Infant mortality reflects the effect of social, economic, and environmental factors on infants and mothers, as well as the effectiveness of national health systems. Pneumonia and diarrhoea continue to be amongst the leading causes of death in infants. Cost-effective and simple interventions as those comprised in the Early Essential Newborn Care (EENC) are key to reduce infant mortality (see section “Neonatal mortality”). Factors such as the health of the mother, quality of antenatal and childbirth care, preterm birth and birth weight, immediate newborn care and infant feeding practices are important determinants of infant mortality.
Infant mortality can be reduced through cost-effective and appropriate interventions -akin to the EENC interventions for newborns-. These interventions include proper infant nutrition; provision of supportive health services such as home visits and health check-ups; immunisation and controlling the influence of environmental factors such as air pollution; and access to safely managed water and sanitation services. Management and treatment of neonatal infections, pneumonia, diarrhoea, and malaria is also critical (UNICEF, 2013[1]).
In 2022, amongst lower-middle- and low-income Asia-Pacific countries and territories, the infant mortality rate was 23.3 deaths per 1 000 live births, a reduction of about 12 deaths compared to the rate observed in 2010 (35.4 deaths per 1 000 live births) (Figure 3.6). Upper-middle-income Asia-Pacific countries and territories reported a rate of 12.0 deaths per 1 000 live births, down from 15.4 in 2010. Geographically, infant mortality was lower in eastern Asian countries and territories, and higher in South and Southeast Asia. Korea, Hong Kong (China), Singapore, Japan and Macao (China) had less than 3 deaths per 1 000 live births in 2022, whereas in Pakistan more than 50 children per 1 000 live births die before reaching their first birthday.
Infant mortality rates have fallen dramatically in the Asia-Pacific since 2010, with many countries and territories experiencing significant declines (Figure 3.6). In India, Cambodia, Mongolia, China and Macao (China), rates have declined in 2020 to almost half or less of the value reported in 2010, whereas rates in Fiji have increased in recent years.
Across countries and territories, important inequities persist in infant mortality rates (Figure 3.7). In general, most Asia Pacific countries report having higher infant mortality rates in the lowest income quintile compared to the highest income quintile. DPRK, Fiji and Mongolia have the smallest gap between these groups. In the other hand, the countries with the highest absolute gap are India, Lao PDR and Myanmar, with more than 30 infant deaths per 1 000 live births higher mortality in the lowest-income group compared to the highest-income group. Similarly, mothers’ lower education (i.e. no education) is associated with higher infant mortality rates compared to higher education; the wider absolute gap is reported for Lao PDR and Myanmar with more than 40 deaths per 1 000 live births in mothers with no education than the highest education group. Geographical location (urban or rural) is another determinant of infant mortality in the region, though relatively less important in comparison to wealth quintiles or mother’s education level – except for the Lao PDR, where infant mortality in rural areas is more than twice as high as in urban settings (Figure 3.7). Reductions in infant mortality will require not only improving quality of care, but also ensuring that all segments of the population benefit from better access to care.
