Using infant mortality as a key indicator of…

Using infant mortality as a key indicator of the status of children, we now begin to have the broad features of a hypothesis as to the causes of higher or lower mortality rates. One aspect is the complex of factors involving the access of mothers to trained personnel and other facilities for child delivery, the nutritional status of pregnant and nursing mothers and the quality of health care and nourishment which babies receive. The other aspect, indicated by rural-urban differentials, is the possible importance of human settlement patterns in relation to the availability of health care and related facilities such as potable water, excreta disposal systems, etc. Thus, in a special sense, it is much cheaper to make health and other basic services available to a community when it is densely settled rather than widely dispersed. It is possible to argue, however, that both these sets of factors are closely related to a third one, namely, income levels. Poorer mothers and babies have less access to health-care facilities and nourishment than those who are better off; urban communities are on an average much better off than rural communities. That economic condition plays a crucial role in determining the status of both mother and child, is beyond dispute. But the question really is whether this is the only decisive factor or whether factors such as the availability of medical facilities, healthcare programs, and nutritional programs have an independent role. If so then the settlement patterns which affect service delivery to the mother and child target groups become a relevant consideration. These are clearly issues of some importance for policy and program planning.