ISLAMABAD: The infant mortality rate (IMR) has been declining in the country over the past few years, but a marked disparity remains between rural and urban areas, the latest demographic survey showed on Thursday.

The IMR — the number of deaths per 1,000 live births of children under one year of age — currently stand at 56, according to the Pakistan Demographic Survey 2020, as compared to 60 in 2018-19 and 62 in 2017-18.

The rate was higher in rural areas (59) than in urban areas (50), where better neonatal and postnatal facilities are available.

Infant mortality is an important indicator to judge socio-economic conditions, cultural factors, the status of hygiene and availability and utilisation of medical services.

While overall IMR stands at 56, the rate is 59 in rural and 50 in urban areas

The survey showed that male IMR was higher at 58 compared to female IMR of 55 in all areas. In urban areas, the IMR was 48 in males and 51 in females, whereas in rural areas, the rate was 62 and 56, respectively.

Mortality during the first year of life is divided into two main periods, i.e. neonatal mortality (occurring within the first month) and post-neonatal mortality (occurring during the remaining 11 months). This distinction is useful as the causes and the levels of mortality are quite different in these two periods.

The impact of mortality on various age groups is not evenly distributed. The age-specific death rate (ASDR) starts at a high peak immediately after birth, declines to a minimum value for the young age population (five to 14 years), rises gradually among the 40-44 age group and then jumps rapidly for the elderly.

Females have higher chances of surviving in all countries, with only a few exceptions. In the past, female life expectancy was lower than that of males in Pakistan. However, at present, the universal pattern has been observed in Pakistan, i.e. female life expectancy is higher than male life expectancy. Besides, females have lower death rates than males for most ages.

The survey showed that the major cause of death in 2020 was cardiovascular disease at 14.7pc, followed by fever 9.3pc, paralysis (stroke) 6.5pc, diabetes 5.6pc, cancer 5.5pc, asthma 3.85pc, respiratory diseases 3.64pc, gastroenteritis with severe diarrhoea and vomiting 3.15pc, and kidney disorder 2.77pc.

Cardiovascular diseases (ischemic heart disease and stroke) are the top global cause of death. Neonatal conditions — including birth asphyxia and birth trauma, neonatal sepsis and infections and preterm birth complications — are mostly included in complications during pregnancy or delivery, postnatal complications and respiratory diseases.

Key findings

Other key findings of the latest demographic survey showed that the total fertility rate — the average number of children that would be born to a woman over her lifetime — was 3.7.

However, the general fertility rate — the number of births in a year per 1,000 women of childbearing ages (i.e. 15 to 44 years) —was 124.

The crude birth and death rates, the number of births and deaths in a year per 1,000 people, were 27 and 6.7, respectively.

The rate of natural increase (or natural population change) — defined as the birth rate minus the death rate and expressed as a percentage of the base population — was 2, according to the survey.

Moreover, overall life expectancy at birth was 65 years, which was 64.5 in males and Life 65.5 in females. The sex ratio — the ratio of males to females in a population — was 103.

Published in Dawn, April 15th, 2022