82), Bhutan (71), India (72), Nepal (79), Pakistan (91), and Iraq (127). Latin America has been even more successful in bringing infant mortality below 50. All Central American countries have achieved that goal except Guatemala, which is on the edge of doing so (51). Cuba's imr (7.2) is comparable to that of the us , in spite of its economic hardships.

When I first started paying attention to imr statistics, no country in Africa scored below 50 except some island nations of the Indian Ocean. Slowly, however, some African nations are getting close to or past the goal, for instance Algeria 44, Tunisia 35 and South Africa 52. However, far too many African countries still lose more than one in 10 of their new-borns, some of them being Niger, Mali, Ethiopia, Malawi, Mozambique, Somalia, Angola. These are also countries without the resources to keep statistics on such everyday events as the deaths of babies, so actual mortality numbers could be even higher than those listed.

Some people, understandably worried about the problem of population growth, would say, "But what if all those babies lived?" Of the 138 million children born worldwide each year, 8 million die. If the mortality rates of Finland or Sweden are applied everywhere, 7.5 million of them would live. That would definitely swell the world population, (which is currently adding 84 million a year). However, the very measures that bring down infant mortality rates also bring down birth rates. For instance, Sierra Leone, with its imr of 195, averages 6.5 births per woman. At the same time, Finland averages only 1.7.

It takes very little money to save babies, especially when compared to money spent for weapons. What it mostly takes is caring. The gdp may measure how economically active a nation is; the imr measures how well it cares for its people.
Donella H Meadows is director of Sustainability Institute and an adjunct professor of Environmental Studies in the us.

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