Infant Mortality Rising Again After Demonetisation: New Study

The drastic policy decision to scrap high-value currency notes in 2016 may have had a huge impact on Infant Mortality Rate (IMR), according to a new study.

A new paper titled "Pauses and Reversals of Infant Mortality Decline in India in 2017 and 2018" by economists Jean Dreze, Aashish Gupta, Sai Ankit Parashar and Kanika Sharma acknowledges that the demonetisation has reversed gains made to check IMR in key states. The study cites government data to show that the decline in the IMR stagnated in some states and slowed down in others in 2017 and 2018 for the first time since 2005, reported The Hindu.

Given that till 2016, India had been clocking impressive declines in infant mortality, the researchers argued that the sudden setback was probably due to demonetisation, reported Scroll.in.

The IMR is the probability of dying between birth and age 1 per 1,000 live births. It is considered to be the "litmus test" for assessing availability, accessibility and affordability of public health services, as explained Dr Amir Maroof Khan, Associate Professor at the University College of Medical Sciences and Guru Teg Bahadur Hospital.

"Children, unlike adults, don't have the capability to endure health problems or various socio-economic factors that influence their health. Therefore, the WHO and governments around the world accept the IMR as the most important indicator. This also explains why the biggest chunk of India's health expenditure is dedicated to child and maternal health whether it is through Anaemia Mukt Bharat, Poshan Abhiyaan, Angwandwadi services or immunisation programmes," he said.

"Infant mortality faltered in eight of 20 States in 2017 for which data is recorded under the Sample Registration System. In 2018, it faltered in six States, including four [Chhattisgarh, Jharkhand, Madhya Pradesh and Uttar Pradesh] where the IMR increased. In Chhattisgarh, Jharkhand and Madhya Pradesh, the IMR was higher in 2018 than two years earlier, and in Uttar Pradesh, it was the same," the research paper highlights.

The stagnation of the decline of the infant mortality in either 2017 or 2018 was more common in urban areas (15 of 20 States) than rural areas (9 of 20 States). The former account for 78.5 per cent of India's urban population and the later account for 49.5 per cent of the rural population, respectively. The States where the overall IMR faltered in 2017 or 2018 constitute 56.4 per cent of the population, the study adds.

The authors opined that demonetisation is "one plausible hypothesis" for the blow to the infant mortality rate.

Explaining why rural areas took longer to feel the impact on the IMR, Co-author Aashish Gupta said, "The rural economy is less dependent on cash, and programmes to improve access to clean fuels and toilets were primarily directed at rural areas. It is likely that without these programmes, the IMR increases would have been higher."

As many as 129 of every 1,000 infants died before reaching their first birthday in 1971 when the Sample Registration System (SRS) started monitoring mortality. By 2011, it had declined to a fourth and reached 44 deaths per 1,000 live births though there were periods of stagnation and pauses in between. But, since 2005, the IMR has seen a uniform decline in rural and urban areas, "year after year, until 2016", says the study.

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