CDS (I) 2022 General Knowledge · Question 61 of 120

Correct — D, None of the above. India's infant mortality sits in a different band from every country named. On the World Bank series, which carries the UN Inter-agency Group for Child Mortality Estimation's numbers, India recorded 28.3 infant deaths per 1,000 live births in 2020 and 27 in 2021, while China recorded 5.5 and 5.1, the United States 5.5 in both years, and Sri Lanka 6.0 and 5.8. India's figure is about five times any of the three, and a fivefold gap is not comparability on any reading. India's own Sample Registration System, run by the Registrar General, puts the national rate at 30 for 2019, with rural areas at 34 against urban 20, so the conclusion does not depend on whose estimate you take. The instructive part is what the three distractors have in common: a rich country, a large middle-income one and a small South Asian neighbour have all converged on a rate near five or six, which is precisely the contrast the examiner wanted drawn.

• (a)China — China's rate was 5.5 per 1,000 in 2020 and 5.1 in 2021, roughly a fifth of India's. The two countries get paired because of population size, but on child survival they parted company decades ago.
• (b)United States of America — The United States recorded 5.5 per 1,000 in both 2020 and 2021. It is a weak performer by rich-country standards, which sometimes tempts candidates into thinking it must be close to India; it is not, by a factor of five.
• (c)Sri Lanka — Sri Lanka is the real trap, because proximity suggests similarity. Its rate was 6.0 in 2020 and 5.8 in 2021, about a fifth of India's, the product of a long record of free public health care and high female literacy. Being a neighbour is not the same as being comparable.

The infant mortality rate is the number of deaths of children under one year of age in a given year, divided by the number of live births in that year, multiplied by 1,000. It is among the most sensitive single measures of a population's health, because an infant surviving its first year depends on nutrition, sanitation, immunisation, maternal health and access to a trained birth attendant all at once. India tracks it through the Sample Registration System of the Registrar General of India; the internationally comparable series is produced by the UN Inter-agency Group for Child Mortality Estimation and republished by the World Bank.

There is nothing to calculate here — the item checks whether you carry an order of magnitude for India and for the countries most often set beside it. The safe way to hold it is in bands: India in the high twenties to low thirties, and China, Sri Lanka and the developed world in the low single digits. Any option pairing India with a single-digit country fails. Note the printed wording as well: the paper says infant mortality ratio, where the standard term is infant mortality rate. The maternal mortality figure really is called a ratio and is expressed per 100,000 live births, so the two words are not interchangeable in demography; the slip does not change what is being asked here. On the present-day position, India's rate has kept falling — 27 per 1,000 by 2021 on the same series — but the gap with all three listed countries remains wide.

• The infant mortality rate counts deaths before the first birthday, per 1,000 live births — not per 100, and not only deaths in the first month.
• World Bank and UN IGME estimates: India 28.3 (2020) and 27 (2021); China 5.5 and 5.1; the United States 5.5 and 5.5; Sri Lanka 6.0 and 5.8.
• India's Sample Registration System reported a national IMR of 30 for 2019, with 34 in rural areas against 20 in urban areas.
• Within India the SRS 2019 spread among the bigger States ran from 6 in Kerala to 46 in Madhya Pradesh — a wider range than the gap between India and the countries in this question.
• Neonatal mortality covers deaths in the first 28 days and is a component of infant mortality; under-five mortality is the wider measure.

• Treating a neighbouring country as a comparable one. Sri Lanka's infant mortality is closer to the United States' than to India's.
• Confusing the infant mortality rate, per 1,000 live births, with the maternal mortality ratio, per 100,000 live births.
• Assuming infant mortality counts only deaths in the first month; that is neonatal mortality.

Either as a definition check on the denominator, the age cut-off or the publishing agency, or as a comparison across countries or across Indian States.

• practice — not a real PYQ

  India's official infant mortality rate is published by which one of the following?

  • (a)Census of India
  • (b)Sample Registration System of the Registrar General of India
  • (c)National Sample Survey Office
  • (d)National Family Health Survey alone

  Answer(b) Sample Registration System of the Registrar General of India — the SRS is the source of India's official birth, death and infant mortality rates.

• practice — not a real PYQ

  The infant mortality rate is expressed as the number of infant deaths per

  • (a)100 live births
  • (b)1,000 live births
  • (c)10,000 live births
  • (d)100,000 live births

  Answer(b) 1,000 live births — deaths before the first birthday per 1,000 live births in the same year.